Medicare Ratings Guide

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  • Medicare Part D Costs in Colorado 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in Colorado: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in Colorado 24
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in Colorado

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in Colorado. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects Colorado beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for Colorado Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in Colorado

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for Colorado

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for Colorado Residents

    Low-income Medicare beneficiaries in Colorado may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in Colorado, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in Colorado

    Colorado has 24 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 24 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in Colorado

    Most Medicare Advantage plans in Colorado include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 38 Medicare Advantage plans in Colorado include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Part D Costs in California 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in California: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in California 28
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in California

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in California. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects California beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for California Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in California

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for California

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for California Residents

    Low-income Medicare beneficiaries in California may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in California, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in California

    California has 28 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 28 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in California

    Most Medicare Advantage plans in California include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 98 Medicare Advantage plans in California include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Part D Costs in Arkansas 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in Arkansas: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in Arkansas 23
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in Arkansas

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in Arkansas. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects Arkansas beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for Arkansas Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in Arkansas

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for Arkansas

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for Arkansas Residents

    Low-income Medicare beneficiaries in Arkansas may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in Arkansas, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in Arkansas

    Arkansas has 23 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 23 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in Arkansas

    Most Medicare Advantage plans in Arkansas include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 31 Medicare Advantage plans in Arkansas include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Part D Costs in Arizona 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in Arizona: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in Arizona 26
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in Arizona

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in Arizona. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects Arizona beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for Arizona Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in Arizona

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for Arizona

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for Arizona Residents

    Low-income Medicare beneficiaries in Arizona may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in Arizona, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in Arizona

    Arizona has 26 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 26 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in Arizona

    Most Medicare Advantage plans in Arizona include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 52 Medicare Advantage plans in Arizona include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Part D Costs in Alaska 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in Alaska: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in Alaska 18
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in Alaska

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in Alaska. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects Alaska beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for Alaska Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in Alaska

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for Alaska

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for Alaska Residents

    Low-income Medicare beneficiaries in Alaska may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in Alaska, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in Alaska

    Alaska has 18 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 18 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in Alaska

    Most Medicare Advantage plans in Alaska include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 4 Medicare Advantage plans in Alaska include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Part D Costs in Alabama 2026: Out-of-Pocket Calculator & Plan Comparison

    Medicare Part D in Alabama: 2026 Key Numbers

    Out-of-Pocket Maximum (2026) $2,100/year
    Maximum Part D Deductible $615/year
    National Base Beneficiary Premium $38.99/month
    Coverage Gap (“Donut Hole”) Eliminated as of 2025
    Standalone Part D Plans in Alabama 22
    Late Enrollment Penalty 1% × $38.99 per month uncovered

    How Medicare Part D Works in Alabama

    Medicare Part D provides prescription drug coverage for Medicare beneficiaries in Alabama. In 2026, the most significant change to Part D is the $2,100 annual out-of-pocket cap — the first hard cap in Part D’s history, established by the Inflation Reduction Act. Once you spend $2,100 on covered drugs in a calendar year, your Part D plan pays 100% for the rest of the year. This protects Alabama beneficiaries with high drug costs from catastrophic prescription expenses.

    2026 Part D Out-of-Pocket Cost Scenarios for Alabama Residents

    Annual Drug Cost Your Estimated OOP (2026) Plan Pays Notes
    $1,200/year (low) ~$615 (deductible) + 25% coinsurance = ~$765 75% after deductible Below catastrophic threshold
    $4,800/year (moderate) ~$1,200–$1,800 75% after deductible Well below $2,100 cap
    $12,000/year (high) Capped at $2,100 100% after cap Cap protects high-cost patients
    $50,000/year (specialty drugs) Capped at $2,100 100% after cap Critical protection for cancer, MS, etc.

    Part D Late Enrollment Penalty in Alabama

    If you go without creditable prescription drug coverage for 63 or more consecutive days after becoming eligible for Medicare Part D, you will pay a late enrollment penalty for as long as you have Part D coverage. The penalty is calculated as 1% of the national base beneficiary premium ($38.99/month in 2026) for each month you were without coverage. For example, if you went 24 months without Part D coverage, your penalty would be 24% × $38.99 = $9.36/month added to your premium permanently.

