How is Medicare Advantage developing in Wake County, North Carolina?
Wake County's MA & other health plan share is 52.3% — above the 51.1% national share by 1.2 points, with 100,511 people in a Medicare Advantage or other health plan out of 192,017 Medicare beneficiaries, on the June 2026 CMS county file. It ranks 70 of 100 North Carolina counties by health plan share.
Source & formula — why trust this number?
- Metric
- MA & other health plan share
- Value
- 52.3%
- Geography
- Wake, NC (FIPS 37183)
- Period
- June 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) — 100,511 here
- Denominator
- TOT_BENES — all Medicare beneficiaries in the county with Part A and/or Part B — 192,017 here
- Formula
- 100,511 ÷ 192,017 × 100 = 52.3%
- Dataset vintage
- June 2026 (prior year June 2025)
- Last refreshed
- 2026-09-26
- 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.
Part A and B basis: source & formula — why trust this number?
- Metric
- MA & other health plan share, Part A and B basis
- Value
- 57.1%
- Geography
- Wake County, NC
- Period
- June 2026
- Source
- CMS Medicare Monthly Enrollment (County record)
- Numerator
- A_B_MA_AND_OTH_BENES — beneficiaries with both Part A and Part B who are in a Medicare Advantage or other health plan — 100,494 here
- Denominator
- A_B_TOT_BENES — beneficiaries with both Part A and Part B — 176,065 here
- Formula
- 100,494 ÷ 176,065 × 100 = 57.1%
- Status
- LIVE
All figures on this row are from the June 2026 CMS Medicare Monthly Enrollment county file.
Market 360. Open this county in Market 360: market, competitors, plans and benefits, D-SNP, Stars and what changed on one page.
Compare the plans offered here. Plan Compare sets any Medicare Advantage or D-SNP plan in this county against its competitors on premium, giveback, MOOP, copays and supplemental benefits.
Market structure in Wake County
| MA and other health plan enrollees | 100,511 |
| Total Medicare beneficiaries | 192,017 |
| MA & other health plan share | 52.3% |
| Dual eligibles | 18,685 (9.7% of Medicare) |
| Full-benefit dual eligibles | 15,051 |
| MA & other health plan share band | 50% to under 65% |
Every row is from the June 2026 CMS Medicare Monthly Enrollment county file. Carrier counts, the leading carrier and D-SNP share of MA are in the carrier and plan competition section below (CMS CPSC, September 2026). 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
June 2025 file compared with the June 2026 file. Source: CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County).
| Measure | June 2026 | Change | Basis |
|---|---|---|---|
| MA & other health plan enrollment Computed by the pipeline from the two published monthly files. | 100,511 | +3.7% | Verified |
| MA & other health plan share A ratio of two published counts, so the change carries both denominators. | 52.3% | +0.3 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. | 192,017 | not published as a change | Verified |
| Dual eligibles Current count from the same file. Same limitation as the line above. | 18,685 (9.7% of Medicare) | not published as a change | Verified |
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.
2027 plan changes in Wake County, NC Verified
Source: CMS MA & Part D Landscape 202610 | CY2027 vs CY2026 | CMS updated Oct 18, 2026 | Ingested Oct 26, 2026 | Unit: Contract-Plan, plan-county offerings | Method: landscape comparison, definitions
Carriers entering: none.
Carriers leaving: Health Care Service Corporation.
