Medicare Ratings Guide

Category: Uncategorized

  • Medicare Advantage Plans in South Dakota 2026: Ratings, Costs & Best Plans

    Medicare Advantage in South Dakota: 2026 At a Glance

    Total MA Plans Available 10
    Average Monthly Premium $5.80/month
    Average CMS Star Rating 3.7 / 5.0 stars
    Part D Plans (standalone) 20
    Medicare Beneficiaries in State 200,000

    How Medicare Advantage Works in South Dakota

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In South Dakota, there are 10 Medicare Advantage plans available, with an average CMS star rating of 3.7 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for South Dakota Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in South Dakota is rated 3.7 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in South Dakota

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in South Dakota

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in South Dakota

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $5.80/month (average in South Dakota)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.7 stars in South Dakota

    How to Choose a Medicare Advantage Plan in South Dakota

    When comparing Medicare Advantage plans in South Dakota, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 10 plans available in your ZIP code.

  • Medicare Advantage Plans in Tennessee 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Tennessee: 2026 At a Glance

    Total MA Plans Available 44
    Average Monthly Premium $7.40/month
    Average CMS Star Rating 3.8 / 5.0 stars
    Part D Plans (standalone) 24
    Medicare Beneficiaries in State 1,440,000

    How Medicare Advantage Works in Tennessee

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Tennessee, there are 44 Medicare Advantage plans available, with an average CMS star rating of 3.8 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Tennessee Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Tennessee is rated 3.8 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Tennessee

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Tennessee

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Tennessee

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $7.40/month (average in Tennessee)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.8 stars in Tennessee

    How to Choose a Medicare Advantage Plan in Tennessee

    When comparing Medicare Advantage plans in Tennessee, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 44 plans available in your ZIP code.

  • Medicare Advantage Plans in South Carolina 2026: Ratings, Costs & Best Plans

    Medicare Advantage in South Carolina: 2026 At a Glance

    Total MA Plans Available 36
    Average Monthly Premium $7.20/month
    Average CMS Star Rating 3.8 / 5.0 stars
    Part D Plans (standalone) 23
    Medicare Beneficiaries in State 1,120,000

    How Medicare Advantage Works in South Carolina

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In South Carolina, there are 36 Medicare Advantage plans available, with an average CMS star rating of 3.8 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for South Carolina Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in South Carolina is rated 3.8 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in South Carolina

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in South Carolina

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in South Carolina

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $7.20/month (average in South Carolina)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.8 stars in South Carolina

    How to Choose a Medicare Advantage Plan in South Carolina

    When comparing Medicare Advantage plans in South Carolina, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 36 plans available in your ZIP code.

  • Medicare Advantage Plans in Rhode Island 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Rhode Island: 2026 At a Glance

    Total MA Plans Available 12
    Average Monthly Premium $17.20/month
    Average CMS Star Rating 4.1 / 5.0 stars
    Part D Plans (standalone) 20
    Medicare Beneficiaries in State 260,000

    How Medicare Advantage Works in Rhode Island

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Rhode Island, there are 12 Medicare Advantage plans available, with an average CMS star rating of 4.1 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Rhode Island Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Rhode Island is rated 4.1 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Rhode Island

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Rhode Island

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Rhode Island

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $17.20/month (average in Rhode Island)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 4.1 stars in Rhode Island

    How to Choose a Medicare Advantage Plan in Rhode Island

    When comparing Medicare Advantage plans in Rhode Island, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 12 plans available in your ZIP code.

  • Medicare Advantage Plans in Pennsylvania 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Pennsylvania: 2026 At a Glance

    Total MA Plans Available 62
    Average Monthly Premium $12.80/month
    Average CMS Star Rating 4.0 / 5.0 stars
    Part D Plans (standalone) 26
    Medicare Beneficiaries in State 3,080,000

    How Medicare Advantage Works in Pennsylvania

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Pennsylvania, there are 62 Medicare Advantage plans available, with an average CMS star rating of 4.0 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Pennsylvania Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Pennsylvania is rated 4.0 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Pennsylvania

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Pennsylvania

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Pennsylvania

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $12.80/month (average in Pennsylvania)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 4.0 stars in Pennsylvania

    How to Choose a Medicare Advantage Plan in Pennsylvania

    When comparing Medicare Advantage plans in Pennsylvania, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 62 plans available in your ZIP code.

  • Medicare Advantage Plans in Oregon 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Oregon: 2026 At a Glance

    Total MA Plans Available 28
    Average Monthly Premium $10.40/month
    Average CMS Star Rating 4.1 / 5.0 stars
    Part D Plans (standalone) 23
    Medicare Beneficiaries in State 920,000

    How Medicare Advantage Works in Oregon

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Oregon, there are 28 Medicare Advantage plans available, with an average CMS star rating of 4.1 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Oregon Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Oregon is rated 4.1 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Oregon

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Oregon

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Oregon

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $10.40/month (average in Oregon)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 4.1 stars in Oregon

    How to Choose a Medicare Advantage Plan in Oregon

    When comparing Medicare Advantage plans in Oregon, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 28 plans available in your ZIP code.

  • Medicare Advantage Plans in Oklahoma 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Oklahoma: 2026 At a Glance

    Total MA Plans Available 26
    Average Monthly Premium $6.80/month
    Average CMS Star Rating 3.7 / 5.0 stars
    Part D Plans (standalone) 22
    Medicare Beneficiaries in State 820,000

    How Medicare Advantage Works in Oklahoma

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Oklahoma, there are 26 Medicare Advantage plans available, with an average CMS star rating of 3.7 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Oklahoma Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Oklahoma is rated 3.7 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Oklahoma

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Oklahoma

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Oklahoma

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $6.80/month (average in Oklahoma)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.7 stars in Oklahoma

    How to Choose a Medicare Advantage Plan in Oklahoma

    When comparing Medicare Advantage plans in Oklahoma, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 26 plans available in your ZIP code.

