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    Medicare Advantage · Puerto Rico · enrollment Oct 2026

    Medicare Advantage in Puerto Rico: 572,929 members, 3 carriers, MHH Healthcare, L.P. in front.

    MHH Healthcare, L.P. holds 57.3% of Puerto Rico’s visible Medicare Advantage members, ahead of Elevance at 28.2% and Guidewell Mutual Holding Corporation at 14.6%. The market shrank −0.2% (−1,102 members) from Nov 2025 to Oct 2026 and stepped −1.6% at the 2026 election period. 85.2% of the state's Medicare beneficiaries are in a Medicare Advantage plan.

    Visible members
    572,929
    Oct 2026
    Carriers
    3
    43 plans with members
    MA penetration
    85.2%
    of 802,858 eligible
    Twelve months
    −0.2%
    −1,102 members
    Election step
    −1.6%
    December to January 2026
    Top three
    100.0%
    HHI 4,286, highly concentrated

    Every carrier with members in Puerto Rico

    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. MHH Healthcare, L.P. leads 68 of the 78 counties with a lead. At the election period MHH Healthcare, L.P. stepped up most (+2.7%) and Elevance stepped down most (−3.9%).

    #CarrierMembersShareTwelve monthsElection stepCounties ledRating$0 premiumPlans
    1MHH Healthcare, L.P.328,101
    57.3%
    		+7.7%+2.7%68 of 785.00100%17
    2Elevance161,367
    28.2%
    		−7.8%−3.9%10 of 784.50100%16
    3Guidewell Mutual Holding Corporation83,461
    14.6%
    		+2.9%+1.3%0 of 774.99100%10