Plans entering (in 2027 landscape, not in 2026) (5)
| Plan | Plan name | Carrier | Type / SNP |
|---|---|---|---|
H1036-137 | Humana Gold Plus H1036-137 (HMO-POS) | Humana Inc. | HMO-POS |
H1036-343 | Humana Gold Plus Giveback H1036-343 (HMO-POS) | Humana Inc. | HMO-POS |
H5253-216 | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | UnitedHealth Group, Inc. | Dual-Eligible |
H5253-217 | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | UnitedHealth Group, Inc. | Dual-Eligible |
H6345-003 | PruittHealth Premier (HMO I-SNP) | UNICO Services, Inc. | Institutional |
Plans leaving (in 2026 landscape, not in 2027) (19)
| Plan | Plan name | Carrier | Type / SNP |
|---|---|---|---|
H1914-010 | Wellcare Giveback Open (PPO) | Centene Corporation | PPO |
H2001-084 | AARP Medicare Advantage Access from UHC NC-23 (PPO) | UnitedHealth Group, Inc. | PPO |
H3146-021 | Aetna Medicare Signature Care (HMO) | CVS Health Corporation | HMO |
H3449-026 | Blue Medicare Choice (HMO) | CuraCor Solutions Corp. | HMO |
H3777-002 | Experience Health Medicare Advantage (HMO) | CuraCor Solutions Corp. | HMO |
H4073-002 | Wellcare Dual Access (HMO-POS D-SNP) | Centene Corporation | Dual-Eligible |
H5253-041 | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | UnitedHealth Group, Inc. | Dual-Eligible |
H5253-184 | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | UnitedHealth Group, Inc. | Dual-Eligible |
H5296-003 | Alignment Health Platinum (HMO) | Alignment Healthcare USA, LLC | HMO |
H5525-050 | HumanaChoice H5525-050 (PPO) | Humana Inc. | PPO |
H5525-083 | HumanaChoice H5525-083 (PPO) | Humana Inc. | PPO |
H7849-113 | HealthSpring True Choice (PPO) | Health Care Service Corporation | PPO |
H9725-003 | HealthSpring TotalCare (HMO D-SNP) | Health Care Service Corporation | Dual-Eligible |
H9725-005 | HealthSpring Courage (HMO) | Health Care Service Corporation | HMO |
H9725-009 | HealthSpring Preferred (HMO) | Health Care Service Corporation | HMO |
H9725-013 | HealthSpring TotalCare Plus (HMO D-SNP) | Health Care Service Corporation | Dual-Eligible |
H9725-014 | HealthSpring Preferred Select (HMO) | Health Care Service Corporation | HMO |
H9725-015 | HealthSpring Preferred Savings (HMO) | Health Care Service Corporation | HMO |
H9725-017 | HealthSpring Preferred Plus (HMO) | Health Care Service Corporation | HMO |
“Leaving” means present in the CY2026 landscape and absent in the CY2027 landscape for this geography. It is not an official termination: a plan can leave a county through a service-area reduction or be renumbered. Only a CMS crosswalk or non-renewal file says why.
Source & method
- Geography
- Wake County, NC
- Source
- CMS Medicare Advantage and Part D Landscape files: CY2027 Landscape 202610 (ReadMe 2026-10-18) and CY2026 Landscape 202609; CY2027 data last updated by CMS October 18, 2026; ingested October 26, 2026
- Plan
- Plans = distinct Contract-Plan IDs (contract + PBP; segments folded in) among MA, MA-PD, SNP and 1876 cost plans. CMS fact sheets count Contract-Plan-Segments and exclude cost plans. PDPs are counted by state and PDP region.
- $0 premium
- $0 premium (any plan) counts MA-only and cost plans with no Part D premium as $0; $0 MA-PD counts only MA-PD plans (no SNPs) with a $0 Part C + D premium.
- Averages
- Average across plan-county offerings: the mean over every contract-plan-segment offered in each county, not weighted by enrollment. CMS publishes enrollment-weighted averages. The landscape carries no enrollment, so they are not what members pay on average.
- Entering / leaving
- “Leaving” means present in the CY2026 landscape and absent in the CY2027 landscape for this geography. It is not an official termination: a plan can leave a county through a service-area reduction or be renumbered. Only a CMS crosswalk or non-renewal file says why.
- Status
- LIVE
Carrier and plan competition in Wake County Verified
Source & formula
- Source
- CMS Monthly Enrollment by Contract/Plan/State/County (CPSC), September 2026 · data
- Carriers
- Distinct parent organisations (MedicareInsights carrier map over CMS
Parent Organization) with at least one non-suppressed plan-county cell - Leading carrier share
- Carrier MA enrollment ÷ reported MA enrollment in the county (suppressed cells excluded from both)
- Suppression
- 850 plan-county cells in this geography were suppressed by CMS (10 or fewer enrollees each). They are excluded from totals and shares; together they could hide at most 8,500 enrollees.
- Status
- LIVE
Which carriers and plans hold Medicare Advantage enrollment here, how concentrated the market is, with drill-down from carrier to contract and plan.
Open competition for Wake County →
Source: CMS Monthly Enrollment by Contract/Plan/State/County, September 2026. Shares there are of MA enrollment, not of all Medicare beneficiaries, so they are not comparable with the health plan share above.
