Medicare Ratings Guide

Category: Uncategorized

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

    CMS Medicare Advantage Star Ratings: Connecticut 2026

    Total MA Plans in Connecticut 22
    State Average Star Rating 4.1 / 5.0 stars
    Plans Rated 4+ Stars (est.) 36%
    National Average Star Rating 3.9 / 5.0 stars
    Connecticut vs. National Average Above average (+0.2)
    5-Star Plans (est.) 12% of plans
    4-4.5 Star Plans (est.) 24% of plans

    How CMS Star Ratings Work in Connecticut

    Every Medicare Advantage plan operating in Connecticut 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 Connecticut is rated 4.1 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Connecticut

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 12% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 9% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 15% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 59% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Connecticut 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 Connecticut, 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 Connecticut.

    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 Connecticut

    To find the current CMS star rating for any Medicare Advantage plan in Connecticut, 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
    Connecticut average star rating 4.1 / 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 Colorado 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Colorado 2026

    Total MA Plans in Colorado 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
    Colorado 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 Colorado

    Every Medicare Advantage plan operating in Colorado 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 Colorado is rated 4.0 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Colorado

    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 Colorado 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 Colorado, 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 Colorado.

    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 Colorado

    To find the current CMS star rating for any Medicare Advantage plan in Colorado, 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
    Colorado 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 California 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: California 2026

    Total MA Plans in California 98
    State Average Star Rating 4.2 / 5.0 stars
    Plans Rated 4+ Stars (est.) 44%
    National Average Star Rating 3.9 / 5.0 stars
    California 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 California

    Every Medicare Advantage plan operating in California 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 California is rated 4.2 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in California

    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 California 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 California, 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 California.

    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 California

    To find the current CMS star rating for any Medicare Advantage plan in California, 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
    California 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 Arkansas 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Arkansas 2026

    Total MA Plans in Arkansas 31
    State Average Star Rating 3.7 / 5.0 stars
    Plans Rated 4+ Stars (est.) 9%
    National Average Star Rating 3.9 / 5.0 stars
    Arkansas vs. National Average Below average (-0.2)
    5-Star Plans (est.) 4% of plans
    4-4.5 Star Plans (est.) 5% of plans

    How CMS Star Ratings Work in Arkansas

    Every Medicare Advantage plan operating in Arkansas 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 Arkansas is rated 3.7 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Arkansas

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 4% 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 5% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 86% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Arkansas 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 Arkansas, 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 Arkansas.

    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 Arkansas

    To find the current CMS star rating for any Medicare Advantage plan in Arkansas, 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
    Arkansas average star rating 3.7 / 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 Arizona 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Arizona 2026

    Total MA Plans in Arizona 52
    State Average Star Rating 4.1 / 5.0 stars
    Plans Rated 4+ Stars (est.) 36%
    National Average Star Rating 3.9 / 5.0 stars
    Arizona vs. National Average Above average (+0.2)
    5-Star Plans (est.) 12% of plans
    4-4.5 Star Plans (est.) 24% of plans

    How CMS Star Ratings Work in Arizona

    Every Medicare Advantage plan operating in Arizona 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 Arizona is rated 4.1 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Arizona

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 12% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 9% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 15% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 59% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Arizona 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 Arizona, 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 Arizona.

    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 Arizona

    To find the current CMS star rating for any Medicare Advantage plan in Arizona, 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
    Arizona average star rating 4.1 / 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 Alaska 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Alaska 2026

    Total MA Plans in Alaska 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
    Alaska 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 Alaska

    Every Medicare Advantage plan operating in Alaska 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 Alaska is rated 3.5 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Alaska

    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 Alaska 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 Alaska, 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 Alaska.

    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 Alaska

    To find the current CMS star rating for any Medicare Advantage plan in Alaska, 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
    Alaska 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 Alabama 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Alabama 2026

    Total MA Plans in Alabama 28
    State Average Star Rating 3.8 / 5.0 stars
    Plans Rated 4+ Stars (est.) 13%
    National Average Star Rating 3.9 / 5.0 stars
    Alabama vs. National Average Below average (-0.1)
    5-Star Plans (est.) 6% of plans
    4-4.5 Star Plans (est.) 7% of plans

    How CMS Star Ratings Work in Alabama

    Every Medicare Advantage plan operating in Alabama 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 Alabama is rated 3.8 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Alabama

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 6% 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 7% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 82% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Alabama 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 Alabama, 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 Alabama.

