A little background: What is the 5-Star Special Enrollment Period?
Special Enrollment Periods (SEPs) allow you to change Medicare Part D or Medicare Advantage plans outside of the annual Open Enrollment Period (AEP) that runs from October 15th through December 7th. But, SEPs are usually granted only for exceptional reasons or circumstances (such as when you move to a new area of the country). However, one of the most accessible Special Enrollment Periods (available in specific areas of the country) is the 5-star Special Enrollment Period. The 5-star SEP allows anyone in the Service Area the opportunity to leave their current Medicare plan and join a 5-star rated Medicare Part D or Medicare Advantage plan - at any time during the year - but you can only use the SEP once during the plan year. You can even leave your 5-star rated Medicare plan to join another 5-star plan that may be available in your area.
You can click here to read more about the 5-star Special Enrollment Period - with a few cautions about choosing your 5-star plan. You can click here to read more about other Special Enrollment Periods.
How is it possible that 30 million Medicare beneficiaries can use the 2022 5-star SEP?
In 2022, 5-Star rated Medicare Advantage plans are available in 1,626 counties across 44 states. Unfortunately, the only 5-star rated Medicare Part D prescription drug plans (PDPs) are employer/union plans.
Currently*, there are approximately 30,553,379 Medicare beneficiaries enrolled in a Medicare plan that has a star rating of less than 5 stars - and these people are living in counties where a 5-star Medicare Advantage plan is available (MA, MAPD, or SNPs).
(*Using September 2021 CMS Enrollment Data)
More about the 5-star Medicare plans that are available in 2022
The chart below lists the carriers whose Medicare Advantage plans have a 5-Star CMS quality rating for the plan year 2022. Since there are more 5-star Medicare Advantage plans than ever before, we are not able to list each plan individually.
Carriers Offering 5-Star Rated Medicare Advantage Plans (MA, MAPD) |
|||
| Carrier |
Contract ID |
Nbr of Counties | |
| Aetna Medicare | H3597 | 32 | |
| Aetna Medicare | H5522 | 201 | |
| Asuris Northwest Health | H5010 | 6 | |
| BayCare Health Plans | H2235 | 12 | |
| Blue Care Network | H5883 | 298 | |
| Blue Cross & Blue Shield of Rhode Island | H3557 | 5 | |
| Blue Cross & Blue Shield of Rhode Island | H4152 | 40 | |
| Blue Plus | H2425 | 62 | |
| Capital Health Plan | H5938 | 21 | |
| CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA | H9808 | 14 | |
| CarePlus Health Plans, Inc. | H1019 | 104 | |
| CDPHP Medicare Advantage | H3388 | 130 | |
| CDPHP Medicare Advantage | H5042 | 78 | |
| Cigna | H5410 | 89 | |
| Commonwealth Care Alliance, Inc. | H2225 | 10 | |
| Dean Advantage, Prevea360 Medicare Advantage | H9096 | 61 | |
| Dean Health Plan, Inc. | H5264 | 24 | |
| Essence Healthcare | H2610 | 33 | |
| Excellus Health Plan, Inc | H3351 | 95 | |
| HealthPartners | H2422 | 12 | |
| HealthPartners | H2462 | 165 | |
| HealthPartners | H4882 | 190 | |
| HealthPartners UnityPoint Health | H3416 | 96 | |
| HealthSun Health Plans, Inc. | H5431 | 12 | |
| Highmark Blue Cross Blue Shield of Western New Yo | H5526 | 54 | |
| Highmark Inc. | H3916 | 344 | |
| Highmark Inc. | H3957 | 175 | |
| Humana | H0292 | 10 | |
| Humana | H1951 | 215 | |
| Humana | H4461 | 421 | |
| Independence Blue Cross | H3952 | 30 | |
| Independent Health | H3344 | 16 | |
| Independent Health | H3362 | 49 | |
| Kaiser Permanente | H0524 | 85 | |
| Kaiser Permanente | H0630 | 53 | |
| Kaiser Permanente | H1170 | 54 | |
| Kaiser Permanente | H1230 | 6 | |
