Medicare Advantage in Sussex County, New Jersey
12,079 people in Sussex County, New Jersey were enrolled in Medicare Advantage in October 2026, 34.2% of 35,366 eligible beneficiaries (−0.02 pts since October 2025). CVS Health Corporation is the largest parent organization with 53% of reported enrollment; 8 parent organizations have 11 or more members and the HHI is 3,924 (highly concentrated). For 2027, 726 members here are in plans that terminate or leave the county, and Health Care Service Corporation leaves. MA plans offered go from 30 to 30.
Parent organizations in Sussex County
| Parent organization | Members | Change since October 2025 | Share |
|---|---|---|---|
| CVS Health Corporation | 6,392 | +167 | 53.2% |
| UnitedHealth Group, Inc. | 3,872 | −57 | 32.2% |
| Horizon Mutual Holdings, Inc | 750 | +76 | 6.2% |
| Clover Health Holdings, Inc. | 515 | +176 | 4.3% |
| Elevance Health, Inc. | 187 | −30 | 1.6% |
| Humana Inc. | 144 | +103 | 1.2% |
| Centene Corporation | 126 | −1 | 1.0% |
| Health Care Service Corporation | 40 | −74 | 0.3% |
CMS suppresses county and contract counts of 10 or fewer; shares are of reported enrollment.
Value-based care alongside MA
In PY 2024, 9,335 beneficiaries in Sussex County were assigned to 95 Medicare Shared Savings Program ACOs, 56.8% of assignable Original Medicare beneficiaries. Together, roughly 72% of all Medicare beneficiaries in the county are in Medicare Advantage or an MSSP ACO. See the ACOs in the MSSP Explorer.