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2020 Medicare Advantage Plans with Consistently Low CMS Quality Ratings

Star Ratings & plan quality · published Oct 27, 2019

Seventeen 2020 Medicare plans (from five providers) have received low-quality ratings for the last three years, and therefore members may qualify for a Special Enrollment Period (SEP) to leave the plan and enroll in a higher quality Medicare plan.  Four of the plans are stand-alone Medicare Prescription Drug plans (PDPs) and thirteen are Medicare Advantage plans.

As a reminder, the Centers for Medicare and Medicaid Services (CMS) will alert existing plan members if their Medicare Part D drug plan or Medicare Advantage health plan has failed for three straight years to achieve at least a 3-star quality rating and offer a Special Enrollment Period (SEP), if desired, that will allow the plan member to move to a higher quality Medicare plan that might be available in their area.

You can click on the Plan ID in the chart below to see more Medicare plan details including service area and a link to the plan's formulary (drug list).

You can click here to read more about the SEP for members of plans that consistently receive low quality ratings.


State Carrier Plan Name Plan ID
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Health LI - SNP (HMO C-SNP) H2773-003
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Health NYC - SNP (HMO C-SNP) H2773-017
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Premium NY (HMO) H2773-023
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Silver - NY (HMO) H2773-019
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Silver - NY City (HMO) H2773-020
NY QUALITY HEALTH PLANS OF NEW YORK, INC. Advantage Value One NY - Dual (HMO D-SNP) H2773-018
IL COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP Community Advantage (HMO) H3071-002
IL COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP Community Flex-Plan (HMO-POS) H3071-003
NY CENTERS PLAN FOR HEALTHY LIVING, LLC Centers Plan for Dual Coverage Care (HMO D-SNP) H6988-002
NY CENTERS PLAN FOR HEALTHY LIVING, LLC Centers Plan for Medicaid Advantage Plus (HMO D-SNP) H6988-004
NY CENTERS PLAN FOR HEALTHY LIVING, LLC Centers Plan for Medicare Advantage Care (HMO) H6988-001
NY CENTERS PLAN FOR HEALTHY LIVING, LLC Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003
TX PROMINENCE HEALTHFIRST OF TEXAS Prominence Plus (HMO-POS) H7680-001
AZ MERIT HEALTH INSURANCE COMPANY Magellan Rx Medicare Basic (PDP) S4607-023
DC DE MD MERIT HEALTH INSURANCE COMPANY Magellan Rx Medicare Basic (PDP) S4607-003
NY MERIT HEALTH INSURANCE COMPANY Magellan Rx Medicare Basic (PDP) S4607-002
VA MERIT HEALTH INSURANCE COMPANY Magellan Rx Medicare Basic (PDP) S4607-009