    Puerto Rico county by county

    78 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
    San Juan46,2013MHH Healthcare, L.P.55.1%72.9%446
    Bayamon30,2133MHH Healthcare, L.P.53.0%85.2%213
    Ponce27,1443MHH Healthcare, L.P.43.6%83.9%224
    Carolina22,9573MHH Healthcare, L.P.54.7%90.9%212
    Caguas21,6013MHH Healthcare, L.P.64.4%84.3%180
    Arecibo18,4293MHH Healthcare, L.P.52.4%86.4%175
    Mayaguez14,7893MHH Healthcare, L.P.71.3%87.5%124
    Guaynabo12,4843MHH Healthcare, L.P.54.7%79.6%72
    Toa Baja12,1373MHH Healthcare, L.P.59.7%87.8%125
    Humacao10,8683MHH Healthcare, L.P.79.8%82.8%106
    Vega Baja10,4343MHH Healthcare, L.P.61.2%100.0%99
    Aguadilla10,4323MHH Healthcare, L.P.72.7%85.0%101
    Toa Alta9,5083MHH Healthcare, L.P.59.9%88.2%78
    San Sebastian8,9443MHH Healthcare, L.P.72.6%89.1%81
    Cayey8,5933MHH Healthcare, L.P.46.1%83.9%61
    Isabela8,4573MHH Healthcare, L.P.67.5%88.9%84
    Cabo Rojo8,3743MHH Healthcare, L.P.58.0%86.4%60
    Aguada8,1713MHH Healthcare, L.P.85.3%89.1%77
    Manati8,0993MHH Healthcare, L.P.54.6%90.7%87
    Trujillo Alto8,0613MHH Healthcare, L.P.57.2%92.7%56
    Rio Grande7,7903MHH Healthcare, L.P.58.3%97.7%87
    Juana Diaz7,4883MHH Healthcare, L.P.39.8%91.8%106
    Yauco7,2693MHH Healthcare, L.P.57.4%87.9%59
    Moca7,2453MHH Healthcare, L.P.75.8%91.8%69
    Yabucoa7,1243MHH Healthcare, L.P.74.3%85.8%74
    Canovanas7,1143MHH Healthcare, L.P.55.3%87.3%90
    San Lorenzo7,0393MHH Healthcare, L.P.76.5%87.8%78
    Cidra6,9103MHH Healthcare, L.P.56.5%88.8%68
    Las Piedras6,8493MHH Healthcare, L.P.83.9%93.0%67
    Hatillo6,7163MHH Healthcare, L.P.45.9%88.6%59
    Vega Alta6,6863MHH Healthcare, L.P.64.8%76.3%83
    Guayama6,5723Elevance49.9%100.0%93
    Juncos6,5473MHH Healthcare, L.P.74.8%86.3%74
    Camuy6,4563MHH Healthcare, L.P.49.3%80.3%56
    Coamo6,1013Elevance41.8%84.8%78
    Gurabo6,0983MHH Healthcare, L.P.72.3%88.6%53
    San German5,9493MHH Healthcare, L.P.68.0%88.6%46
    Corozal5,8783MHH Healthcare, L.P.65.3%88.1%54
    Dorado5,6233MHH Healthcare, L.P.59.7%87.3%59
    Anasco5,5033MHH Healthcare, L.P.73.8%84.1%40
    Lares5,4753MHH Healthcare, L.P.45.8%78.6%50
    Morovis5,4413MHH Healthcare, L.P.58.5%89.7%43
    Fajardo5,3483MHH Healthcare, L.P.59.0%87.2%70
    Salinas5,2343Elevance43.8%89.4%84
    Utuado5,2273MHH Healthcare, L.P.43.0%85.9%58
    Aibonito5,2023Elevance67.7%85.7%32
    Quebradillas5,0623MHH Healthcare, L.P.62.3%85.5%48
    Naranjito4,7853MHH Healthcare, L.P.60.0%81.6%31
    Sabana Grande4,6233MHH Healthcare, L.P.66.0%87.2%41
    Barceloneta4,4143MHH Healthcare, L.P.54.2%85.2%38
    Lajas4,3603MHH Healthcare, L.P.67.1%86.0%56
    Barranquitas4,2783Elevance65.7%82.5%29
    Villalba4,2543MHH Healthcare, L.P.40.0%82.7%31
    Aguas Buenas4,2213MHH Healthcare, L.P.59.0%84.7%33
    Orocovis4,0373Elevance56.4%83.7%41
    Naguabo3,9593MHH Healthcare, L.P.65.1%84.2%51
    Penuelas3,9353MHH Healthcare, L.P.38.6%88.0%27
    Ciales3,8433MHH Healthcare, L.P.51.9%82.8%27
    Patillas3,6943Elevance57.8%84.2%41
    Guayanilla3,6843MHH Healthcare, L.P.41.1%65.6%40
    Hormigueros3,3313MHH Healthcare, L.P.65.2%87.3%22
    Santa Isabel3,3143Elevance43.4%84.3%37
    Arroyo3,1983Elevance59.1%87.9%53
    Catano3,1743MHH Healthcare, L.P.56.5%84.3%41
    Rincon3,0343MHH Healthcare, L.P.73.7%85.6%36
    Guanica2,9563MHH Healthcare, L.P.55.0%85.0%49
    Comerio2,8943MHH Healthcare, L.P.62.1%84.5%29
    Luquillo2,8863MHH Healthcare, L.P.58.5%83.0%33
    Florida2,8373MHH Healthcare, L.P.59.5%78.8%26
    Adjuntas2,7383MHH Healthcare, L.P.41.6%80.0%17
    Loiza2,5553MHH Healthcare, L.P.49.7%86.0%41
    Jayuya2,5433MHH Healthcare, L.P.51.6%81.7%24
    Maunabo2,3123Elevance47.1%83.8%33
    Ceiba1,9363MHH Healthcare, L.P.48.2%83.7%23
    Las Marias1,4853MHH Healthcare, L.P.72.8%100.0%–
    Vieques9133MHH Healthcare, L.P.69.7%72.5%23
    Maricao7553MHH Healthcare, L.P.76.0%77.9%–
    Culebra1392MHH Healthcare, L.P.92.1%76.6%–

    Puerto Rico's twelve months

    Visible Medicare Advantage members in Puerto Rico 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 · 574,031Oct 2026 · 572,929

    What 2027 does to Puerto Rico

    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
    0

    members in Puerto Rico are in plans that end for 2027.

    Plans dropping counties
    0

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

    The plans on sale in Puerto Rico 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
    100%

    of members are in a plan with no monthly premium

    In-network maximum
    $3,400

    median out-of-pocket maximum, member weighted

    Star Rating
    4.86

    2027 overall, member weighted

    Carrier Command · for Medicare Advantage plans

    The read on every carrier in Puerto Rico is in Carrier Command.

    A monthly position page for each of the 3 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.

    MHH Healthcare, L.P. in every state · Elevance in every state · Guidewell Mutual Holding Corporation 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 Puerto Rico.
    • A carrier is a parent organization; its brands in Puerto Rico may carry other names. The rank 1st to 3rd 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.