How is Medicare Advantage developing in Miami-Dade County, Florida?
Miami-Dade County's MA & other health plan share is 75.4% — above the 51.1% national share by 24.3 points, with 394,113 people in a Medicare Advantage or other health plan out of 522,929 Medicare beneficiaries, on the April 2026 CMS county file. It ranks 1 of 67 Florida counties by health plan share.
Why trust this number?
- Metric
- MA & other health plan share
- Value
- 75.4%
- Geography
- Miami-Dade, FL (FIPS 12086)
- Period
- April 2026
- Source
- CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County)
- Numerator
- MA_AND_OTH_BENES — beneficiaries in a Medicare Advantage or other health plan (includes cost plans, PACE and demonstrations) — 394,113 here
- Denominator
- TOT_BENES — all Medicare beneficiaries in the county with Part A and/or Part B — 522,929 here
- Formula
- 394,113 ÷ 522,929 × 100 = 75.4%
- Dataset vintage
- April 2026 (prior year April 2025)
- Last refreshed
- 2026-07-31
- Status
- LIVE
Full methodology · Download the source data · CMS dataset
The denominator counts everyone with Part A and/or Part B, including people with Part A only who cannot enroll in Medicare Advantage. Figures published elsewhere on an eligible-only denominator will read higher. Match the basis before comparing.
All figures on this row are from the April 2026 CMS Medicare Monthly Enrollment county file.
Market structure in Miami-Dade County
| MA and other health plan enrollees | 394,113 |
| Total Medicare beneficiaries | 522,929 |
| MA & other health plan share | 75.4% |
| Dual eligibles | 227,397 (43.5% of Medicare) |
| Full-benefit dual eligibles | 135,765 |
| Market type | Mature (65%+ penetration) |
Every row is from the April 2026 CMS Medicare Monthly Enrollment county file. Carrier counts, the leading carrier and D-SNP share of MA are not shown because this site has no county-level carrier source yet — that needs the CMS CPSC ingest. They previously appeared here from a dataset that has since been withdrawn. Carrier-level enrollment and stars are tracked at the state level.
What changed in the last twelve months
April 2025 file compared with the April 2026 file. Source: CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County).
| Measure | April 2026 | Change | Basis |
|---|---|---|---|
| MA & other health plan enrollment Computed by the pipeline from the two published monthly files. | 394,113 | +2.5% | observed |
| MA & other health plan share A ratio of two published counts, so the change carries both denominators. | 75.4% | +0.1 pp | derived |
| Medicare beneficiaries The county file publishes the current count. It does not publish a prior-year count for this county, and we do not reconstruct one. | 522,929 | not published as a change | observed |
| Dual eligibles Current count from the same file. Same limitation as the line above. | 227,397 (43.5% of Medicare) | not published as a change | observed |
These are observed changes. This panel does not assert why a figure moved: the county file records what happened, not what caused it. A release-over-release view, rather than this twelve-month view, needs the per-vintage metrics store described in docs/backend-architecture.md.
Market Opportunity Score
View score components
| Component | Raw value | Normalized (percentile) | Published weight | Applied weight | Contribution |
|---|---|---|---|---|---|
| Market size | 522,929 beneficiaries | 99.8 | 0.30 | 0.30 | 29.9 |
| Headroom | 24.6% not in MA or other health plans | 2.9 | 0.25 | 0.25 | 0.7 |
| Growth | +0.1 pts | 27.5 | 0.25 | 0.25 | 6.9 |
| Enrollment growth | +2.5% | 47.6 | 0.20 | 0.20 | 9.5 |
| Competition | Not yet available: Market concentration. Needs the CMS Monthly Enrollment by Contract/Plan/State/County (CPSC) file, not yet ingested nationally (loaded for the MA & D-SNP Competitive Lens footprint only). | — | |||
| Carrier diversity | Not yet available: Number of distinct parent organisations competing. Needs the CMS Monthly Enrollment by Contract/Plan/State/County (CPSC) file, not yet ingested nationally (loaded for the MA & D-SNP Competitive Lens footprint only). | — | |||
| Product opportunity | Not yet available: Benefit generosity of plans already sold here. Needs the Landscape and PBP files, not yet ingested nationally (validated for the MA & D-SNP Competitive Lens footprint only). | — | |||
| Quality environment | Not yet available: Star ratings of contracts serving the county. Needs the contract-level Star Ratings files, not yet ingested nationally (contract Overall Star Ratings are loaded for the Competitive Lens footprint only). | — | |||
| Total | Sum of contributions (percentiles shown to 1 decimal) | 47.1 | |||
- Methodology version
- v0.1 · rank-percentile within all US counties, weighted, weights renormalised over available components
- Data vintage
- April 2026 vs April 2025, CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County) (county geography)
- Normalization
- Percentile rank against all 3,199 US counties (ties share the mean rank). Rank-based, so one extreme county cannot flatten the distribution.
- Weighting
- Published weights, renormalised over the components that exist for this county. Components not yet available are listed above, never scored as zero.
- Missing data
- None for this county: every available component is published.
- Limitations
- Not back-tested. No predictive validity, expected enrollment, conversion lift or ROI is claimed. Describes market attractiveness from public CMS counts only; carrier concentration, product and Stars components are not yet included.
Full methodology · Marketing Opportunity Score (MA and D-SNP modes)
So what / Now what Interpretation
Miami-Dade County is a mature market at 75.4% MA & other health plan share — expansion means winning members from incumbent MA plans on benefits, network and brand.
- Compare to the rest of Florida on the state page; with D-SNP at 31% of MA, review D-SNP deployment gaps
- Check 2026 plan exits for orphaned membership contestable in Florida.
- Sales teams: rank this market on health-plan share headroom and momentum in the county explorer, and see which competitive facts apply on the carrier battlecards.
Neighboring Florida counties
Provenance — MA & other health plan share, April 2026
- Source file
- CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County)
- Vintage
- April 2026 (prior year April 2025)
- Ingested
- 2026-07-31
- Refresh cadence
- Monthly, following the CMS Medicare Monthly Enrollment release (CCW-derived, roughly three months in arrears)
- Method
- penetration_pct = MA_AND_OTH_BENES / TOT_BENES * 100, rounded to 1 decimal
- Coverage
- All 3199 US counties
- Known limitations
- The denominator includes beneficiaries with Part A only, who cannot enroll in Medicare Advantage. Figures that use an eligible-only denominator will be higher. This file does not carry carrier, plan or star-rating detail. Any such figure needs the CPSC ingest, which is not yet built.