2025 Medicare AEP Report: More Seniors Are Switching Plans as Costs and Confusion Rise
Key Findings:
- 19% of Medicare enrollees adjusted their coverage during last year’s AEP, up from 9% in the previous period.
- Premium prices are the top priority when evaluating Medicare coverage for 82% of Americans.
- Due to costs, 17% of Medicare beneficiaries have delayed procedures; 13% skipped doctor visits; and 12% rationed their medications.
- 33% of seniors admit they don’t fully understand their current coverage, and 43% of beneficiaries say they’re overwhelmed by all the information they receive during the open enrollment process.
- 1 in 3 beneficiaries say their current Medicare coverage isn’t a good fit for their needs, but adjusting coverage is too difficult.
- 61% of seniors fear that new government policies will negatively impact their personal healthcare.
October 15th marks the start of Medicare’s annual enrollment period (AEP), a seven-week window when seniors can switch Medicare plans for the 2026 coverage year. The AEP is an opportunity for enrollees to secure better coverage and address rising out-of-pocket costs, yet many don’t know which way to turn.
Amidst increasing healthcare costs and unpredictable politics, finding the right Medicare plan is more important than ever. Unfortunately, many recipients are confused by their options, overwhelmed by information, or feel that switching coverage is too onerous. Despite those impediments, the number of enrollees switching plans doubled last year and may go even higher this year.
As part of its mission to empower seniors and their families to make informed decisions, SeniorLiving.org annually surveys older Americans about the open enrollment process. Following the 2024 AEP, we asked nearly 1,000 adults age 65+ to assess their experiences, choices, and concerns.
Medicare Migration: More Seniors are Switching Plans
The number of seniors switching plans during the AEP remains relatively low, but has grown consistently over recent years. Though the AEP allows seniors to escape unwanted plans or address changes in health, finances, or networks, many forego the opportunity. During the 2025 AEP, nearly 40 percent of enrollees failed even to review their Medicare coverage, and four out of five simply let their plans auto-renew. Sadly, one third of Medicare enrollees told us that even though their current plan is an imperfect fit, they’d auto-renew because switching is too tricky.
| AEP for 2024 Coverage Year | AEP for 2025 Coverage Year | |
|---|---|---|
| Percentage of beneficiaries who reviewed current coverage | 42% | 62% |
| Percentage of beneficiaries who changed coverage or plans | 9% | 19% |
Still, the number of seniors who switch plans during the AEP has surged. Over one-third of recipients have adjusted their enrollment at least once, with 13 million making a change last year alone. The ratio of seniors who swapped plans during the last AEP was more than double the previous year. That spike was likely driven by harsh inflation and elevated living costs. Those who switched plans during the last AEP told us that lowering healthcare expenses was their main motivation. Changing health requirements and securing coverage for specific treatments also played prominent roles.
| Reasons for switching Medicare plans or providers during 2024 AEP | Percentage of people who switched plans |
|---|---|
| Needed lower premium costs | 27% |
| Lack of coverage for specific treatments or medications | 13% |
| Change in health needs or conditions | 11% |
| Recommendations from friends or family | 9% |
| Limited network of doctors or hospitals | 9% |
| Difficulty in using the plan's services (e.g., claims, approvals) | 6% |
| Unsatisfactory customer service | 6% |
| Plan no longer covered essential medications | 5% |
| Employer no longer offered that plan | 2% |
| Poor plan reviews or low Star Rating | 2% |
| Relocation to a new area | 2% |
| I didn’t use enough of the plan's benefits | 2% |
Note: Multiple responses allowed
The search for better, more affordable coverage drove many to enlist in Medicare Advantage. Plan-switchers were six times more likely to move from Original Medicare (Plans A & B) to Medicare Advantage (Part C) than to migrate in the other direction. Today, more than half of Medicare beneficiaries are enrolled in Medicare Advantage, a significant jump from barely one-third (32 percent) just ten years ago.
In our survey, Medicare Advantage enrollees reported monthly out-of-pocket spending that was about 34 percent lower than that of those with Original Medicare, and approximately 88 percent were satisfied with the quality of care they’d received.
With consumer confidence still shaky, seniors will likely continue migrating towards more affordable options. The AEP for 2026 coverage could see another surge in plan switching, as two-thirds of enrollees are open to changing their coverage.
Which considerations might compel seniors to pull the trigger on a Medicare switch during this year’s AEP?
What Forces Are Fueling Medicare Plan Changes?
With two-thirds of Medicare recipients open to switching plans during the upcoming AEP, we wanted to know which factors might drive the most change. Though individual healthcare decisions are often quite personal, aggregating opinions illuminates patterns.
The Medicare AEP gives beneficiaries about seven weeks to:
- switch between Original Medicare and Medicare Advantage plans
- change from one Medicare Advantage plan to another
- or join, switch, or drop a stand-alone Part D prescription drug plan.