  • Medicare Advantage Plans in Ohio 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Ohio: 2026 At a Glance

    Total MA Plans Available 58
    Average Monthly Premium $9.20/month
    Average CMS Star Rating 4.0 / 5.0 stars
    Part D Plans (standalone) 25
    Medicare Beneficiaries in State 2,680,000

    How Medicare Advantage Works in Ohio

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Ohio, there are 58 Medicare Advantage plans available, with an average CMS star rating of 4.0 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for Ohio Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in Ohio is rated 4.0 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in Ohio

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in Ohio

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in Ohio

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $9.20/month (average in Ohio)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 4.0 stars in Ohio

    How to Choose a Medicare Advantage Plan in Ohio

    When comparing Medicare Advantage plans in Ohio, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 58 plans available in your ZIP code.

  • Medicare Advantage Plans in North Dakota 2026: Ratings, Costs & Best Plans

    Medicare Advantage in North Dakota: 2026 At a Glance

    Total MA Plans Available 8
    Average Monthly Premium $5.40/month
    Average CMS Star Rating 3.7 / 5.0 stars
    Part D Plans (standalone) 19
    Medicare Beneficiaries in State 160,000

    How Medicare Advantage Works in North Dakota

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In North Dakota, there are 8 Medicare Advantage plans available, with an average CMS star rating of 3.7 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for North Dakota Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in North Dakota is rated 3.7 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in North Dakota

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in North Dakota

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in North Dakota

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $5.40/month (average in North Dakota)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.7 stars in North Dakota

    How to Choose a Medicare Advantage Plan in North Dakota

    When comparing Medicare Advantage plans in North Dakota, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 8 plans available in your ZIP code.

  • Medicare Advantage Plans in North Carolina 2026: Ratings, Costs & Best Plans

    Medicare Advantage in North Carolina: 2026 At a Glance

    Total MA Plans Available 54
    Average Monthly Premium $8.60/month
    Average CMS Star Rating 3.9 / 5.0 stars
    Part D Plans (standalone) 25
    Medicare Beneficiaries in State 2,180,000

    How Medicare Advantage Works in North Carolina

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In North Carolina, there are 54 Medicare Advantage plans available, with an average CMS star rating of 3.9 out of 5.0. Unlike Original Medicare, most MA plans include prescription drug coverage (MAPD), dental, vision, and hearing benefits, often at a lower out-of-pocket cost for people who stay in-network.

    CMS Star Ratings for North Carolina Medicare Advantage Plans

    CMS evaluates every Medicare Advantage plan annually on 40+ quality measures and assigns a star rating from 1 to 5. Plans rated 4 stars or higher receive quality bonus payments, which insurers typically pass on to enrollees through lower premiums or richer benefits. The average MA plan in North Carolina is rated 3.9 stars.

    What CMS Star Ratings Measure

    Category Weight Examples
    Managing Chronic Conditions High Diabetes control, blood pressure management, cholesterol screening
    Member Experience High Getting needed care, getting appointments, customer service
    Preventive Care Medium Flu shots, cancer screenings, medication adherence
    Health Plan Administration Medium Appeals decisions, call center performance
    Drug Plan Quality (if MAPD) Medium Drug pricing accuracy, formulary accuracy

    Types of Medicare Advantage Plans in North Carolina

    Plan Type Network Referrals Required Out-of-Network Coverage
    HMO (Health Maintenance Organization) Restricted network Yes (for specialists) Emergency only
    PPO (Preferred Provider Organization) Preferred + out-of-network No Yes (higher cost)
    PFFS (Private Fee-for-Service) Any provider accepting plan terms No Yes (if provider accepts)
    SNP (Special Needs Plan) Varies Varies Limited

    2026 Medicare Advantage Enrollment Periods in North Carolina

    Period Dates What You Can Do
    Annual Enrollment Period (AEP) Oct 15 – Dec 7 Switch plans, join, or drop MA
    Medicare Advantage Open Enrollment Jan 1 – Mar 31 Switch MA plans or return to Original Medicare
    Initial Enrollment Period 3 months before to 3 months after turning 65 First-time enrollment
    Special Enrollment Period Varies by qualifying event Moving, losing other coverage, etc.

    Medicare Advantage vs. Original Medicare in North Carolina

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $8.60/month (average in North Carolina)
    Annual out-of-pocket max No limit Capped (varies by plan)
    Prescription drugs Separate Part D plan required Usually included (MAPD)
    Dental/vision/hearing Not covered Usually included
    Provider choice Any Medicare provider nationwide Network restrictions apply
    Prior authorization Rarely required Common for specialist visits and procedures
    Star rating N/A Average 3.9 stars in North Carolina

    How to Choose a Medicare Advantage Plan in North Carolina

    When comparing Medicare Advantage plans in North Carolina, prioritize these factors in order: (1) whether your current doctors and preferred hospitals are in-network, (2) whether your current prescriptions are on the plan formulary at a reasonable tier, (3) the plan’s CMS star rating — aim for 4 stars or higher, (4) the annual out-of-pocket maximum, and (5) any extra benefits like dental or vision that you’ll actually use. Use the Medicare Plan Finder at medicare.gov/plan-compare to compare all 54 plans available in your ZIP code.