Medicare Advantage margins are outperforming other lines of business, according to a Feb. 23 KFF data brief.
The analysis relied on 2024 insurer-reported financial data found in Mark Farrah Associates’ Health Coverage Portal database, looking across individual, group, Medicaid and Medicare Advantage markets. KFF excluded plans that filed negative or zero premiums to avoid data integrity issues.
Gross margins per enrollee — how much greater the total premium income is than total claims costs — reached $1,655 in the MA market by the end of 2024, followed by $987 for the individual, $846 for the group and $608 for the Medicaid managed care segments.
Notably, these margins do not suggest all insurers are thriving within MA. Amid concerns over financial sustainability, several insurers exited MA in 2025. Gross margins have declined across all lines of business year over year.
Medical loss ratios were the highest for Medicaid managed care plans at 91%, followed closely by MA at 90%. However, all four segments had closely aligned ratios, with the individual market at 85% and the group market at 88%. MLRs increased across the board between 2023 and 2024.
