Medicare Advantage in Toa Baja, Puerto Rico
15,206 people in Toa Baja, Puerto Rico were enrolled in Medicare Advantage in October 2026, 87.8% of 17,313 eligible beneficiaries (+0.9 pts since October 2025). MHH Healthcare, L.P. is the largest parent organization with 54% of reported enrollment; 3 parent organizations have 11 or more members and the HHI is 4,090 (highly concentrated). For 2027, 0 members here are in plans that terminate or leave the county. MA plans offered go from 21 to 22.
Parent organizations in Toa Baja
| Parent organization | Members | Change since October 2025 | Share |
|---|---|---|---|
| MHH Healthcare, L.P. | 8,134 | +903 | 53.6% |
| Elevance Health, Inc. | 4,811 | −439 | 31.7% |
| Guidewell Mutual Holding Corporation | 2,241 | +156 | 14.8% |
CMS suppresses county and contract counts of 10 or fewer; shares are of reported enrollment.
Value-based care alongside MA
In PY 2024, 19 beneficiaries in Toa Baja were assigned to 9 Medicare Shared Savings Program ACOs, 4.8% of assignable Original Medicare beneficiaries. Together, roughly 88% of all Medicare beneficiaries in the county are in Medicare Advantage or an MSSP ACO. See the ACOs in the MSSP Explorer.