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Over Thirty million people can take advantage of the 2022 "5-Star" Medicare plan Special Enrollment Period.

Category: Star Ratings & Plan Quality
Published on 2021-11-08 09:09:52

Over 30 million people have access to a 2022 Medicare Advantage plan with a 5-Star quality rating - and this means these people have the option of using the 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 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)

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
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

The chart below lists the states where 5-Star rated Medicare Advantage plans are available in 2022.

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 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)

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

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Tips & Disclaimers
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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
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  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
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  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
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