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    FreeTwo 2027 reports
    Medicare Advantage · Iowa · enrollment Oct 2026

    Medicare Advantage in Iowa: 225,576 members, 13 carriers, Aetna (CVS) in front.

    Aetna (CVS) holds 34.4% of Iowa’s visible Medicare Advantage members, ahead of UnitedHealth at 24.7% and Blue Cross Blue Shield of Michigan Mutual Ins. Co. at 14.6%. The market grew +0.8% (+1,765 members) from Nov 2025 to Oct 2026 and stepped −1.9% at the 2026 election period. 37.6% of the state's Medicare beneficiaries are in a Medicare Advantage plan.

    Visible members
    225,576
    Oct 2026
    Carriers
    13
    53 plans with members
    MA penetration
    37.6%
    of 713,920 eligible
    Twelve months
    +0.8%
    +1,765 members
    Election step
    −1.9%
    December to January 2026
    Top three
    73.7%
    HHI 2,258, moderately concentrated

    Every carrier with members in Iowa

    Ranked by visible members in Oct 2026. The twelve-month change runs Nov 2025 to Oct 2026; the election step is the carrier’s own December-to-January change. Counties led counts counties where the carrier has the most visible members and at least one other carrier is visible. Aetna (CVS) leads 60 of the 99 counties with a lead. At the election period Centene stepped up most (+252.3%) and UnitedHealth stepped down most (−35.5%).

    #CarrierMembersShareTwelve monthsElection stepCounties ledRating$0 premiumPlans
    1Aetna (CVS)77,670
    34.4%
    		+24.5%+17.4%60 of 924.0095%8
    2UnitedHealth55,635
    24.7%
    		−38.5%−35.5%15 of 903.7370%10
    3Blue Cross Blue Shield of Michigan Mutual Ins. Co.ends every plan for 202733,015
    14.6%
    		−1.9%−5.2%14 of 82––2
    4Humana32,310
    14.3%
    		+42.5%+30.6%6 of 944.15100%7
    5Centene12,294
    5.5%
    		+250.2%+252.3%0 of 712.50100%4
    6Trinity Health Corporation7,804
    3.5%
    		+123.5%+112.0%3 of 393.2499%5
    7Elevance3,692
    1.6%
    		−30.7%−21.2%1 of 683.50100%2
    8Mitchell Family Office1,398
    0.6%
    		+17.6%−0.2%0 of 514.50100%1
    9Molina867
    0.4%
    		––0 of 123.50–2
    10Devoted321
    0.1%
    		––0 of 34.50100%3
    11University of Wisconsin Hospitals and Clincs Autho208
    0.1%
    		−23.8%−16.5%0 of 24.006%4
    12Medica Holding Company184
    0.1%
    		+8.2%+17.8%0 of 34.00–3
    13Sanford Health178
    0.1%
    		+173.8%+126.8%0 of 34.00–2

    Iowa county by county

    99 counties with visible members, largest first. A county’s leader is the carrier with the most visible members there; a county with one visible carrier shows no leader, because the others are suppressed, not absent. Penetration is Medicare Advantage members as a share of the county’s Medicare beneficiaries.

