Half of People Eligible for Medicare Selected Medicare Advantage Plans in 2024


April 22, 2024

Now that the 2024 Medicare Open Enrollment season is finished, over half of people eligible for Medicare, 50.8%, have decided on Medicare Advantage (MA) plans, up from 48.8% in April of 2023. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment data* for April 1, 2024, MA, including MA with prescription drug benefits (MA-PD), membership stood at 33,418,874, with a net gain of 2,012,117 members from April 1, 2023. Another third, 34.4%, of people eligible for Medicare selected a stand-alone Medicare Part D prescription drug plan (PDP). Medicare PDPs covered 22,667,060 members as of April 1, 2024, a net increase of 467,307 from the previous year. The top 10 insurers, out of the 284 offering coverage in the MA market, covered 79.6% of MA enrollees in 2024. This brief assesses MA and PDP performance, market share, and market growth by state as of April 1, 2024.

Medicare Advantage (MA) Membership

Medicare Advantage (MA) market penetration remains strong; however, there is still opportunity for growth with 50.8% of the 66.7 million people eligible for Medicare enrolled in a MA plan. According to CMS MA enrollment reports aggregated by Mark Farrah Associates (MFA) in Medicare Business Online™, total MA plan enrollment, as of April 1, 2024, increased 6.4% from April 2023. The top ten companies, each with more than 300,000 members in this segment, collectively provided coverage for 79.6% of the market. Per the “April 2024 Top 10 MA Organizations” table below, most leading MA companies realized year-over-year growth, with an overall net gain of 6.1%.

MA Leading Plan Performance

There are 284 insurers covering the MA marketplace in the United States; however, 79.6% of MA enrollees selected one of only 10 insurers. As of April 2024, UnitedHealth continues to dominate in this highly competitive segment. With over 9.4 million enrolled, UnitedHealth commands 28% of the MA market. Humana ranks second with 18% market share and over 6 million lives. CVS maintains the third position, enrolling approximately 4.1 million, and Elevance Health follows with nearly 2 million lives. Together the top three insurers cover 58.6% of the MA market, a gain of 1.5% over last year.



The table below indicates membership gains were considerable for the leaders in this segment. CVS Health had the largest increase in membership, adding over 800,000 members year-over-year, for a net gain of 24.1%. Humana experienced the second largest gain with more than 438,000 new members. UnitedHealth also gained over 400,000 new enrollees between 2023 and 2024; however, this was significantly lower than the more than 1 million net new members it gained the previous year.



MA Individual and Group Enrollment

As of April 1, 2024, 83% of membership was from individual MA policies with approximately 27.7 million enrolled lives. Enrollment in group MA plans continues to grow as these plans allow employers to provide comprehensive medical coverage and quality plan designs at lower costs for retirees. Group membership increased by approximately 295,000 members, compared to the same period a year ago. UnitedHealth Group, with its AARP branded products, consistently leads in the individual sector with over 7.4 million members enrolled in individual MA plans. In addition to direct purchase policies, nearly 5.7 million members originated through an employer group health plan or retirement health benefit. UnitedHealth increased its group enrollment by approximately 121,000, driving the company’s total employer-group membership to nearly 2 million. Over 90% of CVS’s 2024 growth came from the individual market sector; nonetheless, it does have nearly 1.3 million MA members from employers. Both Kaiser Foundation Group and Humana had more than 530,000 members from group plans.



MA Enrollment Growth by State

As of April 1, 2024, MA enrollment increased in all fifty states, the District of Columbia, and most U.S. territories. Overall, a net membership gain of nearly 2.0 million was seen nationally. California, Texas, Florida, and New York experienced significant enrollment gains, each with increases of 100,000 members or more. California experienced the most sizeable year-over-year increase, gaining approximately 148,000 members.


Source: Mark Farrah Associates' analysis of CMS data available in Medicare Business Online™.


Stand-alone Prescription Drug Plan (PDP) Enrollment

Stand-alone prescription drug plans (PDPs), also referred to as Medicare Part D stand-alone plans, enrolled approximately 22.7 million members as of April 1, 2024, reflecting an increase of roughly 467,000 enrollees from April 1, 2023. This increase is due to a new federal employee plan with the BlueCross BlueShield Association (BCBSA), where over 800,000 enrollees were automatically enrolled in BCBSA’s PDP plans on January 1, 2024; without this new enrollment, PDP totals would have continued to decline by more than 346,000 members from April 2023 to April 2024. PDP plans provide prescription drug coverage for 34.4% of the 66.7 million people eligible for Medicare. Enrollment in PDP products sold to individuals was 17.8 million in April 2024, a year-over-year decrease of 471,527. More than 4.8 million Medicare beneficiaries were enrolled in employer group PDPs as of April 1, 2024. It is important to note this assessment is reporting on Stand-alone PDP members only, and Medicare Advantage with prescription drug plan (MA-PD) members are included in the MA portion of this report.

PDP Leading Plan Performance

There are currently 43 organizations competing in Medicare stand-alone PDPs, as of April 2024. Five companies have more than 2 million members and command 87.5% of the PDP market. As indicated in the table below, there were significant enrollment swings between April 2023 and April 2024 among leading PDP organizations. After announcing that it was pursuing significant expansion initiatives in MA and PDP markets for 2024, Centene now covers the largest number of people enrolled in PDPs, having increased PDP membership by 44.2% between April 2023 and April 2024.



PDP Market Penetration by State

As of April 1, 2024, stand-alone prescription drug plan enrollment increased in 42 states within the U.S., including the District of Columbia. Texas had the largest year-over-year aggregate increase with nearly 66,000 more enrollees in this segment. Virginia and Maryland also had noteworthy increases, most likely due to the large federal employee presence there, adding 61,810 and 54,777 new PDP enrollees, respectively. Michigan, with more than 808,000 PDP enrollees, experienced the largest decline with a drop of over 15,000.


Source: Mark Farrah Associates' analysis of CMS data available in Medicare Business Online™.


About this Data

This brief is based on an analysis of enrollment data for Medicare Advantage (MA) and Prescription Drug Plans (PDPs) released by the Centers for Medicare & Medicaid Services (CMS). Mark Farrah Associates’ Medicare Business Online™ simplifies the tracking of monthly MA and PDP enrollment by competitor. Enrollment data is updated monthly as CMS releases new data.

* It is important to note that MA enrollment counts by company or geography for the same reporting period may be slightly different, depending on the CMS enrollment source. CMS county-level reports, used in the above analysis, do not output enrollment for plans with 10 or fewer members per county.

Many companies conduct their post-OEP competitive assessments by using tools such as Mark Farrah Associates’ (MFA) Medicare Business Online™, Medicare Benefits Analyzer™, and Health Coverage Portal™. Health insurers continue to invest in MA and PDP growth opportunities for increased enrollment, revenue, and profits as the number of people entering retirement increases each year. MFA will continue to monitor plan performance in this highly competitive Medicare segment.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website (www.markfarrah.com), or call 724-338-4100.

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