Alaska is a state of contrasts. With fewer than 700,000 residents spread out over 663,000 square miles, it is the biggest but least densely populated of the 50 United States. Ranking 47^th in population, it is one of five states with uninsured rates above 20%. Its cost of living and per capita healthcare costs are among the highest in the country, and its number of private physicians per 1,000 residents is among the lowest in the United States. It has the smallest percentage of total population enrolled in Medicare, 9%, and the lowest Medicare Advantage (MA) penetration rate, 0.6%.

This article was published in February 2010 in Medicare Business Online in a series of briefs on state competition among managed Medicare plans. The challenge in preparing this brief was discussing the lack of competition in this market.

Copies of the brief are available on request.