Medicare Advantage in Monroe County, Pennsylvania
18,270 people in Monroe County, Pennsylvania were enrolled in Medicare Advantage in October 2026, 45.1% of 40,511 eligible beneficiaries (+0.2 pts since October 2025). CVS Health Corporation is the largest parent organization with 30% of reported enrollment; 15 parent organizations have 11 or more members and the HHI is 1,854 (highly concentrated). HRSA classifies the county as fully rural. For 2027, 864 members here are in plans that terminate or leave the county. MA plans offered go from 55 to 54.
Parent organizations in Monroe County
| Parent organization | Members | Change since October 2025 | Share |
|---|---|---|---|
| CVS Health Corporation | 5,509 | +984 | 30.3% |
| UnitedHealth Group, Inc. | 3,269 | +78 | 18.0% |
| Risant Health, Inc. | 2,944 | +131 | 16.2% |
| Humana Inc. | 2,353 | +490 | 12.9% |
| Highmark Health | 2,296 | −1,957 | 12.6% |
| Devoted Health, Inc. | 615 | +458 | 3.4% |
| Thomas Jefferson University | 407 | +350 | 2.2% |
| Independence Health Group, Inc. | 260 | +65 | 1.4% |
| Centene Corporation | 215 | −27 | 1.2% |
| Elevance Health, Inc. | 161 | −5 | 0.9% |
| UPMC Health System | 67 | +16 | 0.4% |
| Horizon Mutual Holdings, Inc | 30 | +6 | 0.2% |
| NY Hotel Trades Council&Hotel Assn of NYC | 19 | +4 | 0.1% |
| EmblemHealth, Inc. | 13 | +1 | under 0.1% |
| CAPITAL BLUE CROSS | 13 | +1 | under 0.1% |
CMS suppresses county and contract counts of 10 or fewer; shares are of reported enrollment.
Value-based care alongside MA
In PY 2024, 7,727 beneficiaries in Monroe County were assigned to 109 Medicare Shared Savings Program ACOs, 48.9% 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.