Top Medigap Markets: States Leading in Coverage and Growth
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Top Medigap Markets: States Leading in Coverage and Growth
Roughly 14 million Americans are currently enrolled in Medicare Supplement Insurance coverage, commonly referred to as Medigap insurance.
With more than 10,000 Americans turning 65 each day, the U.S. Census Bureau predicts that all Baby Boomers will hit that milestone by 2030, increasing demand for Medicare plans.
As a result, enrollment in Medicare Supplement plans is expected to grow to over 17 million by 2032.
But Medicare Supplement policies are more popular in some areas than others, with population density, income status, and the availability of plans all playing a role.
Which State Has the Most Medigap Enrollees?
Based on the most recently available public data (2023), California has more residents covered by a Medicare Supplement Insurance policy than any other state, followed closely by Texas, Florida, Illinois, and Pennsylvania.
According to data from AHIP, the number of Medigap enrollees in the top five states are:
- California: 1,134,309
- Texas: 945,247
- Florida: 927,710
- Illinois: 752,795
- Pennsylvania: 680,688
Enrollees are concentrated in metropolitan areas, with 22% living in rural areas with less than 50,000 people. Many policyholders choose Medicare Supplement plans for increased financial security, with 61% earning less than $80,000 annually, and 40% living without a partner.
Sales of Medigap policies are growing as the population ages. As more insurers offer coverage, and more insurance professionals market Medigap plans, that growth is likely to continue.
However, not all plans are growing equally. Plan G is the most popular, covering 39% of Traditional Medicare enrollees, and is the only plan to have an increase in enrollment between 2022-2023. Every other plan saw a decline in enrollment, including a 22% decline each for Plans A and B.
Coverage options also vary widely by state, with 39% of insurers offering Medigap plans in just one state, and less than half available in 11 or more states.
What State Has the Highest Medigap Enrollment?
California has the highest number of enrollees, but Iowa has the highest percentage of enrollees, with 67.2% of Traditional Medicare beneficiaries enrolled in a Medigap plan. The top 5 states by percentage are:
- Iowa: 67.2%
- Nebraska: 66.2%
- Kansas: 62.7%
- South Dakota: 55.7%
- Wyoming: 54.3%
California only has 33.5% enrollment, representing a high capacity for growth, while Alaska and Hawaii have the lowest percentage of enrollment, at 19.4% and 9.5% respectively.
Medigap plans are most appealing to those who want to be able to visit any doctor or healthcare facility that welcomes Medicare beneficiaries, without worrying about high out-of-pocket costs.
Women and older Americans are more likely to choose Medicare Supplement coverage, with nearly half of Medigap policyholders over the age of 75.
Where Medigap Coverage Is Increasing
Year by year, the share of Medicare beneficiaries with Medigap coverage is increasing, from 28.25% in 2013 to 50.96% in 2025, according to the Centers for Medicare and Medicaid Services (CMS).
Southern California had some of the highest penetration rates, with more than half of enrollees in San Diego, San Bernardino, Riverside, and Orange County enrolled in a Medicare Advantage or Other Health Plan (which includes Medicare Supplement Insurance).
In Illinois, Cook County alone has nearly 1 million Medicare beneficiaries, 44% of whom had an MA or Medigap plan. Statewide, coverage jumped from 11% to 44% in just 10 years.
Compare Medigap Plans with AAMSI
With so many options to consider, the American Association for Medicare Supplement Insurance (AAMSI) offers an online directory for individuals seeking to learn more about Medicare insurance plans and their costs. Use the directory to find local Medicare insurance agents in your ZIP code, without having to enter your personal data and risk unsolicited phone calls.
The American Association for Medicare Supplement Insurance advocates for educated planning and supports insurance professionals who market Medicare insurance solutions. For more information, visit the organization’s website at www.medicaresupp.org.
