Medicare Advantage Market Snapshot

CSG Actuarial’s MarketEdge and MarketAdvisor are the ultimate sales and marketing research tools, allowing you to view Medicare Advantage market share and demographics to better understand the opportunity.  Below is just a sampling of data using November 2020 enrollment files:

Overall Medicare Advantage Market Leaders – November 2020:

Rank	Parent Organization	Enrollment	Market Share
1	UnitedHealth Group	6,535,596	26%
2	Humana Inc	4,583,882	18%
3	CVS Health Corporation	2,674,736	10%
4	Kaiser Foundation Health Plan, Inc	1,723,011	7%
5	Anthem Inc	1,420,586,	6%
6	Centene Corporation	974,093	4%
7	Blue Cross Blue Shield of Michigan Mutual Ins. Co.	592,128	2%
8	CIGNA	527,409	2%
9	Summit Master Company, LLC	265,073	1%
10	Highmark Health	237,818	1%
	All Other	5.939.966	23%

Source: CMS, Monthly_Report_By_Contract_2020_11

 

Medicare Advantage Penetration by State, Market Leader:

State	Medicare Eligibles	MA Enrolled	MA Penetration	MA Market Share Leader
Alabama	1,064,861	494,079	46%	Humana Inc
Alaska	102,005	1,301	1%	CVS Health Corporation
Arizona	1,369,709	587,409	43%	UnitedHealth Group
Arkansas	647,628	196,625	30%	UnitedHealth Group
California	6,448,583	2,957,632	46%	Kaiser Foundation Health Plan Inc.
Colorado	945,914	416,805	44%	UnitedHealth Group
Connecticut	694,300	316,501	46%	UnitedHealth Group
Delaware	216,230	41,274	19%	CVS Health Corporation
Florida	4,679,353	2,305,834	49%	Humana Inc
Georgia	1,779,810	774,731	44%	UnitedHealth Group
Hawaii	282,376	135,222	48%	Hawaii Medical Service Association (BCBS of HI)
Idaho	350,065	131,682	38%	Blue Cross of Idaho Health Services Inc
Illinois	2,278,853	695,465	31%	UnitedHealth Group
Indiana	1,287,041	468,421	36%	UnitedHealth Group
Iowa	640,482	162,064	25%	UnitedHealth Group
Kansas	548,912	118,783	22%	CVS Health Corporation
Kentucky	945,935	373,594	39%	Humana Inc
Louisiana	892,863	378,853	42%	Humana Inc
Maine	348,903	153,305	44%	Martin's Point Health Care Inc
Maryland	1,061,915	138,283	13%	Kaiser Foundation Health Plan Inc
Massachusetts	1,358,968	370,383	27%	Tufts Health Plan Inc
Michigan	2,110,843	1,021,143	48%	Blue Cross Blue Shield of Michigan
Minnesota	1,052,409	516,498	49%	Aware Integrated Inc (BCBS of MN)
Mississippi	612,833	148,767	24%	Humana Inc
Missouri	1,253,264	509,214	41%	UnitedHealth Group
Montana	239,127	48,728	20%	Humana Inc
Nebraska	355,331	73,122	21%	UnitedHealth Group
Nevada	549,974	223,146	41%	UnitedHealth Group
New Hampshire	309,205	68,665	22%	UnitedHealth Group
New Jersey	1,641,831	535,194	33%	CVS Health Corporation
New Mexico	434,954	173,352	40%	UnitedHealth Group
New York	3,686,702	1,630,513	44%	UnitedHealth Group
North Carolina	2,042,467	835,821	41%	UnitedHealth Group
North Dakota	135,062	26,976	20%	Medica Holding Company
Ohio	2,388,368	1,118,426	47%	Anthem Inc
Oklahoma	755,183	193,686	26%	UnitedHealth Group
Oregon	890,226	422,428	47%	UnitedHealth Group
Pennsylvania	2,786,573	1,251,193	45%	CVS Health Corporation
Rhode Island	225,739	109,102	48%	Blue Cross & Blue Shield of Rhode Island
South Carolina	1,107,000	373,272	34%	UnitedHealth Group
South Dakota	180,165	41,644	23%	Medica Holding Company
Tennessee	1,387,364	596,207	43%	BlueCross BlueShield of Tennessee
Texas	4,299,882	1,859,406	43%	UnitedHealth Group
Utah	416,194	169,570	41%	UnitedHealth Group
Vermont	152,163	22,233	15%	UnitedHealth Group
Virginia	1,552,641	398,257	26%	Humana Inc
Washington	1,406,866	518,424	37%	UnitedHealth Group
Washington D.C.	94,876	21,325	22%	UnitedHealth Group
West Virginia	443,790	172,096	39%	Humana Inc
Wisconsin	1,208,444	563,364	47%	UnitedHealth Group
Wyoming	114,765	5,093	4%	UnitedHealth Group