Of the nearly 1,000 seniors we surveyed, more than 60 percent would seek alternate plans or providers if either prices increased, preferred practitioners moved out-of-network, or specific treatments fell outside their coverage. Roughly half will look elsewhere should their plan's processes prove too cumbersome, and more than one-third would be motivated by poor customer service. Others cited poor plan ratings or trusted recommendations as potential reasons for switching.
| What would cause you to look for other coverage or a provider? | Percentage of Medicare beneficiaries |
|---|---|
| Increased cost (premiums, deductibles, or copayments) | 69% |
| If all my doctors/hospitals were not covered | 64% |
| Lack of coverage for specific treatments or medications | 61% |
| Difficulty in using the plan's services (e.g., claims, approvals) | 47% |
| Unsatisfactory customer service | 38% |
| Poor plan reviews or low Star Rating | 18% |
| Recommendations from friends or family | 10% |
Note: Multiple responses allowed
Collectively, our respondents’ reasons for considering Medicare changes boiled down to three basic categories: cost, confusion, and concern.
3 Steps to a Smarter AEP Switch:
- Look at total cost, not just premium: Compare premiums, deductibles, copays, drug costs, and out-of-pocket maximums.
- Consider doctors and drugs: Confirm your providers and every medication are still in-network.
- Check savings programs: See if you qualify for Extra Help or state pharmaceutical/Medicaid programs.
Costs: Escalating Expenses Force Difficult Decisions
Seniors on fixed incomes are especially susceptible to price hikes, making healthcare costs a primary consideration. Most Medicare recipients mentioned price increases as the main reason they’d leave current plans, and 82 percent cited affordability as the top priority when choosing new coverage.
Unfortunately, high out-of-pocket expenses already force some seniors to seek savings by neglecting their health. Significant numbers stretched out their meds, skipped doctor visits, or delayed procedures to cut healthcare costs.
| Which of the following measures have you employed to control your healthcare expenses? | Percentage of Medicare beneficiaries |
|---|---|
| Delaying surgeries or procedures | 17% |
| Skipping doctor visits | 13% |
| Rationing prescription medications | 12% |
Medigap policies (also known as Medicare Supplemental Insurance) help mitigate OOP expenditures but require additional premiums. About 42 percent of people with traditional (Original) Medicare had a Medigap policy in 2022; the share varies widely by state.
In 2025, the Part D benefit was redesigned: the annual out-of-pocket cap is $2,000 for covered prescriptions (with optional monthly ‘smoothing’ installments). Also, Extra Help (LIS) expanded in 2024, so more people now qualify for no Part D premium/deductible and reduced copays.
Choosing Medicare Advantage is one way to lower expenses. Respondents enrolled in Advantage paid less out-of-pocket than those using Original Medicare. Part C’s annual OOP limits and ancillary benefits (which may include dental, vision, hearing, and prescription coverage) trimmed nearly $100 per month from the average senior’s OOP outlays.
| Type of Medicare plan | Average monthly out-of-pocket medical spending |
|---|---|
| Medicare Advantage | $205 |
| Original Medicare | $310 |
Unfortunately, seniors’ resources will likely need to stretch further to accommodate some Medicare price increase in 2026. Premiums for Plan B will jump by 11 percent, with an increase also expected for Plan D. Additionally, prescription plans will impose a higher deductible and raise the annual medication OOP limit (which may be offset by negotiated reductions in prescription prices).
Confusion: Seniors Struggle to Understand Medicare Plans
It’s challenging to select the right Medicare plan if you don’t comprehend the choices. Unfortunately, Medicare’s various provisions prove confusing to many recipients. One third of Medicare enrollees told us they don’t fully understand their coverage options. This confusion can manifest in several ways, including gaps in coverage, carrying unnecessary protection, and failing to access existing benefits.
Our survey found that among Medicare enrollees lacking supplemental Medigap insurance, 34 percent did not know of the program’s existence. Eighteen percent said their current Medicare plan includes benefits that sound good but don't match their needs. Additionally, nearly one quarter of Medicare Advantage members with qualifying chronic conditions were unaware of their eligibility for Special Needs Plans (SNPs).
Indeed, Medicare Advantage members remain in the dark about many of their plans’ provisions. Though specific options vary by provider, our findings suggest that those enrolled in Part C overlook myriad benefits, such as meals, telehealth, and fitness programs.
Did You Know? The Annual Enrollment Period for 2026 coverage runs from October 15-December 7, 2025. Please consult our in-depth guide to learn how Medicare works.