| Kaiser Permanente | H2172 | 96 | |
| Kaiser Permanente | H5050 | 48 | |
| Kaiser Permanente | H9003 | 38 | |
| KelseyCare Advantage | H0332 | 41 | |
| Martin's Point Generations Advantage | H1365 | 26 | |
| Martin's Point Generations Advantage | H5591 | 73 | |
| Medical Associates Clinic Health Plan of Wisconsin | H5256 | 12 | |
| Medical Associates Health Plan, Inc. | H1651 | 74 | |
| Medical Mutual of Ohio | H4497 | 290 | |
| My Choice Wisconsin Health Plan | H5209 | 46 | |
| Network Health Medicare Advantage Plans | H5215 | 131 | |
| NHC Advantage | H4172 | 43 | |
| Optimum HealthCare, Inc. | H5594 | 109 | |
| Peoples Health | H1961 | 163 | |
| PrimeTime Health Plan | H3664 | 48 | |
| PrimeWest Health | H2416 | 13 | |
| Providence Medicare Advantage Plans | H9047 | 73 | |
| Quartz Medicare Advantage | H5262 | 270 | |
| Quartz Medicare Advantage | H9834 | 20 | |
| SelectHealth | H1994 | 61 | |
| Sharp Health Plan | H5386 | 3 | |
| South Country Health Alliance | H2419 | 9 | |
| Tufts Health Plan | H2256 | 78 | |
| UCare | H2459 | 558 | |
| UnitedHealthcare | H0169 | 298 | |
| UnitedHealthcare | H0294 | 246 | |
| UnitedHealthcare | H0710 | 518 | |
| UnitedHealthcare | H2001 | 54 | |
| UnitedHealthcare | H2226 | 20 | |
| UnitedHealthcare | H2292 | 49 | |
| UnitedHealthcare | H3794 | 70 | |
| UnitedHealthcare | H4590 | 154 | |
| UnitedHealthcare | H5253 | 1,339 | |
| UnitedHealthcare | H5420 | 6 | |
| UnitedHealthcare | H5652 | 113 | |
| UPMC for Life | H3907 | 343 | |
| UPMC for Life | H5533 | 120 | |
| VIVA Medicare | H0154 | 182 | |
| Wellcare | H5087 | 20 | |
Once on the state page, you can click on your county to see a list of plans available along with plan highlights and links to plan details, formulary, and star rating details. Any plan marked with the
qualifies for the 2022 5-Star Special Enrollment Period (SEP).Medicare beneficiaries currently enrolled any MA, MAPD, or PDP plan (including people already enrolled in another Medicare plan with 5-star rating) can take advantage of the 5-star Special Enrollment Period. The 5-star rating SEP can only be used one time during the plan year.
Remember: If you are currently enrolled in a stand-alone Medicare Part D plan (PDP) and wish to join a 5-star Medicare Advantage plan (MAPD or SNP), you must also be enrolled in Original Medicare Part A and Part B - and meet the eligibility requirements if the plan is a Special Needs Plan (SNP). Click here to read more about 5-star SEP cautions.
States, County Count, and Number of Medicare Beneficiaries Who Can Take Advantage of a 5-Star Medicare Advantage Plans (MA, MAPD) |
|||
| State |
Nbr of Counties |
Nbr of People |
|
| AL | 36 | 538,263 | |
| AZ | 6 | 815,564 | |
| CA | 31 | 3,174,529 | |
| CO | 15 | 424,087 | |
| CT | 8 | 462,457 | |
| DC | 1 | 48,601 | |
| DE | 3 | 124,875 | |
| FL | 40 | 2,894,334 | |
| GA | 42 | 720,309 | |
| HI | 3 | 113,032 | |
| IA | 87 | 461,488 | |
| ID | 16 | 140,588 | |
| IL | 42 | 1,239,468 | |
| IN | 29 | 586,647 | |
| KS | 55 | 319,167 | |
| KY | 56 | 419,251 | |
| LA | 64 | 619,405 | |
| MA | 11 | 710,287 | |
| ME | 16 | 197,593 | |
| MI | 74 | 1,168,456 | |
| MN | 87 | 815,619 | |
| MO | 115 | 885,338 | |
| MS | 7 | 127,508 | |
| NC | 59 | 1,071,795 | |
| ND | 14 | 64,885 | |
| NE | 46 | 218,074 | |
| NH | 10 | 184,753 | |
| NV | 2 | 271,240 | |
| NY | 58 | 2,258,167 | |
| OH | 85 | 1,643,878 | |
| OK | 5 | 209,264 | |
| OR | 15 | 394,785 | |
| PA | 67 | 1,888,246 | |
| RI | 5 | 166,138 | |
| SC | 13 | 457,858 | |
| SD | 11 | 68,244 | |
| TX | 67 | 1,983,354 | |
| UT | 20 | 269,091 | |
| VA | 84 | 745,266 | |
| WA | 19 | 792,164 | |
| WI | 72 | 859,311 | |