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More than five million people can take advantage of the 2019 "5-Star" Medicare plan Special Enrollment Period.

Category: Star Ratings & Plan Quality
Published on 2018-11-01 15:19:26


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.

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)

5-Star Rated
Medicare Advantage Plans (MA, MAPD)

State

Carrier

Plan Name (Plan ID)
Nbr of Counties
CAKaiser PermanenteKaiser Permanente Senior Advantage LA, Orange Co. (HMO) - (H0524-003-0)2
CAKaiser PermanenteKaiser Permanente Senior Advantage Solano (HMO) - (H0524-008-0)1
CAKaiser PermanenteKaiser Permanente Sr Adv Enhanced Sac., Sonoma (HMO) - (H0524-013-0)8
CAKaiser PermanenteKaiser Permanente Senior Advantage Inland Empire (HMO) - (H0524-015-0)2
CAKaiser PermanenteSenior Advantage Medicare Medi-Cal Plan South (HMO SNP) - (H0524-029-0)7
CAKaiser PermanenteSenior Advantage Medicare Medi-Cal Plan North (HMO SNP) - (H0524-030-0)24
CAKaiser PermanenteKaiser Permanente Senior Advantage Marin San Mateo (HMO) - (H0524-031-0)2
CAKaiser PermanenteKaiser Permanente Senior Advantage Alam., SF, Napa (HMO) - (H0524-032-0)3
CAKaiser PermanenteKaiser Permanente Senior Advantage Contra Costa (HMO) - (H0524-033-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Ventura (HMO) - (H0524-034-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Enhanced Kern (HMO) - (H0524-035-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Basic Kern (HMO) - (H0524-036-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage San Diego (HMO) - (H0524-037-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Enhanced Fresno (HMO) - (H0524-038-0)5
CAKaiser PermanenteKaiser Permanente Senior Advantage Santa Clara (HMO) - (H0524-039-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Enhanced Stanis (HMO) - (H0524-040-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Basic Stanis (HMO) - (H0524-041-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Enhanced SnJoaq (HMO) - (H0524-042-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Basic SnJoaq (HMO) - (H0524-043-0)1
CAKaiser PermanenteKaiser Permanente Senior Advantage Basic Fresno (HMO) - (H0524-046-0)5
CAKaiser PermanenteKaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) - (H0524-051-0)8
CAKaiser PermanenteKaiser Permanente Senior Advantage Santa Cruz (HMO) - (H0524-054-0)1
DCKaiser PermanenteKaiser Permanente Medicare Advantage High DC (HMO) - (H2172-001-0)1
DCKaiser PermanenteKaiser Permanente Medicare Advantage Standard DC (HMO) - (H2172-003-0)1
DCKaiser PermanenteKaiser Permanente Medicare Advantage w/o Part D (HMO) - (H2172-005-0)1
FLCarePlus Health Plans, Inc.CareOne (HMO) - (H1019-001-0)1
FLCarePlus Health Plans, Inc.CareOne PLUS (HMO) - (H1019-006-0)1
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-023-0)2
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-024-0)1
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-026-0)4
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-028-0)6
FLCarePlus Health Plans, Inc.CareOne (HMO) - (H1019-043-0)2
FLCarePlus Health Plans, Inc.CareOne PLUS (HMO) - (H1019-054-0)4
FLCarePlus Health Plans, Inc.CareOne PLUS (HMO) - (H1019-057-0)6
FLCarePlus Health Plans, Inc.CareFree (HMO) - (H1019-060-0)4
FLCarePlus Health Plans, Inc.CareFree (HMO) - (H1019-065-0)2
FLCarePlus Health Plans, Inc.CareOne (HMO) - (H1019-069-0)1