Concerns: Political Uncertainty and Fears for the Future
The chaos and conflict caused by political division and Donald Trump’s mercurial leadership style have sown anxiety in many aspects of American life. Seniors are no exception. More than 40 percent of those 65+ told us they worry about obtaining and maintaining access to quality, affordable healthcare in the future. Even more damning, nearly two-thirds of Medicare-eligible adults fear that government changes to healthcare law will harm them personally.
| What impact do you think government policies will have on your personal healthcare? | Percent of Medicare beneficiaries |
|---|---|
| Strongly harm | 15% |
| Somewhat harm | 46% |
| No impact | 26% |
| Somewhat benefit | 11% |
| Strongly benefit | 2% |
While the administration's legislative agenda isn't yet clear, the recently signed “Big Beautiful Bill” includes several provisions limiting access to healthcare. Now that we understand why many seniors may switch Medicare plans, let's examine how they might make those changes.
Picking Plans: How Seniors Will Select Their New Coverage
To better understand how Medicare users will choose alternative coverage during the 2026 annual enrollment period, we asked seniors about their priorities, information sources, and the obstacles to switching plans.
What Seniors Seek in New Medicare Plans and Providers
Price point proved to be the priority for seniors choosing a new Medicare plan. Four out of five enrollees named cost as a top consideration when weighing their options. Prescription drug coverage was the second priority, followed by geographical convenience and dental and vision coverage.
| Which of these factors was the most important when choosing a Medicare coverage plan? | Percent of Medicare beneficiaries |
|---|---|
| Cost of premiums and out-of-pocket expenses | 82% |
| Prescription coverage | 62% |
| Dental coverage | 30% |
| Geographic coverage (e.g., travel benefits, out-of-state coverage) | 26% |
| Vision coverage | 24% |
| Fitness benefits | 11% |
| Telehealth | 9% |
Note: Up to three responses allowed
Seniors switching to privately administered plans must also select insurance providers. The primary differences among carriers include network types (HMO, PPO, etc.), network size (number and location of medical providers), quality, logistics, and reputation. Prospective plan-switchers told us network composition was the most important factor, followed by plan clarity and provider reputation.
| Which of these factors was the most important when choosing a Medicare provider? | Percent of Medicare beneficiaries |
|---|---|
| Doctor and hospital network | 68% |
| Transparency of plan details | 47% |
| Reputation | 34% |
| Ease of enrolling or switching | 25% |
| Medicare star ratings | 24% |
| Recommendations from others | 24% |
| Online tools and resources | 17% |
Note: Up to three responses allowed
How Seniors Find Medicare Information
The private sector’s inclusion in Medicare plans has generated a tidal wave of advertising and information that inundates seniors seeking superior plans. Medicare’s complex structure can make it feel more like a tangled web than a genuine safety net.
More than 40 percent of Medicare recipients feel overwhelmed by the flood of information that finds them regarding the Annual Enrollment Period. Many others reported feeling skeptical, frustrated, or confused as they try to untangle the quagmire of info.
| Which of these options do you believe to be the most trustworthy when it comes to credible, honest, and reliable information about Medicare coverage? | Percent of Medicare beneficiaries |
|---|---|
| Medicare.gov website | 52% |
| Friend or family recommendation | 14% |
| Doctor or other medical professional | 9% |
| Help/assistance phone lines | 8% |
| Insurance company websites or mailers | 7% |
| Financial advisor | 6% |
| None of these is trustworthy | 5% |
To cut through the confusion of aggressive marketing, most Medicare recipients prefer to obtain their own info directly from government and insurance provider websites. Wisely, 70 percent of adults age 65 and older said that receiving expert advice is “highly important” when choosing Medicare coverage. For some, this might mean government officials, personal doctors, financial advisors, or insurance companies.
Most respondents placed far more faith in official sources and trusted consultants than in promotional material. Three-quarters of seniors believe that Medicare.gov, friends, family, or medical professionals provide the most trustworthy information, while only seven percent defer to private insurance providers.
Outlook for 2026 Annual Enrollment Period
In the current climate of economic volatility and political uncertainty, seniors wish to secure safe and affordable healthcare. Although many are confused by the multitude of options, overwhelmed by information, and put off by logistical difficulties, 61 percent of enrollees are open to changing their coverage. Those looking to switch primarily look for better pricing, prescriptions, and networks.
SeniorLiving.org looks forward to serving as an invaluable resource for seniors during this AEP. By supplying updated news and unbiased reviews, we hope to facilitate optimal choices. We believe every enrollee deserves dignity and the best available healthcare, and that no American should stretch pills, skip appointments, or delay medical treatment to make ends meet.
Methodology
SeniorLiving.org researchers conducted an online poll of 931 adults who were 65 or older and currently enrolled in Medicare. They answered questions about their current Medicare coverage and changes made during the 2024 AEP. The poll was open from December 20, 2024, to January 2, 2025. The respondents' ages ranged from 65 to 90, with a median age of 69. 54% of respondents were female, and 46% were male.