Enrollment in Medicare Advantage (MA) plans continued to increase between 2021 and 2022. As of March 2022, approximately 29 million Medicare beneficiaries (46 percent of all beneficiaries) were enrolled in MA plans. A total of 3,834 MA plans nationwide are available to Medicare beneficiaries representing an 8 percent increase from 2021. An average of 39 plans are accessible to each beneficiary. Supplemental benefits such as dental, vision, and/or hearing services, no or low monthly payments, and annual out-of-pocket limits make MA plans more attractive than traditional Medicare.

Aggregate enrollment in MA special needs plans (SNPs) more than doubled from 2.3 million in 2017 to 4.8 million as of June 2022. The characteristics of enrollees in MA plans are shared with those in traditional Medicare plans only when people in SNPs are excluded from analysis, and most studies exclude those in SNP. When SNP enrollees are included, MA enrollees are more likely to be Black or Hispanic and to have at least one chronic condition. Studies evaluating racial and ethnic disparities in MA program quality metrics have shown mixed results, with some showing better performance by MA plans (in mammography rates, preventable admissions) and others lower performance in readmission rates and immunization for influenza. Increases in the number of plan options, increased enrollment, and new firm market entry continue to signal growth for MA programs.

Key Findings:

• Overall MA enrollment grew by 8.7 percent (2.3 million) from 2021 to 2022; the rate of growth was higher in nonmetropolitan counties (13.4 percent) than in metropolitan counties (7.9 percent).
• Overall, more than half of MA enrollees (57.9 percent) were in Health Maintenance Organization (HMO) plans. The largest proportion of nonmetropolitan enrollees (51.5 percent) were in Local Preferred Provider Organization (PPO) plans, whereas the largest proportion of metropolitan enrollees (61.4 percent) were in HMO plans.
• The percentage of nonmetropolitan MA enrollees in HMO plans increased from 36.8 percent in 2021 to 37.8 percent in 2022. However, there was a decrease in metropolitan enrollees in HMO plans (63.0 percent in 2021 to 61.4 percent in 2022).
• Enrollment in Local PPO plans increased in both nonmetropolitan (from 48.9 percent to 51.5 percent) and metropolitan counties (from 33.2 percent to 35.6 percent) between 2021 and 2022.