More than five million people can take advantage of the 2019 "5-Star" Medicare plan Special Enrollment Period.
More than five million people have access to 2019 Medicare Part D plans and Medicare Advantage plans with a 5-Star quality rating - and this means these people have the option of using a once-a-year Special Enrollment Period (SEP) to change to a 5-Star Medicare plan 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 Medicare Part D or Medicare Advantage plan - at anytime during the 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 5 million Medicare beneficiaries can use the 2019 5-star SEP?
In 2019, 5-star rated Medicare Part D prescription drug plans (PDPs) are available across all counties in 11 states and 5-Star rated Medicare Advantage plans are available in 271 counties across 15 states.
Currently*, there are approximately 4,516,919 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) and for about 725,608 of these people, a 5-star stand-alone Medicare Part D prescription drug plan (PDP) is also available in their state.
A total of 1,336,418 Medicare beneficiaries are enrolled in a Medicare plan that has a star rating of less than 5 stars and are living in states where a 5-star stand-alone Medicare Part D prescription drug plan (PDP) is available, but these people are not enrolled in the 5-star plan, as noted above, 725,608 of these people also have access to a 5-star Medicare Advantage plan. The other 610,810 people have access to only a 5-star stand-alone Medicare Part D prescription drug plan and no 5-star Medicare Advantage plan.
(* Using September 2018 CMS Enrollment Data)
More about the 5-star Medicare plans that are available in 2019
The charts below lists the Medicare Part D and Medicare Advantage plans that have a 5-Star CMS quality rating for the plan year 2019.
You can click on the plan name to see plan details including service area, link to formulary (drug list) and enrollment options.
The plans below all qualify for the 2019 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. You can click here to read more about the 5-star SEP.
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 for the Medicare Advantage plan. Click here to read more about 5-star SEP cautions.
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 Medicare Part D or Medicare Advantage plan - at anytime during the 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 5 million Medicare beneficiaries can use the 2019 5-star SEP?
In 2019, 5-star rated Medicare Part D prescription drug plans (PDPs) are available across all counties in 11 states and 5-Star rated Medicare Advantage plans are available in 271 counties across 15 states.
Currently*, there are approximately 4,516,919 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) and for about 725,608 of these people, a 5-star stand-alone Medicare Part D prescription drug plan (PDP) is also available in their state.
A total of 1,336,418 Medicare beneficiaries are enrolled in a Medicare plan that has a star rating of less than 5 stars and are living in states where a 5-star stand-alone Medicare Part D prescription drug plan (PDP) is available, but these people are not enrolled in the 5-star plan, as noted above, 725,608 of these people also have access to a 5-star Medicare Advantage plan. The other 610,810 people have access to only a 5-star stand-alone Medicare Part D prescription drug plan and no 5-star Medicare Advantage plan.
(* Using September 2018 CMS Enrollment Data)
More about the 5-star Medicare plans that are available in 2019
The charts below lists the Medicare Part D and Medicare Advantage plans that have a 5-Star CMS quality rating for the plan year 2019.
You can click on the plan name to see plan details including service area, link to formulary (drug list) and enrollment options.
The plans below all qualify for the 2019 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. You can click here to read more about the 5-star SEP.
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 for the Medicare Advantage plan. Click here to read more about 5-star SEP cautions.
| 5-Star Rated Stand-Alone Medicare Part D Prescription Drug Plans (PDP) |
||
| State | Carrier | Plan Name (Plan ID) |
| CT MA RI VT | Anthem Blue Cross and Blue Shield | Blue MedicareRx Premier (PDP) (S2893-003) |
| CT MA RI VT | Anthem Blue Cross and Blue Shield | Blue MedicareRx Value Plus (PDP) (S2893-001) |
| IA MN MT NE ND SD WY | Wellmark Blue Cross and Blue Shield of Iowa | MedicareBlue Rx Premier (PDP) (S5743-004) |
| IA MN MT NE ND SD WY | Wellmark Blue Cross and Blue Shield of Iowa | MedicareBlue Rx Standard (PDP) (S5743-001) |
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