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Medicare star ratings

What are Medicare star ratings?

What are Medicare star ratings?

The Centers for Medicare and Medicaid Services uses a star rating system to evaluate Medicare Advantage plans and Medicare Part D plans. Plans can receive from one star (poor) to five stars (excellent), and the ratings are based on numerous metrics, including factors such as customer service, how easy it is for enrollees to receive care, how well the plan does at improving or maintaining members’ physical and mental health, and how quickly the plan handles appeals – among many others. (See Tables 7, 8, and 9).

There are up to 40 metrics for Medicare Advantage plans with Part D coverage (MA-PDs), up to 30 metrics for Medicare Advantage plans without Part D coverage, and up to 12 metrics for stand-alone Part D plans (PDPs).1

Star ratings are assigned at the contract level, rather than the plan level. Most contracts have numerous plans, but all plans under a given contract receive the same star rating. Some contracts do not receive star ratings, either because sufficient data are not available, or because the contract is too new.

For 2024, the average Medicare Advantage plan with integrated Part D coverage (MA-PD) received 4.04 stars, down from 4.14 in 2023 (the average is weighted by enrollment). And the average stand-alone Part D plan received 3.11 stars (down from 3.25 in 2023). CMS reported that nearly three-quarters of 2023 MA-PD enrollees were in plans that had received at least four stars for 2024, but only about 2% of PDP enrollees were in plans that had received four or more stars for 2024.1

The overall number of plans receiving 5-star ratings is significantly lower than it was in 2022 and 2023, but higher than it was in 2021.1 Part of the reason for the decline in 2024 ratings is due to the introduction of a new methodology that removed extreme outliers from the data, mostly on the lower end of the spectrum. This made it more challenging for plans to earn 4 or 5 stars, and will result in lower rating-based bonuses for plans.2

Which Medicare contracts received 5-star ratings for 2024?

For 2024, there are a total of 36 Medicare contracts nationwide that have a 5-star rating. Three are Medicare cost plans and 31 are MA-PDs. The other two are stand-alone Part D plans, but they’re only available as employer group plans, and cannot be purchased by individuals (see Tables A1, A2, and A3 here for details about the plans that received 5-star ratings for 2024).

The following contracts have 5-star ratings for 2024.1 Some of these plans (including both of the PDPs) are EGWPs, which means they’re only available via an employer that offers them, rather than being available for individual Medicare beneficiaries to purchase.

5-Star Medicare Advantage plans with Part D coverage

  • Viva Health
  • UnitedHealthcare of Wisconsin
  • Humana Health Plan of Ohio
  • KS Plan Administrators
  • Care Improvement Plus South Central Insurance
  • Humana Medical Plan
  • Devoted Health Plan of Florida
  • Care Improvement Plus South Central Insurance
  • Peoples Health
  • Select Health
  • Care Improvement Plus South Central Insurance Co.
  • Essence Healthcare
  • Devoted Health Plan of Ohio
  • Independent Health Benefits Corp
  • Independent Health Association
  • Aultcare Health Insuring Corp.
  • UPMC Health Plan
  • Highmark Choice Co.
  • NHC Advantage
  • Leon Health
  • Cariten Health Plan
  • Network Health Insurance Corp.
  • Preferred Care Network
  • Simply Healthcare Plans
  • UPMC Health Network
  • MCS Advantage
  • Optimum Healthcare
  • Sierra Health and Life Insurance Co.
  • Emphesys Insurance Co.
  • West Virginia Senior Advantage
  • Quartz Health Plan MN Corp.

5-Star Medicare cost plans

  • Medical Associates Health Plan
  • Medical Associates Clinic Health Plan
  • Dean Health Plan

5-Star Stand-alone Part D plans

Both of the five-star Part D plans are employer group health plans, and are not available for individuals to purchase on their own:

  • HealthPartners
  • Independent Health Benefits Corp.

What is the 5-star special enrollment period?

If there’s a 5-star plan available in a given area, Medicare beneficiaries in that area have an opportunity to switch to that plan throughout most of the year (from December 8 through November 30). But although the majority of Medicare Advantage plans (and quite a few stand-alone Part D plans) receive at least four stars, very few receive five stars. The 5-start special enrollment period (SEP) is only available to you if there’s a 5-star plan in your area (available to you, meaning it’s not available just to employees/retirees of a particular business) and you’re choosing to enroll in it during the SEP.

  1. Fact Sheet – 2024 Medicare Advantage and Part D Star Ratings. Centers for Medicare and Medicaid Services. October 2023.    
  2. Medicare Advantage 2024 Star Ratings: More Stars Fade Again This Year. Chartis. October 2023. 
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