Medicare Advantage Opportunities by MSAs Narrowing

October 31, 2024

There are 34.4 million people enrolled in Medicare Advantage (MA) products nationwide, representing 51% of the 67.5 million Americans eligible for Medicare. Within Metropolitan Statistical Areas (MSAs) nationwide, where 93% of Medicare Eligible people reside, most individual Medicare beneficiaries have three or more, often many more, MA health insurance carrier options to choose from, as of October 1, 2024. 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, as of October 1, 2024, included in 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 opportunities. MFA analyzed Medicare and Medicare Advantage market enrollment figures by MSAs and found seven MSAs with over a million people eligible for Medicare. As shown below, original Medicare and MA penetration rates vary across the seven largest MSAs.

• Miami continues to have the highest penetration rate of the top seven MSAs in the MA market at 64.9%, up from 63.9% last year, and the lowest original Medicare penetration rate at 35.5%.
• Houston joined the list of largest MSAs in 2024 with over 1 million Medicare Eligibles and has the second highest MA penetration rate at 58.3%.
• The Chicago and Philadelphia MSAs have the highest original Medicare rates among the top seven MSAs, at 58.0% and 57.6% respectively, and correspondingly the lowest MA penetration rates.

MA penetration rates increased across all the top MSAs in the nation, between 2023 and 2024, including Chicago and Philadelphia.

MFA also noted, as of October 1, 2024, that there are 13 MSAs, out of 937, with less than three carriers serving individual MA members, the same as last year. Eleven MSAs have two carriers, typically UnitedHealthcare (UHC), Humana and/or CVS, the top MA carriers nationwide. More than 200 MSAs have ten or more choices in 2024, up from 187 last year.

For the MSAs with less than three carriers serving MA members, the top seven based on Medicare Eligibles are shown below:

• Of the 13 MSAs, with less than three carriers to choose from, three dropped a carrier in 2024, or a carrier had de minimis enrollment; and 11 MSAs have had at least the same carriers since 2019.
• Four of the 13 MSAs with minimal choice of MA plans are in Kansas.
• All the Top Six MSAs from last year’s Business Strategy report, Medicare Advantage Opportunities by MSAs Still Exist, added additional carriers in 2024.

Based on October 1, 2024 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. As the number of carriers increases within MSAs, markets become more competitive with fewer opportunities to gain membership for health insurers. Preliminary analysis of 2025 CMS Landscape data suggests fewer plans will be available in some MSAs. Nationwide, a total of 4,186 MA and MAPD plans are being offered for 2025, a slight decrease from the 4,428 plans offered for 2024.

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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