    CountyVisible membersCarriersLeaderLeader shareMA penetrationDual eligibles
    Polk37,6909UnitedHealth36.1%44.3%12,228
    Linn21,8938Aetna (CVS)43.9%48.3%5,911
    Scott15,6139Aetna (CVS)47.7%48.1%4,836
    Black Hawk10,6327Aetna (CVS)33.4%49.5%4,427
    Pottawattamie9,19010UnitedHealth42.7%45.8%3,384
    Woodbury8,7708Aetna (CVS)54.8%45.3%3,398
    Johnson7,8318Aetna (CVS)38.4%32.8%2,886
    Dallas5,9188Aetna (CVS)37.5%37.5%1,342
    Warren4,5448UnitedHealth35.6%42.4%941
    Clinton4,5158Aetna (CVS)40.1%43.2%1,594
    Story4,0226UnitedHealth45.7%27.2%1,442
    Jasper3,6768UnitedHealth34.1%42.2%1,128
    Marshall3,6747UnitedHealth37.1%41.7%1,399
    Muscatine3,1289Aetna (CVS)36.3%37.5%1,313
    Cerro Gordo3,0436Trinity Health Corporation25.5%27.7%1,568
    Des Moines3,0257UnitedHealth32.6%31.3%1,414
    Wapello2,7486Aetna (CVS)31.4%43.6%1,449
    Webster2,7145Aetna (CVS)37.3%33.9%1,253
    Marion2,5228Aetna (CVS)26.4%34.0%793
    Benton2,2737Aetna (CVS)42.6%39.1%588
    Jones2,1367Aetna (CVS)37.8%45.6%481
    Jefferson2,1286Humana27.2%45.5%670
    Lee2,0157Humana32.9%24.2%1,287
    Boone2,0008Aetna (CVS)25.9%33.8%599
    Dubuque1,9454Elevance45.5%60.9%2,523
    Mahaska1,7918Humana25.0%37.1%706
    Washington1,7006Aetna (CVS)30.7%33.0%577
    Plymouth1,5185Aetna (CVS)55.9%28.1%483
    Buchanan1,4897Aetna (CVS)37.8%40.3%514
    Cedar1,4556Aetna (CVS)43.2%36.1%340
    Tama1,4348Aetna (CVS)42.8%39.4%379
    Fayette1,4198Aetna (CVS)39.8%32.3%713
    Madison1,3966UnitedHealth35.6%42.2%310
    Iowa1,3555Aetna (CVS)44.5%34.4%320
    Appanoose1,3498Trinity Health Corporation24.5%41.8%572
    Bremer1,3465Aetna (CVS)59.6%33.7%370
    Hardin1,2618Blue Cross Blue Shield of Michigan Mutual Ins. Co.25.7%30.2%488
    Delaware1,2496Aetna (CVS)40.0%36.8%365
    Poweshiek1,2374Aetna (CVS)40.2%31.1%396
    Henry1,2307UnitedHealth29.7%28.0%591
    Jackson1,1267Aetna (CVS)31.3%47.7%673
    Mills1,0776Aetna (CVS)32.5%34.5%296
    Carroll1,0576Aetna (CVS)45.9%20.5%602
    Page1,0086Aetna (CVS)36.5%26.7%646
    Harrison9829UnitedHealth26.4%30.3%452
    Butler9747Aetna (CVS)33.2%32.9%329
    Guthrie9635Aetna (CVS)67.7%33.4%307
    Clayton9448Aetna (CVS)36.6%34.9%507
    Dickinson9346Blue Cross Blue Shield of Michigan Mutual Ins. Co.56.1%18.8%383
    Floyd9247UnitedHealth30.9%28.5%575
    Grundy8945Aetna (CVS)38.7%37.2%233
    Monona8796Aetna (CVS)42.4%37.5%317
    Cass8516UnitedHealth39.1%24.8%542
    Keokuk8385Humana25.1%36.0%271
    Greene8375Aetna (CVS)46.5%36.0%266
    Hamilton8197Aetna (CVS)31.1%25.3%379
    Union8065Aetna (CVS)45.3%28.1%473
    Crawford8016Aetna (CVS)35.5%23.5%450
    Clarke8006Blue Cross Blue Shield of Michigan Mutual Ins. Co.52.5%40.8%294
    Montgomery7907Aetna (CVS)29.8%31.3%396
    Louisa7875Humana26.8%34.9%288
    Buena Vista7605Humana31.4%20.3%497
    Lucas7307Aetna (CVS)37.5%35.1%322
    Clay7145Blue Cross Blue Shield of Michigan Mutual Ins. Co.37.1%19.2%509
    Allamakee7075Aetna (CVS)46.4%23.0%339
    Shelby7076Aetna (CVS)45.7%23.7%370
    Wright6486Aetna (CVS)34.0%23.6%305
    Winneshiek6376Aetna (CVS)53.7%14.5%364
    Cherokee6286Blue Cross Blue Shield of Michigan Mutual Ins. Co.33.4%21.6%303
    Calhoun6166Aetna (CVS)39.1%25.4%323
    Sioux6146Aetna (CVS)44.8%11.8%531
    Kossuth6086UnitedHealth29.4%16.8%388
    Decatur5967Aetna (CVS)31.4%35.0%327
    Van Buren5595Aetna (CVS)41.0%32.4%271
    O'Brien5486Blue Cross Blue Shield of Michigan Mutual Ins. Co.36.5%17.5%356
    Chickasaw5476Aetna (CVS)48.4%24.1%229
    Winnebago5316Trinity Health Corporation26.6%23.2%245
    Wayne5097Aetna (CVS)24.4%33.0%232
    Monroe4917Blue Cross Blue Shield of Michigan Mutual Ins. Co.24.4%33.2%233
    Humboldt4474UnitedHealth35.6%21.7%228
    Davis4374Aetna (CVS)50.1%30.4%194
    Fremont4315Aetna (CVS)47.1%27.0%180
    Adair4205Aetna (CVS)53.3%26.7%185
    Pocahontas4165Aetna (CVS)32.7%24.9%220
    Sac3775Aetna (CVS)37.9%16.7%239
    Emmet3725Blue Cross Blue Shield of Michigan Mutual Ins. Co.40.3%17.6%232
    Howard3674Blue Cross Blue Shield of Michigan Mutual Ins. Co.62.9%18.8%225
    Franklin3626Blue Cross Blue Shield of Michigan Mutual Ins. Co.31.8%19.4%210
    Hancock3616UnitedHealth27.7%18.1%212
    Worth3426Blue Cross Blue Shield of Michigan Mutual Ins. Co.27.8%25.2%165
    Mitchell3352Blue Cross Blue Shield of Michigan Mutual Ins. Co.83.9%17.9%220
    Ida3215Aetna (CVS)50.2%21.1%168
    Palo Alto3054Blue Cross Blue Shield of Michigan Mutual Ins. Co.43.6%14.7%306
    Lyon2623Aetna (CVS)64.9%20.3%149
    Audubon2605Aetna (CVS)38.5%19.5%163
    Taylor2345Aetna (CVS)55.6%17.0%178
    Ringgold1985Aetna (CVS)37.9%20.6%174
    Osceola1323Blue Cross Blue Shield of Michigan Mutual Ins. Co.64.4%18.7%135
    Adams824Aetna (CVS)37.8%16.6%157

