CAPITAL BLUE CROSS in Pennsylvania: 48,437 Medicare Advantage members, 3.5% share, 8th of 17.
CAPITAL BLUE CROSS added 15,767 members (+48.3%) from Nov 2025 to Oct 2026 and stepped +40.8% at the 2026 election period against the market's −0.9%. It sells in 21 of Pennsylvania’s 67 counties with visible members and leads 0; Humana sits just ahead at 6.6%, Health Care Service Corporation just behind at 2.6%.
CAPITAL BLUE CROSS's twelve months in Pennsylvania
Visible members each month, Nov 2025 to Oct 2026. The December-to-January step is the election period. The market line for the state is on the Pennsylvania page.
Where CAPITAL BLUE CROSS's Pennsylvania members are
The carrier’s five largest counties by visible members, with its share of each county’s visible Medicare Advantage members. It sells in 21 counties and leads 0 of them.
| County | CAPITAL BLUE CROSS members | Share of county | County visible members | County leader |
|---|---|---|---|---|
| Northampton | 5,922 | 20.8% | 28,448 | Highmark Health |
| Berks | 5,738 | 14.9% | 38,426 | Highmark Health |
| Lehigh | 5,488 | 16.2% | 33,873 | Highmark Health |
| York | 4,647 | 9.2% | 50,418 | Aetna (CVS) |
| Franklin | 4,043 | 28.1% | 14,374 | Aetna (CVS) |
CAPITAL BLUE CROSS against the Pennsylvania market
The carrier’s figures beside the state’s, each weighted by members. A difference is a difference, not a grade: a higher maximum or a lower rating is a design and a result, read in context.
top three hold 58.6%
market 4.00, +0.00, 3rd of 10 rated
market 79%, +3 points
market $7,150, −$350
| # | Carrier | Members | Share | Twelve months | Election step | Counties led | Rating | $0 premium |
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna (CVS) | 328,628 | 23.5% | +1.9% | +1.1% | 14 of 67 | 3.88 | 72% |
| 2 | Highmark Health | 271,302 | 19.4% | −6.2% | −8.9% | 15 of 66 | 4.35 | 93% |
| 3 | UPMC Health System | 220,116 | 15.7% | −1.0% | −3.0% | 14 of 64 | 4.32 | 47% |
| 4 | Independence Health Group, Inc. | 130,194 | 9.3% | −7.4% | −8.5% | 5 of 63 | 3.91 | 83% |
| 5 | UnitedHealth | 115,916 | 8.3% | +1.4% | −2.1% | 1 of 65 | 3.76 | 86% |
| 6 | Risant Health, Inc. | 95,418 | 6.8% | +0.9% | −3.4% | 17 of 46 | 4.00 | 63% |
| 7 | Humana | 92,426 | 6.6% | +17.5% | +12.0% | 1 of 67 | 4.00 | 100% |
| 8 | CAPITAL BLUE CROSS | 48,437 | 3.5% | +48.3% | +40.8% | 0 of 21 | 4.00 | 82% |
| 9 | Health Care Service Corporation | 36,116 | 2.6% | −3.4% | −4.5% | 0 of 26 | 3.00 | 84% |
| 10 | Thomas Jefferson University | 28,035 | 2.0% | +72.0% | +43.9% | 0 of 19 | 3.00 | 100% |
What 2027 does to CAPITAL BLUE CROSS's plans in Pennsylvania
The fate assigned to each of the carrier’s plans for 2027, joined to the members in it today.
22,921 members are in 2 plans that drop at least one county; which counties is not stated. In all, 47% of CAPITAL BLUE CROSS’s Pennsylvania members are in a plan whose service area or status changes.
The read on CAPITAL BLUE CROSS in Pennsylvania is in Carrier Command.
Risk and rebate against the market, the five-test read on coding versus selection, Stars levers and next year's cut points, the election-period forecast and the county-by-county standing, written as a monthly page.
CAPITAL BLUE CROSS elsewhere, and the rest of Pennsylvania
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.
- CAPITAL BLUE CROSS is the parent organization CAPITAL BLUE CROSS; its 10 plans in Pennsylvania may sell under other brand names. The rating is the 2027 overall Star Rating of its contracts weighted by members in Pennsylvania; $0 premium and the in-network maximum are the 2027 filings weighted by members today.
- Plan fates are the ones assigned for contract year 2027.
- 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.