    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 Alabama

    To find the current CMS star rating for any Medicare Advantage plan in Alabama, 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
    Alabama average star rating 3.8 / 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.

  • SSDI and Medicare in District of Columbia: When Coverage Starts & What to Do During the Wait

    SSDI to Medicare in District of Columbia: Key Facts

    Medicare Wait Period 24 months from SSDI onset date
    Medicare Coverage Begins Month 25 of disability
    Medicaid Available During Wait? Yes — income limit $1,118/month
    Medicaid Expansion in District of Columbia Yes — 138% FPL
    Medicare Beneficiaries in District of Columbia 98,000

    When Does Medicare Start After SSDI Approval in District of Columbia?

    If you receive Social Security Disability Insurance (SSDI) in District of Columbia, you must wait 24 months from your disability onset date (not your approval date) before Medicare coverage begins. This means your Medicare coverage starts in month 25 of your disability, regardless of when you were actually approved for SSDI. The 24-month waiting period is one of the most significant coverage gaps in the American healthcare system.

    Bridging the Coverage Gap in District of Columbia

    During the 24-month Medicare waiting period, District of Columbia SSDI recipients have several options for health coverage:

    Option 1: Medicaid in District of Columbia

    District of Columbia has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage. SSDI recipients with monthly income below $1,118 may qualify for Medicaid for the Aged, Blind, and Disabled (ABD) program in District of Columbia. Since District of Columbia has expanded Medicaid, you may also qualify under the ACA expansion if your income is below 138% FPL ($1,831/month for an individual).

    Option 2: COBRA Coverage

    If you had employer-sponsored health insurance before becoming disabled, you can continue that coverage through COBRA for up to 18 months (29 months if disabled). COBRA in District of Columbia can be expensive — you pay the full premium plus a 2% administrative fee — but it maintains your existing provider relationships during the Medicare waiting period.

    Option 3: ACA Marketplace Plans

    SSDI recipients in District of Columbia can purchase health insurance through the ACA Marketplace. SSDI income counts toward ACA subsidy calculations. If your income is between 100-400% FPL, you may qualify for premium tax credits that significantly reduce your monthly premium.

    Medicare Parts Available to SSDI Recipients in District of Columbia

    Once your 24-month waiting period ends, you automatically receive Medicare Part A (hospital insurance) and Part B (medical insurance). You will need to actively enroll in Part D (prescription drugs) and decide whether to add a Medigap supplement or switch to Medicare Advantage. In District of Columbia, there are 8 Medicare Advantage plans available with an average premium of $22.4/month.

    ESRD Exception: No Waiting Period

    If you have End-Stage Renal Disease (ESRD) requiring dialysis or a kidney transplant, you qualify for Medicare immediately — there is no 24-month waiting period. This exception applies to SSDI recipients in District of Columbia with ESRD regardless of age.

    ALS Exception: Medicare Starts Immediately

    If you have Amyotrophic Lateral Sclerosis (ALS), your Medicare coverage begins the same month your SSDI benefits begin — no waiting period. This is a critical exception for ALS patients in District of Columbia who need immediate access to Medicare-covered treatments.

  • SSDI and Medicare in Wyoming: When Coverage Starts & What to Do During the Wait

    SSDI to Medicare in Wyoming: Key Facts

    Medicare Wait Period 24 months from SSDI onset date
    Medicare Coverage Begins Month 25 of disability
    Medicaid Available During Wait? Yes — income limit $994/month
    Medicaid Expansion in Wyoming No — limited eligibility
    Medicare Beneficiaries in Wyoming 120,000

    When Does Medicare Start After SSDI Approval in Wyoming?

    If you receive Social Security Disability Insurance (SSDI) in Wyoming, you must wait 24 months from your disability onset date (not your approval date) before Medicare coverage begins. This means your Medicare coverage starts in month 25 of your disability, regardless of when you were actually approved for SSDI. The 24-month waiting period is one of the most significant coverage gaps in the American healthcare system.

    Bridging the Coverage Gap in Wyoming

    During the 24-month Medicare waiting period, Wyoming SSDI recipients have several options for health coverage:

    Option 1: Medicaid in Wyoming

    Wyoming has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 43% FPL ($11,748/year for a family of three) may qualify. SSDI recipients with monthly income below $994 may qualify for Medicaid for the Aged, Blind, and Disabled (ABD) program in Wyoming. Since Wyoming has not expanded Medicaid, eligibility is more limited for working-age adults without dependents.

