Medicare Special Needs Plan enrollment beats expectations

Medicare Special Needs Plan sign-ups rose more than the Centers for Medicare and Medicaid Services and Wall Street expected during the 2025 annual enrollment period, offering a welcome boost to an otherwise slowing Medicare Advantage market.

More than 7.3 million people were enrolled in Special Needs Plans as of Feb. 1, up 10.1% from a year before, according to a Modern Healthcare analysis of data CMS published last week. UnitedHealth Group subsidiary UnitedHealthcare, the Medicare Advantage market leader, made the greatest gains among its peers in Dual Eligible Special Needs Plan membership. Humana, the No. 2, Medicare Advantage carrier, suffered significant losses in that line.

Related: Medicare Advantage enrollment 2025: Winners and losers

Special Needs Plan, or SNP, sign-ups offer a bright spot for troubled Medicare Advantage sector, which has identified these products as key to growth, even though the rate of increase slowed from 13% in 2024. By comparison, enrollment in standard Medicare Advantage plans rose at one of the slowest paces in program history this year amid heightened scrutiny from regulators and lawmakers.

Special Needs Plans are available to Medicare beneficiaries who have severe chronic conditions, need long-term institutional care or are enrolled in both Medicare and Medicaid. Dual Eligible Special Needs Plans, or D-SNPs, for Medicare-Medicaid beneficiaries account for 83% of SNP enrollments.

Unlike traditional Medicare Advantage, insurers threw money behind Special Needs Plans in 2025, adding generous supplemental benefits and entering new geographic markets. Medicare Advantage insurers report generating the highest profit margins from D-SNPs.

UnitedHealthcare added more than 171,700 D-SNP members, the most of any insurer, while Humana lost nearly 102,400 enrollees, the biggest decrease. Together, the leading carriers cover a slight majority of D-SNP enrollees, similar to their share in 2024. Elevance Health gained more than 31,200 D-SNP policyholders.

Centene, which made D-SNPs a priority to stabilize its shaky Medicare Advantage business, shed 9.7% of its members. The privately held insurtech Devoted Health saw enrollment shrink after enjoying several years of sector-leading growth.

VNS Health emerged as one of the fastest-growing D-SNP insurers, boasting an 81% growth rate. The nonprofit insurance company paid an undisclosed sum last year to buy Elderwood Health Plan, Kalos Health, Prime Health Choice and Senior Network Health, four struggling Medicaid plans in its core upstate New York market.