Source:  CMS, MA State/County Penetration; Monthly MA Enrollment by State/County/Contract

 

Medicare Advantage Penetration & Market Share in the 75 Counties with the Largest Medicare Eligible Population:

Rank	County, State	Medicare Eligibles	MA Enrolled	MA Penetration	MA Market Share Leader
1	Los Angeles, California	1,530,266	798,307	52%	Kaiser Foundation Health Plan, Inc
2	Cook, Illinois	830,431	276,205	33%	Humana Inc
3	Maricopa, Arizona	722,475	329,387	46%	UnitedHealth Group
4	Harris, Texas	567,208	289,955	51%	UnitedHealth Group
5	San Diego, California	548,782	275,813	50%	Kaiser Foundation Health Plan, Inc
6	Orange, California	524,738	276,536	53%	Kaiser Foundation Health Plan, Inc.
7	Miami-Dade, Florida	476,958	343,822	72%	UnitedHealth Group
8	Riverside, California	390,777	232,257	59%	Kaiser Foundation Health Plan, Inc.
9	Kings, New York	378,065	179,084	47%	Healthfirst, Inc.
10	Clark, Nevada	372,079	171,688	46%	UnitedHealth Group
11	Queens, New York	369,175	189,194	51%	UnitedHealth Group
12	Wayne, Michigan	335,735	169,601	51%	Blue Cross Blue Shield of Michigan Mutual Ins. Co.
13	Broward, Florida	333,497	197,511	59%	Humana Inc.
14	Palm Beach, Florida	333,444	140,117	42%	Humana Inc.
15	Dallas, Texas	332,356	142,706	43%	UnitedHealth Group
16	King, Washington	329,007	140,134	43%	UnitedHealth Group
17	San Bernardino, California	309,217	192,012	62%	Kaiser Foundation Health Plan, Inc.
18	Bexar, Texas	302,331	150,070	50%	UnitedHealth Group
19	Suffolk, New York	296,853	66,654	22%	CVS Health Corporation
20	New York, New York	287,234	117,850	41%	Healthfirst, Inc.
21	Middlesex, Massachusetts	278,013	77,360	28%	Tufts Health Plan, Inc.
22	Santa Clara, California	277,095	128,347	46%	Kaiser Foundation Health Plan, Inc.
23	Tarrant, Texas	276,488	136,136	49%	UnitedHealth Group
24	Nassau, New York	274,760	71,081	26%	UnitedHealth Group
25	Sacramento, California	266,395	141,166	53%	Kaiser Foundation Health Plan, Inc.
26	Allegheny, Pennsylvania	265,646	169,621	64%	UPMC Health System
27	Cuyahoga, Ohio	262,268	128,670	49%	UnitedHealth Group
28	Philadelphia, Pennsylvania	260,596	124,582	48%	Independence Health Group, Inc.
29	Alameda, California	251,290	115,185	46%	Kaiser Foundation Health Plan, Inc.
30	Pinellas, Florida	249,547	133,176	53%	Humana Inc.
31	Oakland, Michigan	249,125	107,629	43%	Blue Cross Blue Shield of Michigan Mutual Ins. Co.
32	Hillsborough, Florida	247,449	132,243	53%	Humana Inc.
33	Pima, Arizona	231,076	119,583	52%	UnitedHealth Group
34	St. Louis, Missouri	213,817	96,539	45%	UnitedHealth Group
35	Bronx, New York	211,283	130,199	62%	Healthfirst, Inc.
