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Over Thirty-one million people can take advantage of the 2023 "5-Star" Medicare plan Special Enrollment Period.

Category: Star Ratings & Plan Quality
Published: Nov, 02 2022 03:11:44


Over 31 million people have access to a 2023 Medicare Advantage plan with a 5-Star quality rating - and this means these people have the option of using the 5-Star Special Enrollment Period (SEP) to change to a 5-Star Medicare plan once during the year.

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 31 million Medicare beneficiaries can use the 2023 5-star SEP?

In 2023, 5-Star rated Medicare Advantage plans are available in 1,656 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 31,276,553 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 2022 CMS Enrollment Data)


More about the 5-star Medicare plans that are available in 2023

The chart below lists the carriers whose Medicare Advantage plans have a 5-Star CMS quality rating for the plan year 2023. 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
Alignment Health Plan H5296 48
Baylor Scott & White Health Plan H8142 206
Blue Cross & Blue Shield of Rhode Island H3557 5
Blue Cross & Blue Shield of Rhode Island H4152 35
Blue Plus H2425 87
BlueCross BlueShield of Tennessee H7917 478
CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA H9808 22
CDPHP Medicare Advantage H3388 134
CDPHP Medicare Advantage H3388 4
CDPHP Medicare Advantage H5042 92
Cigna H4513 795
Dean Advantage, Prevea360 Medicare Advantage H9096 62
Dean Health Plan, Inc. H5264 16
Devoted Health H2697 235
Essence Healthcare H2610 95
Excellus Health Plan, Inc H3351 87
HealthPartners H4882 212
HealthSun Health Plans, Inc. H5431 11
Highmark BCBS of WNY and Highmark BS of NENY H5526 72
Highmark Inc. H3916 406
Highmark Inc. H3957 180
Highmark Inc. H5106 258
Humana H0292 15
Humana H1951 279
Humana H4461 441
Independence Blue Cross H3952 35
Independent Health H3344 16
Independent Health H3362 49
Kaiser Permanente H0524 91
Kaiser Permanente H0630 66
Kaiser Permanente H1170 84
Kaiser Permanente H1230 6
Kaiser Permanente H2172 105
KelseyCare Advantage H0332 41
Martin's Point Generations Advantage H5591 66
Medical Associates Clinic Health Plan of Wisconsin H5256 12
Medical Associates Health Plan, Inc. H1651 76
Medical Mutual of Ohio H4497 290
Medical Mutual of Ohio H6723 334
MVP HEALTH CARE H3305 241
MVP HEALTH CARE H3305 27
Network Health Medicare Advantage Plans H5215 154
Optimum HealthCare, Inc. H5594 114
Peoples Health H1961 163
PrimeTime Health Plan H3664 48
Priority Health Medicare H2320 209
Quartz Medicare Advantage H5262 288
Quartz Medicare Advantage H9834 20
SelectHealth H1994 65
Sharp Health Plan H5386 3
SummaCare Medicare Advantage Plans H3660 164
Tufts Health Plan H2256 78
UnitedHealthcare H0710 611
UnitedHealthcare H2001 56
UnitedHealthcare H2292 61
UnitedHealthcare H4590 164
UnitedHealthcare H5322 632
UnitedHealthcare H5652 118
UPMC for Life H3907 306
UPMC for Life H5533 221
VIVA Medicare H0154 196


The chart below lists the states where 5-Star rated Medicare Advantage plans are available in 2023.

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 2023 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 44 558,303
AR 45 366,043
AZ 4 822,563
CA 31 3,157,562
CO 15 443,280
CT 8 476,170
DC 1 49,788
DE 3 131,008
FL 30 2,800,364
GA 154 1,118,031
HI 3 118,231
IA 46 287,617
ID 16 140,075
IL 34 1,202,936
IN 33 646,739
KS 63 351,313
KY 17 220,975
LA 64 364,046
MA 10 706,222
MD 14 408,173
ME 16 162,097
MI 68 1,141,655
MN 87 706,286
MO 21 536,524
MS 7 132,240
NC 43 792,685
NH 10 192,974
NJ 19 991,693
NV 2 280,202
NY 62 2,172,994
OH 88 1,541,174
OK 73 469,126
OR 11 370,332
PA 67 1,447,813
RI 5 109,706
SC 9 417,361
TN 95 810,092
TX 163 2,492,753
UT 22 248,994
VA 28 432,935
VT 14 102,456
WA 14 702,685
WI 49 422,805
WV 48 229,532








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