A Current Snapshot of Medicare Advantage, PDP Medicare Employer Group Enrollment

by Clive Riddle, November 22, 2019

As of November, Medicare Advantage now serves 22,584,367 enrollees. Another 709,746 are enrolled in related plans (Dual, Cost and PACE), for a total of 23,294,113 Medicare enrollees in managed plans. 88.3% of these total managed enrollees have Prescription Drug Plan coverage. Another 25,626,600 Medicare enrollees not in managed plans have PDP coverage.

14.1% of Medicare Advantage enrollees are in Special Needs Plans. 20.1% of Medicare Advantage enrollees are in Employer Plans. 18.5% of Medicare PDP only enrollees are in Employer Plans. Below is the CMS November 2019 enrollment contract summary report: 

Speaking of Employer plans, Mark Farrah Associates has just released a brief: Trends in Employer Group Medicare Advantage Enrollment. For the employer group segment, they identified the top five MA payers by group enrollment (Oct. 2019 data) to be:

• UnitedHealth: 1,387,052
• CVS/Aetna: 913,490
• Kaiser: 550,331
• Humana: 510,956
• BCBS Michigan: 378,890

These top five payers comprise 83.7% of total Employer Group MA enrollment, and “all 5 of the leading group MA health plans achieved double-digit growth in membership since December 2016.” Enrollment is also concentrated by state, with the top ten states (20% of the states) comprising 63.9% of Employer Group MA enrollment, with California on top with 622,404 enrollees followed by Michigan with 405,415.

Overall, they note that “employer group MA enrollment has increased by almost 321,000, a 7.7% increase, since December 2018. Moreover, group market enrollment has increased by approximately 1.3 million members since December 2016.”