36	Hennepin, Minnesota	202,689	105,211	52%	UCare Minnesota
37	Contra Costa, California	202,312	101,242	50%	Kaiser Foundation Health Plan, Inc.
38	Erie, New York	202,164	128,360	63%	Independent Health Association, Inc.
39	Lee, Florida	200,155	80,730	40%	UnitedHealth Group
40	Orange, Florida	199,875	104,545	52%	Humana Inc.
41	Franklin, Ohio	190,733	92,176	48%	CVS Health Corporation
42	Honolulu, Hawaii	187,946	94,760	50%	UnitedHealth Group
43	Macomb, Michigan	179,554	82,893	46%	Blue Cross Blue Shield of Michigan Mutual Ins. Co.
44	Westchester, New York	178,619	54,961	31%	CVS Health Corporation
45	Hartford, Connecticut	175,356	92,064	53%	UnitedHealth Group
46	Bergen, New Jersey	173,457	48,215	28%	UnitedHealth Group
47	Montgomery, Maryland	172,095	24,413	14%	Kaiser Foundation Health Plan, Inc.
48	Montgomery, Pennsylvania	171,648	51,050	30%	Independence Health Group, Inc.
49	Duval, Florida	169,075	73,747	44%	UnitedHealth Group
50	New Haven, Connecticut	168,200	80,324	48%	UnitedHealth Group
51	Fairfax, Virginia	162,657	34,065	21%	Kaiser Foundation Health Plan, Inc.
52	Wake, North Carolina	162,513	59,319	37%	UnitedHealth Group
53	Essex, Massachusetts	162,348	43,378	27%	UnitedHealth Group
54	Polk, Florida	162,139	94,066	58%	Humana Inc.
55	DuPage, Illinois	160,831	44,004	27%	Humana Inc.
56	Monroe, New York	160,798	112,856	70%	Lifetime Healthcare, Inc.
57	Worcester, Massachusetts	160,664	59,668	37%	Tufts Health Plan, Inc.
58	Fairfield, Connecticut	160,119	57,052	36%	UnitedHealth Group
59	Brevard, Florida	159,480	69,502	44%	Health First, Inc.
60	Milwaukee, Wisconsin	158,042	86,746	55%	UnitedHealth Group
61	Baltimore, Maryland	157,555	23,732	15%	Kaiser Foundation Health Plan, Inc.
62	Shelby, Tennessee	156,898	56,328	36%	CIGNA
63	Pierce, Washington	155,896	59,870	38%	UnitedHealth Group
64	Ventura, California	155,465	57,012	37%	Kaiser Foundation Health Plan, Inc.
65	Ocean, New Jersey	154,868	49,175	32%	CVS Health Corporation
66	Jefferson, Kentucky	154,134	60,682	39%	Humana Inc.
67	Volusia, Florida	153,320	82,411	54%	Humana Inc.
68	Marion, Indiana	150,311	63,197	42%	UnitedHealth Group
69	San Francisco, California	149,912	64,602	43%	Kaiser Foundation Health Plan, Inc.
70	Sarasota, Florida	149,813	51,514	34%	UnitedHealth Group
71	Hamilton, Ohio	148,703	72,247	49%	Humana Inc.
72	Fresno, California	147,145	53,183	36%	Kaiser Foundation Health Plan, Inc.
73	Salt Lake, Utah	146,610	69,269	47%	UnitedHealth Group
74	Mecklenburg, North Carolina	144,552	60,309	42%	UnitedHealth Group
75	Fulton, Georgia	141,960	64,149	45%	UnitedHealth Group

Source:  CMS, MA State/County Penetration; Monthly MA Enrollment by State/County/Contract