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-073-0)1
FLCarePlus Health Plans, Inc.CareFree PLUS (HMO) - (H1019-076-0)1
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-077-0)6
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-079-0)4
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-081-0)2
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-083-0)1
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-085-0)1
FLCarePlus Health Plans, Inc.CareExtra (HMO) - (H1019-089-0)1
FLCarePlus Health Plans, Inc.CareNeeds PLUS (HMO SNP) - (H1019-090-0)2
FLCarePlus Health Plans, Inc.CareNeeds (HMO SNP) - (H1019-091-0)2
FLCarePlus Health Plans, Inc.CareFree (HMO) - (H1019-092-0)6
FLCarePlus Health Plans, Inc.CareFree (HMO) - (H1019-094-0)1
FLCarePlus Health Plans, Inc.CareExtra (HMO) - (H1019-097-0)2
FLFlorida Blue HMOFHCP Medicare Rx Plus (HMO-POS) - (H1035-002-0)2
FLFlorida Blue HMOFHCP Medicare Rx (HMO) - (H1035-006-0)2
FLFlorida Blue HMOFHCP Medicare Premier Plus (HMO) - (H1035-011-0)3
FLFlorida Blue HMOFHCP Medicare Rx Savings (HMO) - (H1035-014-0)2
FLFlorida Blue HMOFHCP Medicare Flagler Advantage (HMO) - (H1035-016-0)1
FLFlorida Blue HMOBlueMedicare Classic (HMO) - (H1035-017-0)1
FLFlorida Blue HMOBlueMedicare Classic (HMO) - (H1035-018-0)1
FLFlorida Blue HMOBlueMedicare Classic (HMO) - (H1035-019-0)18
FLFlorida Blue HMOBlueMedicare Classic (HMO) - (H1035-020-0)3
FLFlorida Blue HMOBlueMedicare Classic (HMO) - (H1035-021-0)4
FLFlorida Blue HMOBlueMedicare Classic Plus (HMO) - (H1035-022-0)1
FLFlorida Blue HMOBlueMedicare Classic Plus (HMO) - (H1035-023-0)2
FLFlorida Blue HMOBlueMedicare Premier (HMO) - (H1035-024-0)1
FLFlorida Blue HMOBlueMedicare Premier (HMO) - (H1035-025-0)1
FLFlorida Blue HMOBlueMedicare Premier (HMO) - (H1035-026-0)1
FLFlorida Blue HMOBlueMedicare Complete (HMO SNP) - (H1035-027-0)1
FLFlorida Blue HMOBlueMedicare Complete (HMO SNP) - (H1035-028-0)2
FLFlorida Blue HMOBlueMedicare Complete (HMO SNP) - (H1035-029-0)1
FLFlorida Blue HMOBlueMedicare Complete (HMO SNP) - (H1035-030-0)2
FLHealthSpring of Florida, Inc.Leon Medical Centers Health Plans - Leon Cares (HMO) - (H5410-001-0)1
FLHealthSpring of Florida, Inc.Cigna-HealthSpring Advantage (HMO) - (H5410-004-0)5
FLHealthSpring of Florida, Inc.Cigna-HealthSpring TotalCare (HMO SNP) - (H5410-013-0)5
FLHealthSpring of Florida, Inc.Cigna-HealthSpring Preferred (HMO) - (H5410-018-0)5
FLHealthSpring of Florida, Inc.Cigna-HealthSpring Preferred (HMO) - (H5410-024-0)5
FLHealthSpring of Florida, Inc.Cigna-HealthSpring TotalCare (HMO SNP) - (H5410-025-0)5
FLHealthSun Health Plans, Inc.HealthSun SunPlus Advantage Plan (HMO) - (H5431-001-0)1
FLHealthSun Health Plans, Inc.HealthSun MediMax (HMO) - (H5431-006-0)2
FLHealthSun Health Plans, Inc.HealthSun HealthAdvantage Plan (HMO) - (H5431-012-0)1
HIKaiser PermanenteKaiser Permanente Senior Advantage Enhanced (HMO) - (H1230-001-0)1
HIKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO) - (H1230-003-0)1
HIKaiser PermanenteSenior Advantage Medicare Medicaid (HMO SNP) - (H1230-008-0)2
HIKaiser PermanenteKaiser Permanente Senior Advantage Maui (HMO) - (H1230-013-0)1
HIKaiser PermanenteKaiser Permanente Senior Advantage Hawaii Island (HMO) - (H1230-014-0)1
IAMedical Associates Health Plan, Inc.Medical Associates SmartPlan (Cost) - (H1651-001-0)5
IAMedical Associates Health Plan, Inc.Medical Associates Basic Plan (Cost) - (H1651-002-0)5
