Switching to a 5 Star Medicare Advantage Plan

HealthCare Writer

Updated on November 23rd, 2021

Reviewed by Diane Omdahl

We aim to help you make informed healthcare decisions. While this post may contain links to lead generation forms, this won’t influence our writing. We follow strict editorial standards to give you the most accurate and unbiased information.

You can trust that you’re getting high-quality health insurance when you enroll in a five-star Medicare Advantage plan. Because a five-star rating is the top rating for Medicare Advantage (also called Medicare Part C), it’s a good way to judge whether that plan is the real deal.

By law, you have extra opportunities to join a five-star Medicare Advantage plan. If you’re thinking about leaving your current plan to enroll in another that’s rated five stars, we can help you make and act on an informed decision.

What Does a Five Star Medicare Advantage Plan Mean?

Medicare Advantage plans are rated from 1 to 5 stars, with five stars being an “excellent” rating. This means a five-star plan has the highest overall score for how well it offers members access to healthcare and a positive customer service experience.

Here’s a look at what each star rating means to help you better understand a five-star rating.

  • ★★★★★ — excellent
  • ★★★★ — above average
  • ★★★ — average
  • ★★ — below average
  • ★ — poor

If a Medicare Advantage plan also includes Part D prescription drug coverage, which most do, then five stars also indicate the plan does an excellent job at offering members access to safe drugs that are priced accurately. This should give you a boost of confidence when choosing a five-star Medicare Advantage plan that includes coverage for your medications.

Can you benefit from a plan switch?

Compare Medicare Advantage plans and look for savings.


How Are Medicare Advantage Plans Rated Five Stars?

Fortunately, Medicare Advantage plans don’t get an excellent rating by just wishing upon a star.

The Centers for Medicare & Medicaid Services (CMS) has many categories for quality and performance that a plan must meet before it can get a rating of five stars. Medicare star ratings help protect you as a customer because they let you understand how a plan compares to its peers.

A Medicare Part C plan earns five stars if it has the best overall score for health services and drug coverage (if the plan offers this benefit) in these areas:

Medicare Advantage Health Services – Rated in 5 AreasMedicare Advantage Drug Benefits – Rated in 4 Areas
1. Staying healthy: screening tests and vaccines1. Drug coverage customer service
2. Managing chronic (long-term) conditions2. Member complaints and changes in the drug plan’s performance
3. Member experience with the health plan3. Member experience with the drug plan
4. Member complaints and changes in the health plan’s performance4. Drug safety and accuracy of drug pricing
5. Health plan customer service

The information Medicare uses to rate a plan five stars comes from these sources:

  • Member surveys
  • Information plans and healthcare providers submit to Medicare
  • Medicare’s regular monitoring
  • Billing and other information about drug coverage that plans submit to Medicare

Are There Any Five-Star Medicare Advantage Plans?

Yes! Of the 26 million people who have Part C coverage in 2021, 10 percent are enrolled in a plan that’s rated five stars.1

However, it may be easier to find plans with a 4 or 4.5 star rating because more people are enrolled in Medicare Part C plans that have these ratings.

page divider | walking rehab | HealthCare.com

List of Five Star Medicare Advantage Plans

Below is a list of 2022 five-star Medicare Advantage plans that include Medicare Part D drug coverage. Keep in mind that these plans may not have the same rating come 2023, because ratings can change from year to year.

