For example, some states, such as Illinois and Pennsylvania, provide health insurance benefits to their Medicare-eligible retirees exclusively through Medicare Advantage plans. With a group plan, an employer or union contracts with an insurer and Medicare pays the insurer a fixed amount per enrollee to provide benefits covered by Medicare. ![]() While this is roughly the same share of enrollment since 2014 (19%), the actual number has increased from 1.9 million in 2010 to 4.9 million in 2021 (Figure 4). Nearly 4.9 million Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union. Enrollment in Medicare Advantage has more than doubled over the past decade A third analysis compares Medicare Advantage plans’ star ratings and federal spending under the quality bonus program. A second, companion analysis describes Medicare Advantage premiums, out-of-pocket limits, cost sharing, extra benefits offered, and prior authorization requirements in 2021. ![]() To better understand trends in the growth of the program, this brief provides current information about Medicare Advantage enrollment, including the types of plans in which Medicare beneficiaries are enrolled, and how enrollment varies across geographic areas. The average Medicare beneficiary in 2021 has access to 33 Medicare Advantage plans, the largest number of options available in the last decade. In 2021, more than 26 million people are enrolled in a Medicare Advantage plan, accounting for 42 percent of the total Medicare population, and $343 billion (or 46%) of total federal Medicare spending (net of premiums). Over the last decade, the role of Medicare Advantage, the private plan alternative to traditional Medicare, has grown.
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