Medicare Advantage Enrollment Trends for Transgender Beneficiaries

With more than half of Medicare beneficiaries choosing to receive their coverage through private Medicare Advantage plans, more evidence is needed to understand Medicare Advantage enrollment of marginalized populations, including transgender beneficiaries. In this cross-sectional analysis of 60,797 transgender and 403,357 cisgender beneficiaries from 2012 to 2023, cisgender beneficiaries had a 3.14% higher probability of Medicare Advantage enrollment compared with transgender beneficiaries. In addition, we found significant variability in Medicare Advantage enrollment among transgender and cisgender beneficiaries by observed covariates (e.g., race, age, original reason for Medicare entitlement). Overall, there are differential trends in Medicare Advantage enrollment by gender identity and other characteristics, including race, ethnicity, age, and other demographics.