How is Medicare Advantage developing in Pennsylvania?

Q: How is Medicare Advantage developing in Pennsylvania?

Pennsylvania MA and other health plan share is 54.5% (rank 19 of 53) — 1,653,057 of 3,030,753 Medicare beneficiaries, April 2026 CMS state record.

Data through April 2026 · ingested July 31, 2026 live

Pennsylvania's MA-and-other health plan share is 54.5% — above the 51.1% national share by 3.4 points, ranking 18 of 53 with 1,653,057 people in a Medicare Advantage or other Medicare health plan out of 3,030,753 Medicare beneficiaries, on the CMS state record for April 2026.

54.5%

MA & other health plan share

#18

National rank (of 53)

1,653,057

MA and other health plan enrollees

15.7%

Dual eligible share of Medicare

475,344 people · county file

Share and enrollee counts are the CMS state record for April 2026 (Medicare Monthly Enrollment). Summing this state’s 67 county rows gives 54.6% on 3,027,879 beneficiaries, a difference of 2,874 beneficiaries CMS does not assign to a county. Both figures are published; the state record is canonical for the state. Dual counts are county-file aggregates.

Highest-penetration counties in Pennsylvania

County table with momentum

County	MA & other health plan share	YoY change	Enrollment growth	Medicare beneficiaries
Cambria	76.6%	+0.6	+1.3%	38,436
Indiana	76.3%	+1.0	+2.1%	21,147
Armstrong	75.8%	+0.7	+2.2%	18,403
Lawrence	71.9%	+0.5	+1.1%	24,242
Westmoreland	71.8%	+0.6	+2.1%	102,412
Beaver	71.6%	+0.4	+1.7%	45,478
Somerset	70.8%	+0.9	+2.2%	20,955
Greene	70.1%	+0.3	+1.2%	8,989
Venango	69.5%	+1.1	+2.5%	15,130
Butler	69.4%	+0.3	+2.5%	51,262
Mercer	69.2%	+0.9	+1.7%	30,395
Washington	69.0%	+0.3	+1.4%	56,042
Allegheny	68.8%	+0.5	+1.5%	283,061
Fayette	66.9%	+0.5	+2.0%	36,789
Bedford	66.2%	+0.8	+2.4%	14,036
Forest	66.0%	+1.1	+2.5%	1,923
Clinton	65.5%	+0.6	+1.9%	9,285
Erie	65.3%	+1.1	+2.4%	65,826
Blair	65.1%	+0.6	+1.4%	33,106
Huntingdon	62.5%	+1.1	+2.9%	11,533
Clarion	62.3%	+0.9	+2.4%	9,887
Centre	61.8%	+0.8	+3.0%	28,215
Juniata	61.7%	+0.4	+2.1%	5,815
Dauphin	61.4%	+0.5	+2.4%	63,111
Montour	61.1%	+0.6	+2.9%	4,842

Tracked carrier positions in Pennsylvania

Carrier	Enrollment (K)	Plans	Stars	YoY trend	Note
BCBS	342	6	4	+2.8%	Highmark dominates Western PA; IBX in Eastern PA
UHC	298	8	4	+3.2%	Strong growth in suburban Philadelphia and Pittsburgh
Aetna	186	5	4	+2.1%	Philadelphia metro strength
Centene	112	4	3	+12.4%	Gaining in Philadelphia and Pittsburgh via $0 premium
Humana	74	3	3.5	-8.2%	Contracting in select PA markets; exiting some Western PA counties

Carrier coverage is the curated major-carrier extract (March 2026) — not all carriers in the state.

What should I do next?

Work the county listFilter and rank all 3,199 counties Compare two marketsSide by side on the same metrics SNP enrollmentD-SNP, C-SNP and I-SNP by plan and state Open my workspaceSaved markets, analyses and alerts

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Citation: MedicareInsights. “How is Medicare Advantage developing in Pennsylvania?.” Medicare Monthly Enrollment (CCW-derived national, state and county beneficiary counts; data.cms.gov dataset d7fabe1e-d19b-4333-9eff-e80e0643f2fd, public API), data through April 2026. https://medicareinsights.org/market/states/pa/.

Sales playbook one-pager

The Pennsylvania state sales playbook PNG has been withdrawn. It was rendered from the February 2026 enrollment file and carried a Growth Runway class, both retired by the 2026-08-24 data audit. Use the county explorer for April 2026 health plan share, momentum and market size, and the carrier battlecards for competitive facts. Read the audit.

So what / Now what Interpretation

Pennsylvania is a switcher market — expansion means winning members from incumbent MA plans on benefits, network, and brand.

Compare against neighboring states on the national table.
Drill into the county table above; velocity, D-SNP share, and top-carrier columns show where and how growth is happening.
Check 2026 plan exits for orphaned membership contestable in this market.
Sales teams: rank this market on health-plan share headroom and momentum in the county explorer, and see which competitive facts apply on the carrier battlecards.

Provenance — MA enrollment & penetration by state

Source file: Medicare Monthly Enrollment (CCW-derived national, state and county beneficiary counts; data.cms.gov dataset d7fabe1e-d19b-4333-9eff-e80e0643f2fd, public API)
Vintage: April 2026
Last updated: July 31, 2026
Refresh cadence: Monthly (CMS publishes ~3 months in arrears)
Method: State-level rows pulled from the Medicare Monthly Enrollment API; MA share = MA_AND_OTH_BENES / TOT_BENES. Refreshed via automated pipeline from the CMS public API.
Known limitations: Health plan share here is measured against all Medicare beneficiaries (Parts A and/or B), not the KFF eligible-only basis, which runs ~4pts higher.