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Over Twenty-eight million people can take advantage of a 2024 "5-Star" Medicare plan and can use the 5-Star Special Enrollment period in 2024.

Category: Star Ratings & plan quality
Published: Oct 17, 2023 10:54:39
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Over 28 million people have access to a 2024 Medicare Advantage plan with a 5-Star quality rating - and this means these people will have the option of using the 5-Star Special Enrollment Period (SEP) to change to a 5-Star Medicare plan once during 2024.

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 5-Star plan's service area (ZIP code 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 this 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 28 million Medicare beneficiaries can use the 2024 5-star SEP?

In 2024, 5-Star rated Medicare Advantage plans are available in 1,399 counties across 43 states.  Unfortunately, the only 5-star rated Medicare Part D prescription drug plans (PDPs) are employer/union plans.

Currently*, there are approximately 28,099,942 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 rated Medicare Advantage plan is available (MA, MAPD, or SNPs).

(*Using September 2023 CMS Enrollment Data)


More about the 5-star Medicare plans that are available in 2024

The chart below lists the carriers whose Medicare Advantage plans have a 5-Star CMS quality rating for the plan year 2024. Since there are many 5-Star Medicare Advantage plans, 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
Dean Health Plan, Inc. H5264 16
Devoted Health H1290 119
Devoted Health H2697 320
Essence Healthcare H2610 108
Highmark Blue Cross Blue Shield or Highmark Blue S H3957 180
Humana H0292 15
Humana H1036 863
Humana H4461 481
Independent Health H3344 24
Independent Health H3362 49
KelseyCare Advantage H0332 46
Leon Health Plans H4286 3
MCS Classicare H5577 1,111
Medical Associates Clinic Health Plan of Wisconsin H5256 17
Medical Associates Health Plan, Inc. H1651 67
Network Health Medicare Advantage Plans H5215 154
NHC Advantage H4172 54
Optimum HealthCare, Inc. H5594 119
Peoples Health H1961 174
PrimeTime Health Plan H3664 47
Quartz Medicare Advantage H9834 20
Select Health H1994 151
Simply Healthcare Plans, Inc. H5471 100
UnitedHealthcare H0169 457
UnitedHealthcare H0710 766
UnitedHealthcare H2292 61
UnitedHealthcare H5420 6
UnitedHealthcare H5652 118
UPMC for Life H3907 306
UPMC for Life H5533 221
VIVA Medicare H0154 192
West Virginia Senior Advantage H9153 47




The chart below lists the states where 5-Star rated Medicare Advantage plans are available in 2024. Unfortunately, California, Hawaii, and Vermont will no longer have a 5-Star Medicare Advantage plan available, however Nebraska and Puerto Rico will now have at least 5-Star plans available for 2024.

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 5-star rating icon qualifies for the 2024 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 40 558,241
AR 6 73,988
AZ 4 853,028
CO 19 593,650
CT 8 491,247
DC 1 56,102
DE 3 137,079
FL 45 2,870,067
GA 35 750,325
IA 87 470,417
ID 17 162,235
IL 31 1,223,533
IN 43 746,369
KS 53 328,353
KY 29 262,051
LA 64 560,903
MA 2 181,562
MD 15 491,597
ME 7 173,722
MI 1 159,415
MN 12 471,099
MO 115 857,822
MS 13 172,940
NC 96 1,323,824
NE 46 224,651
NH 10 208,892
NJ 19 1,024,517
NV 2 290,779
NY 47 2,261,411
OH 68 1,586,783
OK 6 233,193
OR 15 526,773
PA 66 1,777,087
PR 78 365,590
RI 5 176,666
SC 15 537,850
TN 95 903,681
TX 22 1,445,455
UT 23 267,655
VA 43 643,896
WA 15 830,284
WI 31 584,785
WV 47 240,425



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