Mark Farrah wrote a nice report on the Medicare Advantage marketplace in Pennsylvania. In summary he found that the 30 health insurers offering Medicare Advantage Plans in PA had a 37% market penetration, one of the highest in the country. Of the 30 health insurers, more than 20 were based in PA, including three separate Blue Cross Blue Shield member plans.
The Pennsylvania health insurance marketplace is divided into four distinct regions, Western, Southeastern, Central, and Northeastern, with many health insurers focused on specific regions within the state. For instance, in Western Pennsylvania, there are 20 companies offering Medicare Advantage Plans, but Highmark, and UPMC enroll about 75% of the members in that region.
Statewide there are five health insurers that Mr. Farrah considers the “top tier” in the Medicare Advantage marketplace, and they represent about 75% of statewide enrollment. They are
- Highmark with 249,023 members, 30.4% market share
- Independence Blue Cross with 149,525 members, 18.3% market share
- Coventry Healthcare with 91,724 members and 11.2% market share
- UPMC Health plan with 69,758 members and 8.5% market share
- Aetna with 58,778 members and 7.2% market share
The Pennsylvania competitive landscape will go through drastic changes in 2009, as the two largest players, Highmark, and Independence Blue Cross will finalize there merger this year. In combination they will insure over 400,000 members and nearly 50% of the market.