IAMedical Associates Health Plan, Inc.Medical Associates Community Plan (Cost) - (H1651-004-0)5
IAMedical Associates Health Plan, Inc.Medical Associates Freedom Plan (Cost) - (H1651-008-0)5
IAMedical Associates Health Plan, Inc.Cedar Valley Health Senior Plan (Cost) - (H1651-010-0)8
IAMedical Associates Health Plan, Inc.Central Iowa Health Senior Plan (Cost) - (H1651-011-0)27
IAMedical Associates Health Plan, Inc.Clinton Community Health Senior Plan (Cost) - (H1651-012-0)4
IAMedical Associates Health Plan, Inc.Genesis Health Network Senior Plan (Cost) - (H1651-013-0)5
IAMedical Associates Health Plan, Inc.Mercy Cedar Rapids Senior Plan (Cost) - (H1651-014-0)8
IAMedical Associates Health Plan, Inc.North Iowa Health Senior Plan (Cost) - (H1651-015-0)13
IAMedical Associates Health Plan, Inc.Mercy Iowa City Senior Plan (Cost) - (H1651-016-0)5
ILMedical Associates Health Plan, Inc.Medical Associates SmartPlan (Cost) - (H1651-003-0)1
ILMedical Associates Health Plan, Inc.Medical Associates Community Plan (Cost) - (H1651-005-0)1
ILMedical Associates Health Plan, Inc.Medical Associates Freedom Plan (Cost) - (H1651-009-0)1
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx Plus (HMO) - (H2256-001-1)2
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx Plus (HMO) - (H2256-001-2)5
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx Plus (HMO) - (H2256-001-6)2
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx (HMO) - (H2256-015-1)2
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx (HMO) - (H2256-015-2)5
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx (HMO) - (H2256-015-6)2
MATufts Health PlanTufts Medicare Preferred HMO Prime No Rx (HMO) - (H2256-016-1)2
MATufts Health PlanTufts Medicare Preferred HMO Prime No Rx (HMO) - (H2256-016-2)5
MATufts Health PlanTufts Medicare Preferred HMO Value Rx (HMO) - (H2256-018-1)2
MATufts Health PlanTufts Medicare Preferred HMO Value Rx (HMO) - (H2256-018-7)5
MATufts Health PlanTufts Medicare Preferred HMO Value Rx (HMO) - (H2256-018-8)2
MATufts Health PlanTufts Medicare Preferred HMO Value No Rx (HMO) - (H2256-019-1)2
MATufts Health PlanTufts Medicare Preferred HMO Value No Rx (HMO) - (H2256-019-7)5
MATufts Health PlanTufts Medicare Preferred HMO Basic Rx (HMO) - (H2256-026-1)2
MATufts Health PlanTufts Medicare Preferred HMO Basic Rx (HMO) - (H2256-026-2)5
MATufts Health PlanTufts Medicare Preferred HMO Basic Rx (HMO) - (H2256-026-3)2
MATufts Health PlanTufts Medicare Preferred HMO Saver Rx (HMO) - (H2256-028-0)10
MATufts Health PlanTufts Health Plan Senior Care Options (HMO SNP) - (H2256-029-0)10
MATufts Health PlanTufts Medicare Preferred HMO Prime Rx (HMO) - (H2256-033-0)1
MATufts Health PlanTufts Medicare Preferred HMO Value Rx (HMO) - (H2256-034-0)1
MATufts Health PlanTufts Medicare Preferred HMO Basic Rx (HMO) - (H2256-036-0)1
MATufts Health PlanTufts Medicare Preferred HMO Prime No Rx (HMO) - (H2256-039-0)1
MATufts Health PlanTufts Medicare Preferred HMO Value No Rx (HMO) - (H2256-040-0)1
MATufts Health PlanTufts Medicare Preferred HMO Basic No Rx (HMO) - (H2256-041-0)1
MATufts Health PlanTufts Medicare Preferred HMO Basic No Rx (HMO) - (H2256-042-0)2
MDKaiser PermanenteKaiser Permanente Medicare Plus High w/Part D (AB) (Cost) - (H2150-002-0)4
MDKaiser PermanenteKaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) - (H2150-009-0)4