    Late Enrollment Penalty Calculator for Alabama

    Months Without Coverage Monthly Penalty (2026) Annual Extra Cost
    12 months $4.68/month $56.15/year
    24 months $9.36/month $112.29/year
    36 months $14.04/month $168.44/year
    60 months $23.39/month $280.73/year

    Extra Help (Low Income Subsidy) for Alabama Residents

    Low-income Medicare beneficiaries in Alabama may qualify for Extra Help, which reduces Part D costs to nominal copays ($4.90 for generics, $12.15 for brand-name drugs in 2026) and eliminates the late enrollment penalty. To qualify for full Extra Help in Alabama, your monthly income must be at or below $1,255 (individual) or $1,704 (couple). Apply through Social Security at ssa.gov or call 1-800-772-1213.

    Choosing a Part D Plan in Alabama

    Alabama has 22 standalone Part D plans available. The most important factor in choosing a plan is whether your specific medications are on the plan’s formulary at a reasonable tier. Use the Medicare Plan Finder at medicare.gov/plan-compare to enter your exact medications and compare total annual costs — premium plus deductible plus copays — across all 22 plans. The plan with the lowest premium is rarely the lowest total cost if your drugs are on a high tier.

    Part D and Medicare Advantage in Alabama

    Most Medicare Advantage plans in Alabama include prescription drug coverage (MAPD plans). If you enroll in a Medicare Advantage plan with drug coverage, you cannot also have a standalone Part D plan. The 28 Medicare Advantage plans in Alabama include both MAPD (with drug coverage) and MA-only (without drug coverage) options. If you choose an MA-only plan, you can add a standalone Part D plan.

  • Medicare Advantage Star Ratings in District of Columbia 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: District of Columbia 2026

    Total MA Plans in District of Columbia 8
    State Average Star Rating 4.2 / 5.0 stars
    Plans Rated 4+ Stars (est.) 44%
    National Average Star Rating 3.9 / 5.0 stars
    District of Columbia vs. National Average Above average (+0.3)
    5-Star Plans (est.) 14% of plans
    4-4.5 Star Plans (est.) 30% of plans

    How CMS Star Ratings Work in District of Columbia

    Every Medicare Advantage plan operating in District of Columbia receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in District of Columbia is rated 4.2 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in District of Columbia

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 14% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 12% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 18% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 51% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for District of Columbia Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In District of Columbia, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in District of Columbia.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in District of Columbia

    To find the current CMS star rating for any Medicare Advantage plan in District of Columbia, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    District of Columbia average star rating 4.2 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Wyoming 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Wyoming 2026

    Total MA Plans in Wyoming 4
    State Average Star Rating 3.5 / 5.0 stars
    Plans Rated 4+ Stars (est.) 0%
    National Average Star Rating 3.9 / 5.0 stars
    Wyoming vs. National Average Below average (-0.4)
    5-Star Plans (est.) 0% of plans
    4-4.5 Star Plans (est.) 0% of plans

    How CMS Star Ratings Work in Wyoming

    Every Medicare Advantage plan operating in Wyoming receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Wyoming is rated 3.5 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Wyoming

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 0% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 0% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 95% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Wyoming Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Wyoming, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Wyoming.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Wyoming

    To find the current CMS star rating for any Medicare Advantage plan in Wyoming, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Wyoming average star rating 3.5 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Wisconsin 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Wisconsin 2026

    Total MA Plans in Wisconsin 38
    State Average Star Rating 4.0 / 5.0 stars
    Plans Rated 4+ Stars (est.) 28%
    National Average Star Rating 3.9 / 5.0 stars
    Wisconsin vs. National Average Above average (+0.1)
    5-Star Plans (est.) 10% of plans
    4-4.5 Star Plans (est.) 18% of plans

    How CMS Star Ratings Work in Wisconsin

    Every Medicare Advantage plan operating in Wisconsin receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Wisconsin is rated 4.0 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Wisconsin

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 10% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 6% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 12% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 67% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Wisconsin Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Wisconsin, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Wisconsin.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Wisconsin

    To find the current CMS star rating for any Medicare Advantage plan in Wisconsin, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Wisconsin average star rating 4.0 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in West Virginia 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: West Virginia 2026

    Total MA Plans in West Virginia 16
    State Average Star Rating 3.6 / 5.0 stars
    Plans Rated 4+ Stars (est.) 5%
    National Average Star Rating 3.9 / 5.0 stars
    West Virginia vs. National Average Below average (-0.3)
    5-Star Plans (est.) 2% of plans
    4-4.5 Star Plans (est.) 3% of plans

    How CMS Star Ratings Work in West Virginia

    Every Medicare Advantage plan operating in West Virginia receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in West Virginia is rated 3.6 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in West Virginia

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 2% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 3% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 90% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for West Virginia Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In West Virginia, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in West Virginia.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in West Virginia

    To find the current CMS star rating for any Medicare Advantage plan in West Virginia, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    West Virginia average star rating 3.6 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.