Disenrollment from Traditional Medicare is Slowing, Particularly Among Non-Dual-eligibles and Beneficiaries Who are in the Last Year of Life

By Inna Cintina, PhD, Lanlan Xu, PhD, and Lane Koenig, PhD
October 1, 2025

As the popularity of Medicare Advantage (MA) plans increased, so did the disenrollment from Traditional Medicare (TM). In previous work, we found that increasing rates of disenrollment from TM accounted for two-thirds (67%) of the growth in the share of MA enrollment between 2019 and 2020. In this blog, we update previously reported disenrollment trends through 2020 with more recent data (2021-2024) and assess rates by different population groups. We separately report findings for Medicare-only beneficiaries and Medicare-Medicaid beneficiaries (dual eligibles), as well as for new Medicare beneficiaries and those who are in the last year of life.

Enrollment in MA continues to increase but at a slower rate due to less disenrollment from TM and more switching from MA to TM. Between 2023 and 2024, disenrollment from TM accounted for 53% of growth in new enrollment in MA, down from 67% between 2019 and 2020.  Between 2016 and 2024, the TM disenrollment rate reached its highest point in 2021 at 8.1% and stayed at around the 8% mark until declining to 7% in 2024. The MA disenrollment rate, on the other hand, has increased from 1.9% to 2.7% between 2021 and 2024. In 2024, TM-to-MA switching rates were almost 3 times higher than switching rates from MA to TM (similar to our findings in 2020). However, this reflects a decrease from 2020 for Medicare-only enrollees (2020: 3.7 times higher disenrollment rates from TM-MA vs. MA-TM; 2024: 2.7 times higher) and a small increase for Medicare-Medicaid enrollees (2020: 2.5; 2024: 2.9 times).

Dual eligibles, new enrollees to Medicare, and some minority groups have substantially higher disenrollment rates, especially from TM.

  • Medicare-Medicaid beneficiaries have much higher disenrollment rates from both TM and MA than their Medicare-only counterparts (Exhibit 1). Dual eligible special needs plans (D-SNPs) offer the promise of better coordination of Medicare and Medicaid benefits and greater flexibility in changing coverage throughout the year. These two factors likely explain some of the differences in disenrollment rates between dual and non-dual beneficiaries.
  • New Medicare enrollees had increasing TM disenrollment rates throughout the study period. The switching from TM to MA among new enrollees is almost three times that of the general Medicare population. Coupled with relatively low MA disenrollment rates, new Medicare beneficiaries had the highest net switching rate to MA (especially among dual beneficiaries) and played an important role in the growth of the MA population.
  • Black Medicare beneficiaries continue to disenroll from TM at higher rates than any other group, marking the largest increase in disenrollment across all racial or ethnic groups in 2024. Conversely, Hispanic enrollees had one of the highest TM disenrollment rates in 2020, but that rate has dropped by nearly 50% in 2024.

The differential between TM and MA disenrollment rates is smaller for beneficiaries in their last year of life. Since 2020, disenrollment from TM exceeded that from MA for end-of-life beneficiaries but started to converge in 2022 for Medicare-only beneficiaries as rates of switching fell for beneficiaries in their last year of life (from 6.5% in 2021 to 5.5% in 2023) (Exhibit 2).

Conclusion

  • Between 2023 and 2024, disenrollment rates from TM slowed slightly. As a result, switching from TM to MA accounted for a smaller share of the growth in MA than between 2019 and 2020. If this trend continues, it is likely to result in slower growth in MA.
  • The high rate of switching to MA for dual eligibles may potentially signal that MA plans are better at meeting the care expectations and complex needs of this population. Although not investigated, this may reflect the appeal or value of D-SNPs.
  • MA to TM switching in the last year of life is higher than for the general Medicare population. This could suggest that end-of-life care needs may drive higher rates of disenrollment from MA, possibly reflecting greater provider choice and fewer utilization management controls in TM. Low-income and medically complex populations (e.g., duals) may be especially sensitive to perceived or real limitations in MA near the end of life.

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