Medicare Advantage Hotspots: The Top 5 U.S. States for Enrollment and Quality

Medicare Advantage Hotspots: The Top 5 U.S. States for Enrollment and Quality
  • June 29, 2025


Medicare Advantage (MA) plans combine Parts A, B, and usually Part D, with added benefits. With ongoing changes heading into 2026, understanding where these plans perform best matters more than ever. These plans thrive unevenly across states due to local competition, provider networks, and consumer adoption. Based on CMS and KFF data, here are the top five states in enrollment, plan quality, and variety.

What Makes a State an Medicare Advantage Hotspot?

We use the following criteria:

  • Enrollment penetration: percentage of Medicare beneficiaries enrolled in MA.

  • Plan quality: CMS star ratings and percentage of enrollees in 4+ star plans.

  • Plan variety: number of carriers and plan options available in counties.

  • Supplemental benefits: availability of dental, vision, hearing, OTC, etc.

These metrics reveal which states offer the best mix of access, value, and choice.

Top 5 States Where Medicare Advantage Plans Thrive

1. Florida

Florida leads MA enrollment with over 60% of Medicare beneficiaries enrolled. It combines high saturation with competitive carriers offering robust supplemental benefits. Humana, UnitedHealthcare, Aetna, and Blue Cross dominate, giving retirees a wide range of plan types and networks.

2. Michigan

Michigan is among seven states (AL, CT, MI, HI, ME, FL, RI) with 60%+ MA penetration. Rapid enrollment gains occurred in Wayne, Oakland, and Kent counties during 2024–25, driven by competitive plan offerings and provider partnerships. Multiple local and national carriers ensure strong plan variety.

3. Pennsylvania

Also in the 60%+ cohort. Enrollment spiked in Allegheny and Philadelphia Counties thanks to growth from Medicare Advantage AEP 2025. Large counties also have 10+ plan options monthly in many areas, indicating high variety.

4. Connecticut

Though smaller in population, Connecticut has over 60% MA penetration. Its compact geography supports strong carrier competition and high access to 4+ star plans. However, some concern exists: certain counties show higher shares of low‑rated plans, suggesting uneven quality.

5. Rhode Island

Also in the 60%+ MA penetration group. Rhode Island benefits from dense provider access and urban markets. Star quality remains consistently high, placing many beneficiaries in 4+ star plans. Its small size brings uniform access across the state.

Comparison at a Glance

State

MA Enrollment

4+ Star Access

Plan Variety per County

Florida

60%+

High (multiple carriers)

10+ in most metro counties

Michigan

60%+

Strong in metro areas

High in Wayne, Oakland, Kent

Pennsylvania

60%+

Strong in urban hubs

10+ options in many counties

Connecticut

60%+

High access statewide

Good variety, some low-tier spots

Rhode Island

60%+

High across state

Consistently good options

What Medicare Agents Say: Do MA Plans Really Save Money?

Leslie Kaz

Syndicated Insurance Agency LLC • Sherman Oaks, CA

Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

Short answer: Sometimes yes. Sometimes no. It depends on the person — not the TV commercial.

Here’s the real deal:

Medicare Advantage plans can save seniors money when they’re matched correctly to how someone actually uses healthcare.

Why they can save money:

Lower (sometimes $0) monthly premiums

Built-in extras like dental, vision, hearing, fitness

Annual out-of-pocket maximums (Original Medicare doesn’t have one)

Why they don’t always save money:

Provider networks can be limited

Costs add up if you go out-of-network

Heavy users of care may hit the max and pay more than expected

Benefits change every year

Here’s the part commercials skip:

The plan isn’t the problem — the fit is.

That’s why working with my office matters. We offer concierge service, meaning we don’t just enroll you and disappear. If you’re confused, can’t find a provider, or something isn’t working the way you expected, we step in and help fix it.

Bottom line:

Medicare Advantage can absolutely save money — when chosen strategically and supported properly. One-size-fits-all plans usually cost more in the long run.

What These States Have in Common

They share these traits:

  • High MA adoption (60%+)

  • Competitive insurance markets with multiple major and regional carriers

  • Diverse plan selections, often 10+ options per metro area

  • Strong access to 4+ star plans, driven by quality measures

States like Alaska, Montana, and Wyoming have low MA penetration (<40%) and limited plan choice. Rural areas in hotspots still benefit from adjacent metro networks.

What This Means for You

Even if you don’t live in one of these top five states, strong Medicare Advantage plans may still be available in your area. Start by checking the enrollment penetration and the number of carriers operating in your county, as this often reflects plan competitiveness. Compare star ratings, with a focus on plans rated 4 stars or higher for better quality and satisfaction. Take note of the variety of plan options, ideally, your area should offer five to ten choices to ensure flexibility. Review supplemental benefits carefully, especially if you have specific needs such as dental coverage, vision care, or support for chronic conditions. To make an informed decision, use the Medicare Plan Finder on Medicare.gov, or consult a local broker or state insurance advisor for personalized guidance. You can also learn more about how Medicare agents help with Advantage plans.

Agent Perspective: Original Medicare vs. Medicare Advantage

Emmond Wills

Wills Financial & Benefits LLC. • Nashville, TN

Is Original Medicare or Medicare Advantage better? Why do you recommend one over the other?

The truth is, well neither is “better” for everyone — it depends on the person’s health, doctors, budget, and lifestyle and needs.

What the Numbers Show

Florida, Michigan, Pennsylvania, Connecticut, and Rhode Island lead MA in enrollment, quality, and choice. Yet quality plans exist in many other states. Focus on star ratings, provider access, and benefits in your ZIP code. With careful evaluation and working with the right Medicare Broker near you, you can find an ideal MA plan, no matter where you live. If you already have a Medicare Advantage plan, take time to confirm you have the right one.