February to March enrollment grows after dismal enrollment season
In a February 27 blog, I detailed the growth in Medicare Advantage (MA) from January 2024 to February 2025 after a long delay from the Centers for Medicare and Medicaid Services (CMS) in posting the annual data. As I noted, the January enrollment statistics were up for a short time only to be taken down due to errors and presumably the transition in the White House. As I explained in the blog, the final January data still did not seem quite right, so I compared January 2024 to February 2025 instead.
To summarize, the statistics show some of the financial struggles the industry continues to have. Growth is way down compared with prior years in the 2020s due to major geographic contractions as well as plan benefit reductions by major MA players. As the chart below shows, January 2024 to February 2025 enrollment growth was just 4.39%, or about half the average of the four years prior. And since I did use February 2025 due to concerns about what CMS reported for January 2025, the growth number is slightly inflated because there would be some growth from January to February.
Now we have statistics for March 2025. MA enrollment continues to grow due to aging in America each month as well as the secondary enrollment process from January through March of each year.
What do the latest statistics show?
As I have reported, growth from January 2024 to February 2025 was 4.39% or 1.468 million. Enrollment in MA reached 34.941M in February 2025. From February to March 2025, enrollment climbed by another 126K lives or 0.4%. As of March, enrollment in MA was 35.068M.
How did Big MA do?
From January 2024 to February 2025, Big Plan MA enrollment performed very poorly because of retrenchment among some of these plans. Big MA grew by 780K or 3.1%. Big MA enrollment hit 26.348M. This compares with 688K growth for all other MA plans, or 8.7% and 8.953M in February 2025. Big MA’s penetration dropped from 76.4% in January 2024 to 75.4% in February 2025. Big MA plans rebounded a bit from February to March, taking 82% of overall enrollment gains. In March, Big MA had 26.452M, growing by about 104K or 0.4%.
United Healthcare grew by 95K from February to March 2025. Humana continued its contraction, dropping by 27K. CVS grew by 11K, Centene dropped 7K, and Elevance Health shed 29K. Cigna continued its major growth, adding another 12K. Molina grew by 42K, but this was because it closed its acquisition of ConnectiCare (with 44K MA lives) between the February and March enrollment reports.
Health Care Service Corporation (HCSC) just closed its acquisition of Cigna this week, so next month Cigna will drop off the chart and HCSC will show around 950K lives.
Special Needs Plans chugging along
Special Needs Plans (SNPs) (including MMPs) continued to see a healthy increase in enrollment. From January 2024 to February 2025, SNPs grew to 7.553 million, a gain of about 646K or 9.35%. SNP enrollment grew about 264K in the enrollment season. But this growth is still down from the January 2023 to January 2024 period. In that period, SNPs added 1.154 million or 20.07%.
From February to March, SNPs added 33K more lives, or 0.4%.
PPOs vs. HMOs
Over the years, PPOs began growing and competing well with HMOs in terms of raw numbers as well as percentage growth. While PPOs’ sheer number and percentage growth was beating HMOs over the past several years, that trend changed from January 2024 to February 2025. From January 2023 to January 2024, HMOs grew about 853K (4.8%) and PPOs 1.861 million (14.8%). But from January 2024 to February 2025, HMOs grew more than PPOs in terms of numbers and percentage: HMOs up about 882K (4.7%) vs. PPOs up about 580K (4%). HMOs grew by about 480K during the enrollment season, while PPOs contracted by about 58K.
From February to March, PPOs had a bit of a rebound. PPOs grew 64K compared with 61K for HMOs.
#medicareadvantage #enrollment
— Marc S. Ryan
