Medicare Advantage gross margins per enrollee are double other insurance markets, report finds

Medicare Advantage plans grossed $1,730 per enrollee in 2021, far exceeding margins for individual, group and Medicaid markets, according to Kaiser Family Foundation. 

According to a report published Feb. 28, MA plans brought over twice as much value compared to other markets in 2021. In the individual market, plans grossed $745 per enrollee, while group market plans grossed $689 per enrollee and Medicaid market plans grossed $768 per enrollee. 

In 2020, when the COVID-19 pandemic drove down medical care utilization, MA plans grossed $2,257 per enrollee. 

Though gross margins varied widely across markets, medical loss ratios were largely the same, the analysis found. In 2021, the loss ratio for MA plans was 87 percent. For Medicaid, the ratio was 86 percent, and it was 88 percent for both individual and group markets. 

See the full report here. 

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