  • Aetna Health Inc. (ME) 
  • Asuris Northwest Health 
  • AultCare Health Insuring Corporation 
  • Baycare Select Health Plans, Inc. 
  • Blue Care Network of Michigan 
  • Blue Cross & Blue Shield of Rhode Island 
  • Blue Plus 
  • Capital District Physicians’ Health Plan, Inc. 
  • Capital Health Plan 
  • Care Improvement Plus South Central Insurance Co. 
  • Care Improvement Plus Wisconsin Insurance Company 
  • Care N’ Care Insurance Company of North Carolina 
  • Careplus Health Plans, Inc. 
  • Cariten Health Plan Inc. 
  • CDPHP Universal Benefits, Inc. 
  • Commonwealth Care Alliance, Inc. 
  • Dean Health Plan, Inc. 
  • Essence Healthcare, Inc. 
  • Excellus Health Plan, Inc. 
  • Group Health Plan
  • HealthAssurance Pennsylvania, Inc. 
  • Healthpartners Unitypoint Health, Inc. 
  • Healthpartners, Inc. 
  • HealthSpring of Florida, Inc. 
  • Healthsun Health Plans, Inc. 
  • Highmark Choice Company 
  • Highmark Senior Health Company 
  • Highmark Western And Northeastern New York Inc. 
  • Humana Health Benefit Plan of Louisiana, Inc. 
  • Humana Health Plan of Ohio, Inc. 
  • Independent Health Association, Inc. 
  • Independent Health Benefits Corporation 
  • Kaiser Foundation Health Plan of Ga, Inc. 
  • Kaiser Foundation Health Plan of the Mid-Atlantic States 
  • Kaiser Foundation Health Plan of the Northwest 
  • Kaiser Foundation Health Plan of Washington 
  • Kaiser Foundation Health Plan, Inc. 
  • Kaiser Foundation Hp of Co 
  • Keystone Health Plan East, Inc. 
  • KS Plan Administrators, LLC
  • Martin’s Point Generations Advantage, Inc. 
  • Medica Healthcare Plans, Inc. 
  • Medical Mutual of Ohio 
  • My Choice Wisconsin Health Plan, Inc. 
  • Network Health Insurance Corporation 
  • NHC Advantage, Llc 
  • Optimum Healthcare, Inc. 
  • Oxford Health Insurance, Inc. 
  • Peoples Health, Inc. 
  • Primewest Rural Mn Health Care Access Initiative 
  • Providence Health Assurance 
  • Quartz Health Plan Corporation 
  • Quartz Health Plan Mn Corporation 
  • SelectHealth, Inc. 
  • Sharp Health Plan 
  • Sierra Health And Life Insurance Company, Inc. 
  • Sierra Health And Life Insurance Company, Inc. 
  • Sierra Health And Life Insurance Company, Inc. 
  • South Country Health Alliance 
  • Tufts Associated Health Maintenance Organization 
  • UCare Minnesota 
  • UnitedHealthcare Benefits of Texas, Inc. 
  • Unitedhealthcare Insurance Company 
  • Unitedhealthcare of the Midwest, Inc. 
  • UnitedHealthcare of Wisconsin, Inc. 
  • UPMC Health Network, Inc. 
  • UPMC Health Plan, Inc. 
  • Viva Health, Inc. 
  • Wellcare of California, Inc. 2

How and When Can You Join a Five Star Medicare Advantage Plan?

You can make this switch during the Five Star Special Enrollment Period (SEP), which takes place from December 8 to November 30. It’s in addition to the main Medicare Advantage Open Enrollment Period, when you can switch to all types of Medicare Advantage plans.

Speak with a licensed Medicare agentto help you switch coverage using the Five Star SEP.

If you’re unable to sign up online, contact the plan directly for enrollment paperwork.

If you already know a five-star plan is available in your area, make sure to check if it comes with Part D prescription drug benefits. An excellent, five-star rating doesn’t mean drug coverage is automatically included.

Here are some things to keep in mind:

  • If you’re leaving a Medicare Advantage plan that includes prescription drug coverage and joining a five star MA plan that doesn’t offer this benefit, you may end up losing your drug coverage.
  • If you lose your drug coverage, you may have to wait until the next time you’re eligible to enroll in drug benefits but you could face paying a Part D late enrollment penalty.

When Are Five Star Advantage Plans Updated and Posted?

Each year, CMS does a checkup on Medicare plans that use the star rating system. The results are updated and posted every fall, usually in October.

Considering a Medicare Plan?

Get online quotes for affordable health insurance


Can you benefit from a plan switch?

Compare Medicare Advantage plans and look for savings.


Similar to an annual checkup you get from your doctor, measuring how well Medicare Advantage plans are performing every year is a good thing for you! This ensures that plans continue to provide you with access to quality healthcare and top-notch customer service.

After all, you’re trusting Medicare to help take care of your health. A five-star Medicare Advantage plan is a sure way to know you’re well covered!



Share this article

  1. Medicare Advantage in 2021: Enrollment Update and Key Trends. kff.org. Accessed October 15, 2021; Medicare Advantage in 2021: Star Ratings and Bonuses. kff.org. Accessed October 15, 2021.

     

  2. Fact Sheet – 2022 Part C and D Star Ratings. cms.gov. Accessed on October 14, 2021.