Medicare Advantage Penetration by State, 2026
Medicare Advantage Penetration by State: 2026 Ranking
Michigan has the highest Medicare Advantage penetration among the states included in the August 2026 CMS report, at 63.7%. Alabama ranks second at 61.6%, followed by Rhode Island at 59.8%. Vermont has the lowest reported rate in this states-only comparison, at 12.2%.
Medicare Advantage penetration measures the share of the Medicare population used in the CMS State/County Penetration report that is enrolled in Medicare Advantage. Higher percentages rank higher. The ranking uses published CMS penetration rates rather than forecasts or modeled estimates.
The table covers 48 states. Alaska and Connecticut are excluded because comparable 2026 penetration and eligibility information is unavailable following county-mapping changes. The District of Columbia and U.S. territories are outside this states-only ranking.
Source: CMS MA State/County Penetration, August 2026. Coverage: 48 states. Unit: percent. All 48 rates are published CMS values. No estimates, forecasts, or modeled projections are included.
Michigan leads the August 2026 state ranking.
Vermont has the lowest rate among the 48 included states.
Alaska and Connecticut are excluded rather than estimated.
Median of the 48 published state rates shown in this ranking.
CMS monthly State/County Penetration report.
What Medicare Advantage penetration measures
Medicare Advantage penetration is an enrollment-share measure. A 60% penetration rate means roughly six in ten beneficiaries in the CMS denominator for this report are enrolled in Medicare Advantage.
The measure helps compare how widely Medicare Advantage is used across states. It is not a measure of plan quality and does not show premiums, out-of-pocket costs, star ratings, provider-network breadth, supplemental benefits, beneficiary satisfaction, or health outcomes.
State averages can also conceal substantial local variation. Medicare Advantage enrollment can differ sharply from one county to another within the same state, so county-level CMS data are more appropriate for local market analysis.
Top 10 states by Medicare Advantage penetration
Michigan and Alabama are the only states in the ranking above 60%. The Top 10 contains four Southern states, four Midwestern states, and two Northeastern states.
Top 10 states in the CMS August 2026 penetration report
| Rank | State | Penetration | Source / Method Note |
|---|---|---|---|
| 1 | Michigan | 63.7% | Midwest; CMS; Aug. 2026; published penetration rate. |
| 2 | Alabama | 61.6% | South; CMS; Aug. 2026; published penetration rate. |
| 3 | Rhode Island | 59.8% | Northeast; CMS; Aug. 2026; published penetration rate. |
| 4 | Maine | 58.9% | Northeast; CMS; Aug. 2026; published penetration rate. |
| 5 | North Carolina | 58.0% | South; CMS; Aug. 2026; published penetration rate. |
| 6 | Louisiana | 57.7% | South; CMS; Aug. 2026; published penetration rate. |
| 7 | Florida | 57.5% | South; CMS; Aug. 2026; published penetration rate. |
| 8 | Wisconsin | 57.4% | Midwest; CMS; Aug. 2026; published penetration rate. |
| 9 | Minnesota | 56.9% | Midwest; CMS; Aug. 2026; published penetration rate. |
| 10 | Ohio | 56.8% | Midwest; CMS; Aug. 2026; published rate; tie order uses CMS enrollment and eligibility counts. |
Rates are published by CMS. When two states have the same displayed percentage, their order is resolved from the enrollment and eligibility counts in the same CMS report.
Top 20 states by Medicare Advantage penetration
The chart uses the same published rates as the ranking table. Michigan leads at 63.7%, while New York is 20th at 53.7%.
Methodology
Metric and unit
The metric is Medicare Advantage penetration, expressed as a percentage. A higher published penetration rate receives a higher position in the ranking.
Source and report period
State rates come from the CMS MA State/County Penetration report for August 2026. CMS identifies this report as providing Medicare Advantage market penetration rates at the state and county level.
Coverage
The table contains 48 states. Alaska and Connecticut are omitted because comparable 2026 penetration and eligibility information is unavailable under the current county-mapping methodology. DC and U.S. territories are excluded from this states-only ranking.
Ranking and ties
States are sorted from higher to lower published penetration. If two published values display at the same one-decimal rate, the order is resolved using the MA enrollment-to-eligibility ratio from the corresponding CMS counts. The published penetration rate remains the value shown in the ranking.
