Highmark Health in Pennsylvania: 271,302 Medicare Advantage members, 19.4% share, 2nd of 17.
Highmark Health lost 17,911 members (−6.2%) from Nov 2025 to Oct 2026 and stepped −8.9% at the 2026 election period against the market's −0.9%. It sells in 66 of Pennsylvania’s 67 counties with visible members and leads 15; Aetna (CVS) sits just ahead at 23.5%, UPMC Health System just behind at 15.7%.
Highmark Health'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 Highmark Health'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 66 counties and leads 15 of them.
| County | Highmark Health members | Share of county | County visible members | County leader |
|---|---|---|---|---|
| Allegheny | 48,544 | 28.8% | 168,487 | UPMC Health System |
| Westmoreland | 20,158 | 31.8% | 63,450 | UPMC Health System |
| Lancaster | 18,376 | 31.9% | 57,658 | Highmark Health |
| York | 14,805 | 29.4% | 50,418 | Aetna (CVS) |
| Lehigh | 11,079 | 32.7% | 33,873 | Highmark Health |
Highmark Health 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, +0.35, 1st of 10 rated
market 79%, +14 points
market $7,150, −$200
| # | 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 Highmark Health's plans in Pennsylvania
The fate assigned to each of the carrier’s plans for 2027, joined to the members in it today.
2,892 members are in 1 plan that end and must choose again. 14,785 members move with 2 plans consolidated into another of the carrier’s plans. 16,449 members are in 2 plans that drop at least one county; which counties is not stated. In all, 13% of Highmark Health’s Pennsylvania members are in a plan whose service area or status changes.
The read on Highmark Health 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.
Highmark Health 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.
- Highmark Health is the parent organization Highmark Health; its 41 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.