Medicare Advantage Opportunities by MSAs

November 29, 2022

There are 30.3 million people enrolled in Medicare Advantage (MA) products nationwide, representing 47% of the 64.8 million Americans eligible for Medicare. Within Metropolitan Statistical Areas (MSAs) nationwide, where 93% of Medicare Eligible people reside, most individual Medicare beneficiaries have two or more, often many more, MA health insurance carrier options to choose from, as of November 1, 2022. Market share at the county and MSA level is available and often analyzed to gain a more nuanced competitive picture of specific markets. In this brief, Mark Farrah Associates (MFA) presents a summary of Medicare and MA market enrollment figures by MSAs, included in the Health Coverage Portal™ and Medicare Business Online™.

As the number of Medicare beneficiaries increases, health plans are looking to expand in new and under-penetrated markets. Companies also evaluate their own market positions against competitors to assess ongoing relative market opportunity. MFA analyzed Medicare and Medicare Advantage market enrollment figures by MSAs and found six MSAs with over a million people eligible for Medicare. As shown below, original Medicare and MA penetration rates vary across the six largest MSAs.

• Miami had the highest penetration rate of the top six MSAs in the MA market at 62.8%, up from 61.6% last year, and the lowest original Medicare penetration rate at 37.7%.
• Los Angeles also had an above average MA rate at 54.4%.
• The Chicago MSA had the highest original Medicare rate among the top six MSAs, at 62.9%, and the lowest MA penetration rate of 37.3%. MA penetration rates increased across all the top MSAs in the nation, between 2021 and 2022, including Chicago.

MFA also noted, as of November 1, 2022, that there are 24 MSAs, out of 928, with only one carrier serving individual MA members. Fifty-three MSAs have two carriers, typically Humana and UnitedHealth Group, the top two MA carriers nationwide. More than 850 MSAs offer 3 or more carriers to choose from; and 37 MSAs have ten or more choices.

For the MSAs with only one carrier serving individual MA members, the top six based on Medicare Eligibles are shown below:

• Of the 24 MSAs with only one carrier to choose from, 9 offered their first MA carrier in 2022; and 13 MSAs have had a single carrier since 2018. The single carriers in the remaining two MSAs entered the market after 2018, and before 2022.
• Anchorage, Alaska is the largest MSA with only one carrier serving the MA Individual marketplace. While other carriers offer coverage in the Group MA market in Anchorage, Zing Health is the only carrier offering MA products directly to individuals in 2022. Zing Health, a recent startup that acquired Lasso Healthcare Insurance Co. in 2021 and currently operates in more than 32 states, is one of the few MA insurers that offer Medicare Spending Account products.
• UnitedHealth is the sole carrier offering MA products directly to individuals in 10 MSAs; Humana is the sole carrier for individuals in 8 MSAs.

Based on November 1, 2022 MA enrollment from the Centers for Medicaid and Medicare Services (CMS), as presented in MFA’s Health Coverage Portal™ and Medicare Business Online™ products, MFA found a significant choice of MA carriers for Individuals seeking alternatives to traditional Medicare and Medicare Advantage options, for most MSAs nationwide.

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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