    Option 2: COBRA Coverage

    If you had employer-sponsored health insurance before becoming disabled, you can continue that coverage through COBRA for up to 18 months (29 months if disabled). COBRA in Wyoming can be expensive — you pay the full premium plus a 2% administrative fee — but it maintains your existing provider relationships during the Medicare waiting period.

    Option 3: ACA Marketplace Plans

    SSDI recipients in Wyoming can purchase health insurance through the ACA Marketplace. SSDI income counts toward ACA subsidy calculations. If your income is between 100-400% FPL, you may qualify for premium tax credits that significantly reduce your monthly premium.

    Medicare Parts Available to SSDI Recipients in Wyoming

    Once your 24-month waiting period ends, you automatically receive Medicare Part A (hospital insurance) and Part B (medical insurance). You will need to actively enroll in Part D (prescription drugs) and decide whether to add a Medigap supplement or switch to Medicare Advantage. In Wyoming, there are 4 Medicare Advantage plans available with an average premium of $0/month.

    ESRD Exception: No Waiting Period

    If you have End-Stage Renal Disease (ESRD) requiring dialysis or a kidney transplant, you qualify for Medicare immediately — there is no 24-month waiting period. This exception applies to SSDI recipients in Wyoming with ESRD regardless of age.

    ALS Exception: Medicare Starts Immediately

    If you have Amyotrophic Lateral Sclerosis (ALS), your Medicare coverage begins the same month your SSDI benefits begin — no waiting period. This is a critical exception for ALS patients in Wyoming who need immediate access to Medicare-covered treatments.

  • SSDI and Medicare in Wisconsin: When Coverage Starts & What to Do During the Wait

    SSDI to Medicare in Wisconsin: Key Facts

    Medicare Wait Period 24 months from SSDI onset date
    Medicare Coverage Begins Month 25 of disability
    Medicaid Available During Wait? Yes — income limit $994/month
    Medicaid Expansion in Wisconsin No — limited eligibility
    Medicare Beneficiaries in Wisconsin 1,280,000

    When Does Medicare Start After SSDI Approval in Wisconsin?

    If you receive Social Security Disability Insurance (SSDI) in Wisconsin, you must wait 24 months from your disability onset date (not your approval date) before Medicare coverage begins. This means your Medicare coverage starts in month 25 of your disability, regardless of when you were actually approved for SSDI. The 24-month waiting period is one of the most significant coverage gaps in the American healthcare system.

    Bridging the Coverage Gap in Wisconsin

    During the 24-month Medicare waiting period, Wisconsin SSDI recipients have several options for health coverage:

    Option 1: Medicaid in Wisconsin

    Wisconsin has partially expanded Medicaid. Adults earning up to 100% FPL may qualify, but the state has not adopted full ACA expansion to 138% FPL. SSDI recipients with monthly income below $994 may qualify for Medicaid for the Aged, Blind, and Disabled (ABD) program in Wisconsin. Since Wisconsin has not expanded Medicaid, eligibility is more limited for working-age adults without dependents.

    Option 2: COBRA Coverage

    If you had employer-sponsored health insurance before becoming disabled, you can continue that coverage through COBRA for up to 18 months (29 months if disabled). COBRA in Wisconsin can be expensive — you pay the full premium plus a 2% administrative fee — but it maintains your existing provider relationships during the Medicare waiting period.

    Option 3: ACA Marketplace Plans

    SSDI recipients in Wisconsin can purchase health insurance through the ACA Marketplace. SSDI income counts toward ACA subsidy calculations. If your income is between 100-400% FPL, you may qualify for premium tax credits that significantly reduce your monthly premium.

    Medicare Parts Available to SSDI Recipients in Wisconsin

    Once your 24-month waiting period ends, you automatically receive Medicare Part A (hospital insurance) and Part B (medical insurance). You will need to actively enroll in Part D (prescription drugs) and decide whether to add a Medigap supplement or switch to Medicare Advantage. In Wisconsin, there are 38 Medicare Advantage plans available with an average premium of $10.2/month.

    ESRD Exception: No Waiting Period

    If you have End-Stage Renal Disease (ESRD) requiring dialysis or a kidney transplant, you qualify for Medicare immediately — there is no 24-month waiting period. This exception applies to SSDI recipients in Wisconsin with ESRD regardless of age.

    ALS Exception: Medicare Starts Immediately

    If you have Amyotrophic Lateral Sclerosis (ALS), your Medicare coverage begins the same month your SSDI benefits begin — no waiting period. This is a critical exception for ALS patients in Wisconsin who need immediate access to Medicare-covered treatments.