Medigap
Medigap Market Share by Carrier (Nationwide)
Which insurers write the most Medicare Supplement policies in the United States? Rankings are based on covered lives from the NAIC Medicare Supplement Insurance Experience Exhibit.
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The only free public report with a full ranked carrier table is the December 2024 Medigap Enrollment & Market Share PDF prepared by Mark Farrah Associates for UnitedHealthcare. That report names only UnitedHealthcare and lists every other carrier anonymously (“Medigap Carrier 2, 3, 4…”).
Names shown for ranks #2 through #7 below are inferred from corroborating public evidence — state DOI filings, KFF analyses, Gen Re survey participant lists, and AHIP reports. Each inferred name carries an Name inferred badge. Enrollment counts come directly from the source.
For carrier-named data by state, the NAIC Medicare Loss Ratio Report is the most comprehensive free source.
Top Medigap carriers nationwide (2024)
| # | Carrier / Group | Covered lives | Market share | Source confidence |
|---|---|---|---|---|
| 1 | UnitedHealthcare / AARP UnitedHealth Group Only carrier explicitly named in the MFA/UHC public report. Includes UHC Insurance Co, UHC Insurance Co of America, and UHC Insurance Co of NY. | 4,321,203 | 30.67% | Named in source |
| 2 | Blue Cross Blue Shield (aggregate) BCBS affiliates incl. Health Care Service Corp (IL, TX, OK, NM, MT) BCBS affiliates collectively write a large share of Medigap; HCSC is consistently identified as the largest single BCBS filer. | 1,330,684 | 9.45% | Name inferred |
| 3 | Mutual of Omaha group Mutual of Omaha Insurance Company Includes United of Omaha, United World, Omaha Insurance Co, and Omaha Supplemental. Universally cited as a top-3 Medigap writer. | 1,049,931 | 7.45% | Name inferred |
| 4 | Aetna / CVS Health group CVS Health Includes Aetna Life, Accendo, Continental Life, American Continental, and First Health entities. | 897,409 | 6.37% | Name inferred |
| 5 | Cigna The Cigna Group Includes Cigna HealthSpring / Loyal American / American Retirement Life entities. | 565,148 | 4.01% | Name inferred |
| 6 | Humana group Humana Inc. Includes Humana Insurance Company and state-affiliated Humana entities (NY, KY, etc.). | 427,781 | 3.04% | Name inferred |
| 7 | Physicians Mutual / Globe Life (independent senior-market) Anonymous in the MFA/UHC source; Physicians Mutual and Globe Life are the most commonly cited candidates among independent senior-market carriers at this rank. | 377,304 | 2.68% | Name inferred |
| 8 | All other top-20 carriers MFA/UHC report lists ranks 8-20 anonymously. Known participants include Wellabe (Medico / American Republic), Transamerica Life, State Farm, Bankers Fidelity, Medical Mutual of Ohio, USAA Life, Guarantee Trust Life, Pekin Life, and CareFirst BCBS. | 1,872,859 | 13.29% | Aggregated |
| 9 | All other Medigap carriers (long tail) Roughly 100+ smaller carriers, regional Blues plans, and fraternals. | 2,750,315 | 19.52% | Aggregated |
| Total | 14,088,218 | 100.00% | ||
Plan-type mix nationwide (2023)
Plan G surpassed Plan F as the most-enrolled Medigap plan after Plan F was closed to new Medicare-eligibles in 2020. Plan N continues to grow as a lower-premium alternative.
| Plan | Covered lives | Share |
|---|---|---|
| Plan G | 5,272,496 | 38.8% |
| Plan F | 4,884,493 | 36.0% |
| Plan N | 1,363,398 | 10.0% |
| Other / Pre-Standardized | 968,964 | 7.1% |
| Plan C | 350,328 | 2.6% |
| All other standardized plans | 742,085 | 5.5% |
State penetration highlights (2023)
Roughly 42% of traditional Medicare beneficiaries nationwide are enrolled in a Medigap policy, but penetration varies dramatically by state.
Highest penetration
- Iowa67%
- Nebraska65%
- Wyoming60%
- Kansas55%
Lowest penetration
- Hawaii9%
- California9%
- New York12%
- District of Columbia12%
States with very low penetration (HI, CA, NY, DC) typically have high Medicare Advantage enrollment and, in some cases, community-rated Medigap markets or restrictive underwriting rules.
Methodology
Enrollment counts are from the NAIC Medicare Supplement Insurance Experience Exhibit (MSIEE), an annual filing every Medigap carrier submits to state insurance regulators. Mark Farrah Associates (MFA) aggregates and publishes the data each spring covering the prior calendar year.
Only rank #1 (UnitedHealthcare / AARP) is explicitly named in the free public MFA/UHC PDF. Names for ranks #2 through #7 are inferred from cross-referencing state DOI filings that name carriers, KFF issue briefs, Gen Re survey participant lists, and industry analyst commentary. Enrollment counts are taken verbatim from the MFA/UHC source; only the carrier label is inferred.
Figures represent covered lives (individual policyholders) as of the snapshot date, not premium dollars. Market share by premium is broadly similar but not identical because average premium per policy varies by carrier mix of Plan F, G, and N.
Sources
Opens the December 2024 Medigap Enrollment and Market Share report (PDF) in a new browser tab.Open MFA / UHC 2024 Market Share PDF(opens in a new tab)- Mark Farrah Associates / UnitedHealthcare — December 2024 Medigap Enrollment & Market Share (PDF)(opens in a new tab)
- Mark Farrah Associates / UHC — December 2023 Medigap Market Share (PDF)(opens in a new tab)
- NAIC — Medicare Supplement Loss Ratio Report (named carriers, all states)(opens in a new tab)
- KFF — Key Facts about Medigap Enrollment and Premiums (2024)(opens in a new tab)
- AHIP — The State of Medicare Supplement Coverage (May 2025)(opens in a new tab)
- North Carolina DOI — 2024 Medicare Supplement Statistical Report (named carriers)(opens in a new tab)