Medicare Advantage in 2024: Key Trends and Highlights
Medicare Advantage enrollment has been on a steady climb for the past two decades following changes in policy designed to encourage a robust role for private plan options in Medicare.
In 2024, 32.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 54 percent, of the eligible Medicare population, and $462 billion (or 54%) of total federal Medicare spending (net of offsetting receipts, such as premiums).
Generally, research shows that Medicare pays more to private Medicare Advantage plans for enrollees than their costs would be in traditional Medicare.
More than one-third (37%) of Medicare beneficiaries live in a county where at least 60 percent of all Medicare beneficiaries are enrolled in Medicare Advantage plans.
Medicare Advantage enrollment is highly concentrated among a small number of firms, with UnitedHealthcare and Humana accounting for nearly half (47%) of all Medicare Advantage enrollees nationwide.
Between 2023 and 2024, total Medicare Advantage enrollment grew by about 2.1 million beneficiaries, or 7 percent – a similar growth rate as the prior year (8%). The Congressional Budget Office (CBO) projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to 64% by 2034.
The share of Medicare beneficiaries in Medicare Advantage plans varies across states, ranging from 2% to 63%.
In 30 states, Medicare Advantage enrollees account for more than half of all Medicare beneficiaries, including in 7 states, AL, CT, MI, HI, ME, FL, RI (and Puerto Rico) where 60% or more of all Medicare beneficiaries are enrolled in Medicare Advantage plans (Figure 6). In contrast, Medicare Advantage enrollment is relatively low (less than 40%) in 13 states, including five states with less than 30% of beneficiaries enrolled in a Medicare Advantage plan – AK, MD, ND, SD, and WY – all of which (beside MD) are mostly rural. Overall, Puerto Rico has the highest Medicare Advantage penetration, with 95 percent of Medicare beneficiaries enrolled in a Medicare Advantage plan. A decade ago, the share of Medicare beneficiaries in Medicare Advantage plans did not exceed 50 percent in any state (other than Puerto Rico).