CMS defines the penetration field as the percentage of Medicare beneficiaries in the report's eligibility universe who are enrolled in Medicare Advantage. The ranking therefore uses the CMS penetration field rather than dividing enrollment by a state's total population.
No missing state rate is estimated, no conflicting values are averaged, and no growth assumption is applied. This is an August 2026 observed-data snapshot, not a year-end forecast.
Penetration measures enrollment share only. It does not measure plan quality, premiums, cost sharing, supplemental benefits, provider access, insurer concentration, profitability, beneficiary satisfaction, or future enrollment growth. CMS administrative data may also be revised in later releases.
Full state ranking
Search by state, filter by region, change the sort order, or limit the table to the Top 10 or Top 20. Alaska and Connecticut are not estimated or backfilled.
Medicare Advantage penetration by state, CMS August 2026
| Rank | State | Penetration | Source / Method Note |
|---|---|---|---|
| 1 | Michigan | 63.7% | Midwest; CMS; Aug. 2026; published rate. |
| 2 | Alabama | 61.6% | South; CMS; Aug. 2026; published rate. |
| 3 | Rhode Island | 59.8% | Northeast; CMS; Aug. 2026; published rate. |
| 4 | Maine | 58.9% | Northeast; CMS; Aug. 2026; published rate. |
| 5 | North Carolina | 58.0% | South; CMS; Aug. 2026; published rate. |
| 6 | Louisiana | 57.7% | South; CMS; Aug. 2026; published rate. |
| 7 | Florida | 57.5% | South; CMS; Aug. 2026; published rate. |
| 8 | Wisconsin | 57.4% | Midwest; CMS; Aug. 2026; published rate. |
| 9 | Minnesota | 56.9% | Midwest; CMS; Aug. 2026; published rate. |
| 10 | Ohio | 56.8% | Midwest; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 11 | West Virginia | 56.8% | South; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 12 | Georgia | 56.3% | South; CMS; Aug. 2026; published rate. |
| 13 | Kentucky | 55.6% | South; CMS; Aug. 2026; published rate. |
| 14 | Utah | 55.2% | West; CMS; Aug. 2026; published rate. |
| 15 | Texas | 55.0% | South; CMS; Aug. 2026; published rate. |
| 16 | Missouri | 54.7% | Midwest; CMS; Aug. 2026; published rate. |
| 17 | Pennsylvania | 54.6% | Northeast; CMS; Aug. 2026; published rate. |
| 18 | Oregon | 53.9% | West; CMS; Aug. 2026; published rate. |
| 19 | Tennessee | 53.7% | South; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 20 | New York | 53.7% | Northeast; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 21 | Hawaii | 53.5% | West; CMS; Aug. 2026; published rate. |
| 22 | Colorado | 52.2% | West; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 23 | Nevada | 52.2% | West; CMS; Aug. 2026; published rate; tie ordered from CMS counts. |
| 24 | Arizona | 51.7% | West; CMS; Aug. 2026; published rate. |
| 25 | California | 51.5% | West; CMS; Aug. 2026; published rate. |
| 26 | Indiana | 51.2% | Midwest; CMS; Aug. 2026; published rate. |
| 27 | New Mexico | 50.7% | West; CMS; Aug. 2026; published rate. |
| 28 | Washington | 49.8% | West; CMS; Aug. 2026; published rate. |
| 29 | Arkansas | 47.3% | South; CMS; Aug. 2026; published rate. |
| 30 | South Carolina | 46.8% | South; CMS; Aug. 2026; published rate. |
| 31 | Idaho | 45.9% | West; CMS; Aug. 2026; published rate. |
| 32 | Mississippi | 45.2% | South; CMS; Aug. 2026; published rate. |
| 33 | Illinois | 44.0% | Midwest; CMS; Aug. 2026; published rate. |
| 34 | Oklahoma | 42.5% | South; CMS; Aug. 2026; published rate. |
| 35 | New Jersey | 41.4% | Northeast; CMS; Aug. 2026; published rate. |
| 36 | Virginia | 39.7% | South; CMS; Aug. 2026; published rate. |
| 37 | Iowa | 37.7% | Midwest; CMS; Aug. 2026; published rate. |
| 38 | Massachusetts | 35.7% | Northeast; CMS; Aug. 2026; published rate. |
| 39 | North Dakota | 35.4% | Midwest; CMS; Aug. 2026; published rate. |
| 40 | South Dakota | 35.2% | Midwest; CMS; Aug. 2026; published rate. |
| 41 | Nebraska | 34.2% | Midwest; CMS; Aug. 2026; published rate. |
| 42 | Kansas | 33.5% | Midwest; CMS; Aug. 2026; published rate. |
| 43 | Delaware | 32.7% | South; CMS; Aug. 2026; published rate. |
| 44 | New Hampshire | 30.8% | Northeast; CMS; Aug. 2026; published rate. |
| 45 | Montana | 29.6% | West; CMS; Aug. 2026; published rate. |
| 46 | Maryland | 24.8% | South; CMS; Aug. 2026; published rate. |
| 47 | Wyoming | 14.9% | West; CMS; Aug. 2026; published rate. |
| 48 | Vermont | 12.2% | Northeast; CMS; Aug. 2026; published rate. |
All 48 displayed percentages are published CMS values from the August 2026 State/County Penetration report. Ties at the displayed precision are ordered using the corresponding CMS enrollment and eligibility counts.
