CSG Actuarial compiled the following Medicare Advantage and PDP enrollment highlights.
Medicare Advantage Enrollment by Plan Type
| Plan Type | Enrollment |
|---|---|
| HMO/HMO-POS | 16,066,045 |
| Local PPO | 9,570,866 |
| Regional PPO | 942,516 |
| 1876 Cost | 177,201 |
| PFFS | 58,292 |
Source: Monthly Report by Plan, May 2021
The top 6 Parent Organizations account for roughly 71% of overall Medicare Advantage enrollment:
Medicare Advantage Enrollment by Top 25 Parent Organizations
| Parent Organization | Enrollment |
|---|---|
| UnitedHealth Group, Inc. | 7,278,782 |
| Humana Inc. | 4,881,641 |
| CVS Health Corporation | 2,859,188 |
| Kaiser Foundation Health Plan, Inc. | 1,751,534 |
| Anthem Inc. | 1,538,625 |
| Centene Corporation | 1,1,78,834 |
| Blue Cross Blue Shield of Michigan Mutual Ins. Co. | 607,971 |
| CIGNA | 568,579 |
| Highmark Health | 305,233 |
| Summit Master Company, LLC | 275,474 |
| SCAN Group | 220,673 |
| Healthfirst, Inc. | 211,598 |
| Spectrum Health System | 204,202 |
| UPMC Health System | 199,642 |
| Medical Card System, Inc. | 185,047 |
| Guidewell Mutual Holding Corporation | 181,515 |
| EmblemHealth, Inc. | 166,486 |
| Aware Integrated, Inc. | 166,354 |
| BlueCross Blue Shield of Tennessee | 162,443 |
| Lifetime Healthcare, Inc. | 156,963 |
| California Physicians Service | 151,983 |
| UCare Minnesota | 137,390 |
| Triple-S Management Corporation | 136,410 |
| Medica Holding Company | 134,539 |
Source: Monthly Report by Plan, May 2021
- PDP companies under CVS, United, Centene, Humana and Cigna account for just under 90% of PDP enrollment as of May 2021
Prescription Drug Plan (PDP) Enrollment by Top 25 Parent Organizations
| Parent Organization | Enrollment |
|---|---|
| CVS Health Corporation | 5,709,524 |
| UnitedHealth Group, Inc. | 4,466,821 |
| Centene Corporation | 4,090,111 |
| Humana Inc. | 3,537,775 |
| CIGNA | 3,191,798 |
| Rite Aid Corporation | 799,210 |
| Anthem Inc. | 413,941 |
| Health Care Service Corporation | 282,480 |
Source: Monthly Report by Plan, May 2021
- CSG Actuarial compared the May 2021 and May 2020 State County Penetration files to analyze any noticeable difference in the growth of MA penetration rates. We grouped counties that are included in a Metropolitan Statistical Area (“MSA”) in one category and grouped all other counties in another category. As noted below, non-MSA counties are seeing year-over-year % growth in MA penetration at a higher clip than MSA counties.
Counties in a Metropolitan Statistical Area:
| Month | Medicare Eligibles | Enrolled | Penetration |
|---|---|---|---|
| May 2021 | 51,187,802 | 22,919,355 | 45% |
| May 2020 | 50,144,533 | 20,995,520 | 42% |
| Year over Year % | 2% | 9% |
Non – MSA Counties
| Month | Medicare Eligibles | Enrolled | Penetration |
|---|---|---|---|
| May 2021 | 10,926,163 | 3,803,447 | 35% |
| May 2020 | 10,764,087 | 3,300,862 | 31% |
| Year over Year % | 2% | 15% |
Source: State County Penetration, May 2021 and May 2020. Excludes Puerto Rico, includes D.C.