Here is what you’ll find in this week’s newsletter!

1. Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.

2. Deep Dive 📚 - MA, MAPD, PDP Landscape 🏞 - Part 1

3. Sponsor Snapshot 🚀 - brought to you by Modivcare

4. Compliance Chatter 📢 - final guidance from CMS, DE, MN and more…

It’s only a 5 minute read, but it will make you 10x smarter.

DEEP DIVE 📚

MA, MAPD, PDP Landscape 🏞 - Part 1

CMS has released the Crosswalk and Landscape files for the upcoming 2025 plan year for Medicare Advantage and Part D. 

These publicly available files that are released every October hold a wealth of information, and you might feel like you need a crossing guard to help you cross over into the 2025 plan year. Don’t worry, we’ve got you covered.

The Crosswalk file gives us all Contract and Plan combinations from the 2024 plan year and tells us if these plans are renewing, renewing with service area consolidation, expansions, or reductions, or terminating. It also introduces new plans for 2025.

The Landscape file contains information on all Medicare Advantage and Part D plans for 2025 including Contract, Plan, Segment ID, State and County, Organization and Marketing name, plan type, SNP type, Part C and Part D premiums, and drug benefit information.

When combined, these Crosswalk and Landscape files tell us what the Medicare Advantage and Part D market will look like in the upcoming plan year compared to the previous year.

Today we will specifically be looking at the difference in distinct number of Contract and Plan combinations between the 2024 and 2025 files by:

• Plan Type (HMO, PPO, SNP, etc.) – Here’s a quick refresh on types of plans

• Parent Organization

• State

Overall Look

First let’s look at the number of available plans for Non - Special Needs Plans (“Non SNPs”):

We can see that:

• The number of available HMO plans will decrease 8% 🔻 (167) from 2024 to 2025

• The number of available PPO plans will decrease 5% 🔻 (85) from 2024 to 2025

• The number of available Part D plans will decrease 22% 🔻 (-152) from 2024 to 2025

For Special Needs Plans (“SNPs”), the trend is different:

We can see that:

• The number of available D-SNP plans will increase 8% 🚀 (64) from 2024 to 2025

• The number of available C-SNP plans will increase 21% 🚀 (65) from 2024 to 2025

• The number of available I-SNP plans will decrease 8% 🔻 (-13) from 2024 to 2025

This points to the continued expansion of Special Needs plans in the market.

[Check out this deep dive for a look at historical growth and a look at what’s changing in the D-SNP and C-SNP markets in 2025]

By Parent Organization

When looking at the TOP 10 Medicare Advantage Parent Organizations with the most enrollees as of September 2024, we can see that:

• The number of available MA plans (without Part D benefits) will increase 5% 🚀 (14) in 2025

• The number of available MAPD plans (MA with Part D benefits) will decrease 9% (210) in 2025

• The number of available SNP plans will increase 8% 🚀 (70) in 2025

• Out of the 70 new SNP plans in 2025, UnitedHealth Group is adding 53

When looking at the TOP 8 Part D Parent Organizations with the most enrollees as of September 2024, we can see that:

• CVS and UnitedHealth Group account for the majority of Part D plan decreases

• The number of available Part D plans for the other identified carriers remains the same for 2025

• Group 1001 increased 27 Part D plans from 2024 to 2025, however, all plans are sanctioned in 2025

By State

The overall number Medicare Advantage plans (including MA, MAPD, and SNP) will decrease by 3% (138) nationally from 2024 to 2025. The below map breaks down the change by state. 

We can see that:

• Mississippi, Pennsylvania, Louisiana and North Carolina will see the largest increase in the number of available Medicare Advantage plans in 2025

• California, Wisconsin, New York and Florida will seen the largest decrease in the number of available Medicare Advantage plans in 2025

In comparison, the number of available Part D plans decreased by 152 from 2024 to 2025, with almost all states seeing a decrease of 4 to 7 plans in 2025. 

That’s all for now. Keep following us, as we will continue to dive into the Crosswalk and Landscape files over the coming weeks, providing more insight as we “cross” into AEP2025.

If you’re ready, here are some ways we can help you:

• Newsletter Sponsorship opportunities: Promote your product or services to leaders in the Medicare space. Let’s discuss. (link)

• Market Research: Reports that help you wrap your arms around the Senior focused insurance markets. (link)

• Consulting: We can help you develop new insurance products for the Medicare market, appraise your books of business, and keep you compliant. Let’s discuss. (link)