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

Medicare Advantage (MA) plans combine Parts A, B, and usually Part D, with added benefits. 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

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.

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.