Medicare Advantage Enrollment Reaches 54% in 2024

Medicare Advantage enrollment has reached 54% of all Medicare beneficiaries in 2024, amounting to approximately 32.8 million people. In seven states, including Alabama, Connecticut, Michigan, Hawaii, Maine, Florida, and Rhode Island, enrollment surpasses 60%, with a high of 63%. The report shows that more than half of Medicare eligibles are enrolled in Medicare Advantage plans across 30 states.

However, enrollment remains low in 13 states, such as Alaska, North Dakota, South Dakota, Wyoming, and Maryland, where fewer than 30% of Medicare beneficiaries are enrolled in these plans. Puerto Rico also has an enrollment rate exceeding 60%. These figures represent a notable change from a decade ago when no states had more than 50% of Medicare enrollment in Medicare Advantage plans.

As enrollment increases, there is growing scrutiny on the costs associated with the program and its benefits for members. Research indicates that Medicare Advantage plans have higher payments compared to traditional Medicare, with a MedPAC report earlier this year suggesting that these plans receive payments equal to about 122% of the expenses of traditional Medicare beneficiaries.

Medicare Advantage enrollment trends analyzed

Analysts wrote, “As Medicare Advantage becomes more prominent in the Medicare program, the higher payments compared to traditional Medicare for similar beneficiaries have drawn policymakers’ focus on the effectiveness of Medicare Advantage’s current payment methodology in enhancing efficiency and reducing costs.”

The report also reveals that approximately one-third, or 37%, of Medicare beneficiaries live in counties where Medicare Advantage enrollment reaches or exceeds 60%. In Monroe County, New York; Starr County, Texas; and Miami-Dade County, Florida, enrollment tops 80%. The Medicare Advantage market is highly concentrated among a few key players, with nearly half (47%) of all enrollees in plans through UnitedHealthcare or Humana.

In 29% of U.S. counties, these two insurers account for at least 75% of all Medicare Advantage enrollment. Since 2017, UnitedHealthcare and CVS Health have expanded their market shares, with UnitedHealthcare growing from 25% to 29% in 2024. Humana and Cigna have maintained steady market shares, while Blue Cross Blue Shield Plans, Kaiser Permanente, and Centene have experienced declines.

Smaller firms collectively hold less than 2% of the enrollment share, which has decreased from 19% to 16% since 2024. This data highlights the growing dominance of Medicare Advantage within the broader Medicare landscape and emphasizes the need for ongoing analysis and potential policy adjustments to ensure the program’s sustainability and effectiveness for beneficiaries.