Medicare Ratings Guide

Category: Uncategorized

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

    Medicare Advantage in New York: 2026 At a Glance

    Total MA Plans Available 62
    Average Monthly Premium $19.20/month
    Average CMS Star Rating 4.1 / 5.0 stars
    Part D Plans (standalone) 26
    Medicare Beneficiaries in State 4,200,000

    How Medicare Advantage Works in New York

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In New York, there are 62 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 New York 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 New York 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 New York

    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 New York

    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 New York

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $19.20/month (average in New York)
    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 New York

    How to Choose a Medicare Advantage Plan in New York

    When comparing Medicare Advantage plans in New York, 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 New Mexico 2026: Ratings, Costs & Best Plans

    Medicare Advantage in New Mexico: 2026 At a Glance

    Total MA Plans Available 18
    Average Monthly Premium $4.20/month
    Average CMS Star Rating 3.8 / 5.0 stars
    Part D Plans (standalone) 21
    Medicare Beneficiaries in State 440,000

    How Medicare Advantage Works in New Mexico

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In New Mexico, there are 18 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 New Mexico 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 New Mexico 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 New Mexico

    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 New Mexico

    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 New Mexico

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $4.20/month (average in New Mexico)
    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 New Mexico

    How to Choose a Medicare Advantage Plan in New Mexico

    When comparing Medicare Advantage plans in New Mexico, 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 18 plans available in your ZIP code.

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

    Medicare Advantage in New Jersey: 2026 At a Glance

    Total MA Plans Available 38
    Average Monthly Premium $16.40/month
    Average CMS Star Rating 4.0 / 5.0 stars
    Part D Plans (standalone) 23
    Medicare Beneficiaries in State 1,780,000

    How Medicare Advantage Works in New Jersey

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In New Jersey, there are 38 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 New Jersey 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 New Jersey 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 New Jersey

    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 New Jersey

    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 New Jersey

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $16.40/month (average in New Jersey)
    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 New Jersey

    How to Choose a Medicare Advantage Plan in New Jersey

    When comparing Medicare Advantage plans in New Jersey, 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 38 plans available in your ZIP code.

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

    Medicare Advantage in New Hampshire: 2026 At a Glance

    Total MA Plans Available 14
    Average Monthly Premium $15.80/month
    Average CMS Star Rating 4.0 / 5.0 stars
    Part D Plans (standalone) 20
    Medicare Beneficiaries in State 310,000

    How Medicare Advantage Works in New Hampshire

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In New Hampshire, there are 14 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 New Hampshire 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 New Hampshire 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 New Hampshire

    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 New Hampshire

    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 New Hampshire

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $15.80/month (average in New Hampshire)
    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 New Hampshire

    How to Choose a Medicare Advantage Plan in New Hampshire

    When comparing Medicare Advantage plans in New Hampshire, 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 14 plans available in your ZIP code.

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

    Medicare Advantage in Nevada: 2026 At a Glance

    Total MA Plans Available 32
    Average Monthly Premium $7.60/month
    Average CMS Star Rating 3.8 / 5.0 stars
    Part D Plans (standalone) 23
    Medicare Beneficiaries in State 620,000

    How Medicare Advantage Works in Nevada

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Nevada, there are 32 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 Nevada 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 Nevada 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 Nevada

    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 Nevada

    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 Nevada

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $7.60/month (average in Nevada)
    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 Nevada

    How to Choose a Medicare Advantage Plan in Nevada

    When comparing Medicare Advantage plans in Nevada, 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 32 plans available in your ZIP code.

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

    Medicare Advantage in Nebraska: 2026 At a Glance

    Total MA Plans Available 18
    Average Monthly Premium $6.40/month
    Average CMS Star Rating 3.8 / 5.0 stars
    Part D Plans (standalone) 21
    Medicare Beneficiaries in State 380,000

    How Medicare Advantage Works in Nebraska

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Nebraska, there are 18 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 Nebraska 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 Nebraska 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 Nebraska

    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 Nebraska

    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 Nebraska

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $6.40/month (average in Nebraska)
    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 Nebraska

    How to Choose a Medicare Advantage Plan in Nebraska

    When comparing Medicare Advantage plans in Nebraska, 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 18 plans available in your ZIP code.

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

    Medicare Advantage in Montana: 2026 At a Glance

    Total MA Plans Available 8
    Average Monthly Premium $4.80/month
    Average CMS Star Rating 3.6 / 5.0 stars
    Part D Plans (standalone) 20
    Medicare Beneficiaries in State 240,000

    How Medicare Advantage Works in Montana

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Montana, there are 8 Medicare Advantage plans available, with an average CMS star rating of 3.6 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 Montana 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 Montana is rated 3.6 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 Montana

    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 Montana

    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 Montana

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $4.80/month (average in Montana)
    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 3.6 stars in Montana

    How to Choose a Medicare Advantage Plan in Montana

    When comparing Medicare Advantage plans in Montana, 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 Missouri 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Missouri: 2026 At a Glance

    Total MA Plans Available 44
    Average Monthly Premium $8.20/month
    Average CMS Star Rating 3.9 / 5.0 stars
    Part D Plans (standalone) 24
    Medicare Beneficiaries in State 1,360,000

    How Medicare Advantage Works in Missouri

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Missouri, there are 44 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 Missouri 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 Missouri 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 Missouri

    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 Missouri

    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 Missouri

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $8.20/month (average in Missouri)
    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 Missouri

    How to Choose a Medicare Advantage Plan in Missouri

    When comparing Medicare Advantage plans in Missouri, 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 Mississippi 2026: Ratings, Costs & Best Plans

    Medicare Advantage in Mississippi: 2026 At a Glance

    Total MA Plans Available 22
    Average Monthly Premium $5.60/month
    Average CMS Star Rating 3.6 / 5.0 stars
    Part D Plans (standalone) 22
    Medicare Beneficiaries in State 680,000

    How Medicare Advantage Works in Mississippi

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Mississippi, there are 22 Medicare Advantage plans available, with an average CMS star rating of 3.6 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 Mississippi 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 Mississippi is rated 3.6 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 Mississippi

    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 Mississippi

    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 Mississippi

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $5.60/month (average in Mississippi)
    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 3.6 stars in Mississippi

    How to Choose a Medicare Advantage Plan in Mississippi

    When comparing Medicare Advantage plans in Mississippi, 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 22 plans available in your ZIP code.

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

    Medicare Advantage in Minnesota: 2026 At a Glance

    Total MA Plans Available 38
    Average Monthly Premium $11.20/month
    Average CMS Star Rating 4.2 / 5.0 stars
    Part D Plans (standalone) 23
    Medicare Beneficiaries in State 1,180,000

    How Medicare Advantage Works in Minnesota

    Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by CMS. In Minnesota, there are 38 Medicare Advantage plans available, with an average CMS star rating of 4.2 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 Minnesota 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 Minnesota is rated 4.2 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 Minnesota

    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 Minnesota

    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 Minnesota

    Feature Original Medicare Medicare Advantage
    Monthly premium Part B: $185/month (2026) $11.20/month (average in Minnesota)
    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 4.2 stars in Minnesota

    How to Choose a Medicare Advantage Plan in Minnesota

    When comparing Medicare Advantage plans in Minnesota, 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 38 plans available in your ZIP code.