    Iowa's twelve months

    Visible Medicare Advantage members in Iowa each month, Nov 2025 to Oct 2026. The December-to-January step is the election period; the rest of the year moves on new eligibles, special enrollment and deaths.

    Nov 2025 · 223,811Oct 2026 · 225,576

    What 2027 does to Iowa

    The fate assigned to every plan for 2027, joined to the members in it today. A plan that ends sends its members to choose again; a plan dropping counties keeps the plan but not every county, and which counties is not stated.

    Plans that end
    44,674

    members in Iowa are in plans that end for 2027; Blue Cross Blue Shield of Michigan Mutual Ins. Co. ends every plan in the state.

    • Blue Cross Blue Shield of Michigan Mutual Ins. Co. · every plan33,015
    • UnitedHealth7,013
    • Humana4,284
    • Medica Holding Company184
    • Sanford Health178
    Plans dropping counties
    101,112

    members are in plans that keep selling in Iowa but drop at least one county for 2027.

    • Aetna (CVS) · 6 plans56,866
    • Humana · 6 plans28,026
    • Centene · 4 plans12,294
    • UnitedHealth · 4 plans3,926

    The plans on sale in Iowa for 2027

    Benefit design weighted by each plan’s members today, so a figure is what the market’s members are offered, not a count of plans. The rating is the 2027 overall Star Rating, weighted the same way.

    $0 premium
    90%

    of members are in a plan with no monthly premium

    In-network maximum
    $5,900

    median out-of-pocket maximum, member weighted

    Star Rating
    3.81

    2027 overall, member weighted

    Carrier Command · for Medicare Advantage plans

    The read on every carrier in Iowa is in Carrier Command.

    A monthly position page for each of the 13 carriers here: risk and rebate against the market, Stars levers, the election-period forecast, county standing and the written read. Launching for Medicare Advantage plans.

    Request early access See Carrier Command

    Other states

    Every state has its own page; the largest carriers have one nationally.

    Aetna (CVS) in every state · UnitedHealth in every state · Blue Cross Blue Shield of Michigan Mutual Ins. Co. in every state · All states and carriers

    How these numbers are made

    • Members are visible members: CMS suppresses any plan-county cell of ten or fewer, so small counties undercount. Market share excludes employer group plans.
    • Enrollment is Oct 2026; the twelve months run Nov 2025 to Oct 2026; the election step compares December 2025 with January 2026.
    • Plan fates are the ones assigned for contract year 2027; benefit design is the 2027 filing; the rating is the 2027 overall Star Rating of each carrier's contracts, weighted by members in Iowa.
    • A carrier is a parent organization; its brands in Iowa may carry other names. The rank 1st to 13th counts every parent with visible members in 2026.
    • Every figure comes from public CMS data as Livmor reads it, and the page is rebuilt when a new month posts. Livmor Carrier Command, public CMS data.