Nearly half of Medicare beneficiaries, or 48%, are enrolled in Medicare Advantage plans. As soon as next year, this number could cross the 50% threshold, a report published Thursday predicts.
The Kaiser Family Foundation analysis also found that in 2022, MA enrollment accounted for $427 billion, or 55%, of all federal Medicare spending. The report used data from the Centers for Medicare & Medicaid Services for its study.
Mayo Clinic Platform Program to Help Clinical Digital Health Startups Succeed
Mayo Clinic has developed a new tool that could speed up the time it takes for digital health companies to validate their tech to hospitals.
MA enrollment has more than doubled since 2007, when it was just 19% of the Medicare population, the report said. Between 2021 and 2022, MA enrollment rose by 8%, or by 2.2 million beneficiaries. This is slightly lower than the prior year, when enrollment grew by 10%. The Congressional Budget Office predicts that by 2032, MA enrollees will make up 61% of the Medicare population.
UnitedHealthcare and Humana account for almost half of all MA enrollees this year. UnitedHealthcare has 28% of total MA enrollment and Humana has 18%. In about a third of all counties in the U.S., the payers account for at least 75% of MA enrollment.
Meanwhile, Blue Cross Blue Shield has 14% of MA enrollment, CVS Health has 11%, Kaiser Permanente has 6%, Centene has 5%, Cigna has 2% and the remaining 16% is made up of other insurers.
UnitedHealthcare and Humana historically have had the highest share of MA enrollment. In 2010, UnitedHealthcare had 20% of MA beneficiaries and Humana had 16%. UnitedHealthcare has also seen the largest growth since 2010.
Tackling Messy Provider Data with an NPI-Forward Approach
Mike Wirth of ProviderTrust shares insights about the company in this interview at the ViVE 2025 conference in Nashville last month.
KFF also found:
- About two-thirds of MA enrollees, or 66%, are in individual plans. Meanwhile, 18% are in employer/union-sponsored group plans and 16% are in special needs plans.
- The share of Medicare beneficiaries enrolled in MA plans varies by state. This year, Alaska has the lowest with 1% enrolled in MA, while Hawaii has the highest with 59% enrolled in MA.
- In 2022, almost seven out of 10 MA enrollees are in plans with prescription drug coverage that don’t require premiums other than the Medicare Part B premium. This was reported in a separate analysis by KFF, also published Thursday.
- Most enrollees in individual MA plans have access to benefits that aren’t covered by traditional Medicare. This includes eye exams, hearing exams and fitness.
- Nearly all MA enrollees, or 99%, are in plans that require prior authorization for some services. This refers to a process utilized by insurers that determines if they will cover a certain procedure or medication. It is mostly used for expensive services, such as prescription drugs administered by a physician, skilled nursing facility stays and inpatient hospital stays, KFF found. However, it is rarely needed for preventive services.
Photo: designer491, Getty Images