Market Screening Profile
A descriptive profile of this county from four published CMS county measures, each ranked against every US county. It is a screening aid, not a forecast. A low MA & other health plan share alone does not mean members there are available to enroll: competition, product, Stars and network are not in the composite.
View the components and how the composite is built
| Component | Raw value | Normalized (percentile) | Published weight | Applied weight | Contribution |
|---|---|---|---|---|---|
| Market size | 192,017 beneficiaries | 98.5 | 0.30 | 0.30 | 29.5 |
| Lower MA & other health plan share | 47.7% Original Medicare share | 39.0 | 0.25 | 0.25 | 9.8 |
| Growth | +0.3 pts | 37.7 | 0.25 | 0.25 | 9.4 |
| Enrollment growth | +3.7% | 76.3 | 0.20 | 0.20 | 15.3 |
| Competition | Not yet available: Market concentration. Proposed component, not included in method v0.1. The CMS CPSC file is ingested nationally (September 2026) and shown on each county page; adding it to the score would be a method change and a new version. | — | |||
| Carrier diversity | Not yet available: Number of distinct parent organisations competing. Proposed component, not included in method v0.1. The CMS CPSC file is ingested nationally (September 2026) and shown on each county page; adding it to the score would be a method change and a new version. | — | |||
| Product opportunity | Not yet available: Benefit generosity of plans already sold here. Proposed component, not included in method v0.1. National CMS PBP benefit files (plan years 2025 to 2027) and the CY2026 and CY2027 Landscape are loaded; a benefit-generosity measure has not been defined or validated. | — | |||
| Quality environment | Not scored: Star ratings of contracts serving the county. Not part of the published score method (v0.1), so not scored. Contract-level Star Ratings for the 2022-2027 rating years are on /stars/contracts/, and Market 360 shows the 2027 and 2026 ratings of the contracts with members in this county; assigning ratings to a county score is a method change, not yet made. | — | |||
| Total | Sum of contributions (percentiles shown to 1 decimal) | 64.0 | |||
What each component measures
- Market size
- Total Medicare beneficiaries in the county. A large book is worth more than a fast one. Direction: a higher value raises the composite. Weight 0.30. Vintage: June 2026 vs June 2025.
- Lower MA & other health plan share
- Percentile of the county's Original Medicare share (100% minus MA & other health plan share, CMS Medicare Monthly Enrollment). A higher percentile means a lower MA & other health plan share. It is not a count of beneficiaries available to enroll: the remainder includes people with Part A only, who cannot join MA, and people who choose Original Medicare. Direction: a higher value raises the composite. Weight 0.25. Vintage: June 2026 vs June 2025.
- Growth
- Change in MA & other health plan share over the last twelve months, in percentage points. Direction: a higher value raises the composite. Weight 0.25. Vintage: June 2026 vs June 2025.
- Enrollment growth
- Year-over-year change in MA & other health plan enrollment (CMS Medicare Monthly Enrollment). Direction: a higher value raises the composite. Weight 0.20. Vintage: June 2026 vs June 2025.
Proposed components not included in method v0.1 are listed above. They are left out and the weights renormalised; they are never scored as zero. Labels version 2026-10-03 (labels only; v0.1 arithmetic, weights and band cut-points unchanged).
- Methodology version
- v0.1 · rank-percentile within all US counties, weighted, weights renormalised over available components
- Data vintage
- June 2026 vs June 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. Proposed components not included in method v0.1 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 Screening Score (MA and D-SNP modes)
Planning notes Interpretation
Wake County has 52.3% MA & other health plan share — most beneficiaries are already in MA or another health plan. The share alone does not say how enrollment will move.
- Compare to the rest of North Carolina on the state page.
- Check 2026 plan exits for competitor plans CMS lists as not offered in 2026.
- Sales teams: compare this market's health-plan share and 12-month momentum in the county explorer, and see which competitive facts apply on the carrier battlecards.
Neighboring North Carolina counties
Provenance — MA & other health plan share, June 2026
- Source file
- CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County)
- Vintage
- June 2026 (prior year June 2025)
- Ingested
- 2026-09-26
- 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. Carrier and plan figures come from the separate CMS Monthly Enrollment by Contract/Plan/State/County (CPSC) ingest, September 2026; see Carrier and plan enrollment (CMS CPSC) in the methodology.