What stands out in the state data
Key Insight
Michigan ranks first at 63.7%, 2.1 percentage points above Alabama. Rhode Island is third at 59.8%.
Notable Pattern
Medicare Advantage penetration is at least 50% in 27 of the 48 states included in the August 2026 ranking.
Regional Concentration
The Top 10 contains four Southern states and four Midwestern states. Utah, at rank 14, is the highest-ranked Western state.
Outlier
Vermont is lowest at 12.2%, with Wyoming next at 14.9%. Every other state in the ranking is above 24%.
How to interpret the ranking
A high penetration rate means Medicare Advantage accounts for a larger share of the Medicare population represented by the CMS measure. It can indicate how established Medicare Advantage is in a state, but it does not show whether plans are better or whether the market is more attractive to insurers.
A low rate should not automatically be interpreted as untapped demand. Plan availability, provider networks, rural geography, employer-retiree coverage, local demographics, and beneficiary preferences can all influence enrollment.
For local competitive analysis, county-level CMS data are generally more informative than a statewide average. This ranking is best used for broad state-to-state comparison.
FAQ
Which state has the highest Medicare Advantage penetration in 2026?
Michigan ranks first in the CMS August 2026 states-only comparison at 63.7%, followed by Alabama at 61.6% and Rhode Island at 59.8%.
Are these official CMS percentages?
Yes. The table uses the penetration rates published in the CMS MA State/County Penetration report for August 2026. Enrollment and eligibility counts from the same report are used only to order states when published percentages display at the same precision.
Why are Alaska and Connecticut missing?
Comparable 2026 penetration and eligibility information is unavailable for Alaska and Connecticut following county-mapping changes. The ranking excludes them instead of estimating a value.
What does a 60% Medicare Advantage penetration rate mean?
It means about 60% of beneficiaries represented by the CMS eligibility denominator are enrolled in Medicare Advantage. It does not mean 60% of the state's total population is enrolled.
Does higher penetration mean better Medicare Advantage plans?
No. Penetration measures enrollment share, not plan quality, premiums, benefits, provider networks, star ratings, beneficiary satisfaction, or health outcomes.
Why can another Medicare Advantage state ranking show different percentages?
Results can differ when another source uses a different reporting month, eligibility denominator, plan definition, geographic mapping, or rounding method. This ranking is tied to the CMS August 2026 State/County Penetration report.
Are these forecasts for the end of 2026?
No. They are observed penetration rates from the August 2026 CMS report. No growth assumption, CAGR, forecast, or modeled projection is used.
Sources
CMS — MA State/County Penetration, August 2026
Primary source for the Medicare Advantage penetration rates used in every ranking row.
CMS — Medicare Advantage/Part D Contract and Enrollment Data
CMS documentation for monthly Medicare Advantage enrollment reports and the State/County Penetration series.
HealthScape Advisors — 2026 Medicare Advantage Enrollment Analysis
Methodology cross-check for the 2026 Alaska and Connecticut data limitation associated with county-mapping changes.
https://www.healthscape.com/insights/medicare-advantage-enrollment-depicts-industry-crossroads