MDKaiser PermanenteKaiser Permanente Medicare Plus Basic w/o D (AB) (Cost) - (H2150-017-0)4
MDKaiser PermanenteKaiser Permanente Medicare Plus High w/o D (AB) (Cost) - (H2150-021-0)4
MDKaiser PermanenteKaiser Permanente Medicare Plus Std w/o D (AB) (Cost) - (H2150-022-0)4
MDKaiser PermanenteKaiser Permanente Medicare Plus Basic w/D (AB) (Cost) - (H2150-033-0)4
MDKaiser PermanenteKaiser Permanente Medicare Advantage High MD (HMO) - (H2172-002-0)8
MDKaiser PermanenteKaiser Permanente Medicare Advantage Standard MD (HMO) - (H2172-004-0)8
MDKaiser PermanenteKaiser Permanente Medicare Advantage w/o Part D (HMO) - (H2172-005-0)8
MDKaiser PermanenteKaiser Permanente Medicare Advantage Value (HMO) - (H2172-006-0)2
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Prime (HMO-POS) - (H5591-001-0)11
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Value (HMO) - (H5591-003-0)16
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Prime (HMO-POS) - (H5591-006-1)1
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Prime (HMO-POS) - (H5591-006-2)4
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Focus DC (HMO SNP) - (H5591-007-0)1
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Value Plus (HMO) - (H5591-009-0)11
MEMartin's Point Generations AdvantageMartin's Point Generations Advantage Value Plus (HMO) - (H5591-013-0)4
MNSenior PreferredGundersen MN Senior Preferred Elite (w/Rx) (HMO) - (H9834-001-0)3
MNSenior PreferredGundersen MN Senior Preferred Value (w/Rx) (HMO) - (H9834-003-0)3
MNSenior PreferredGundersen MN Senior Preferred Value (no Rx) (HMO) - (H9834-004-0)3
MNSenior PreferredGundersen MN Senior Preferred Elite (no Rx) (HMO) - (H9834-005-0)3
NHMartin's Point Generations AdvantageMartin's Point Generations Advantage Prime (HMO-POS) - (H5591-001-0)3
NHMartin's Point Generations AdvantageMartin's Point Generations Advantage Value (HMO) - (H5591-003-0)8
NHMartin's Point Generations AdvantageMartin's Point Generations Advantage Prime (HMO-POS) - (H5591-005-0)5
NHMartin's Point Generations AdvantageMartin's Point Generations Advantage Value Plus (HMO) - (H5591-013-0)2
TNHumanaHumana Gold Plus H4461-004 (HMO) - (H4461-004-0)35
TNHumanaHumana Gold Plus SNP-DE H4461-022 (HMO SNP) - (H4461-022-0)50
TNHumanaHumana Gold Plus H4461-025 (HMO) - (H4461-025-0)4
TNHumanaHumana Gold Plus H4461-029 (HMO) - (H4461-029-0)11
TNHumanaHumana Gold Plus H4461-030 (HMO) - (H4461-030-1)8
TNHumanaHumana Gold Plus H4461-030 (HMO) - (H4461-030-2)18
TNHumanaHumana Gold Plus H4461-030 (HMO) - (H4461-030-3)9
TNHumanaHumana Gold Plus H4461-031 (HMO) - (H4461-031-1)8
TNHumanaHumana Gold Plus H4461-031 (HMO) - (H4461-031-2)18
TNHumanaHumana Gold Plus H4461-031 (HMO) - (H4461-031-3)9
TNHumanaHumana Gold Plus H4461-034 (HMO) - (H4461-034-0)8
TNHumanaHumana Gold Plus H4461-035 (HMO) - (H4461-035-0)18
TNHumanaHumana Gold Plus H4461-036 (HMO) - (H4461-036-0)9
TXKelseyCare AdvantageKelseyCare Advantage Essential (HMO) - (H0332-001-0)4
TXKelseyCare AdvantageKelseyCare Advantage Rx (HMO) - (H0332-002-0)4
TXKelseyCare AdvantageKelseyCare Advantage Essential+Choice (HMO-POS) - (H0332-003-0)4
TXKelseyCare AdvantageKelseyCare Advantage Rx+Choice (HMO-POS) - (H0332-004-0)4
VAKaiser PermanenteKaiser Permanente Medicare Plus High w/Part D (AB) (Cost) - (H2150-002-0)9
VAKaiser PermanenteKaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) - (H2150-009-0)9
VAKaiser PermanenteKaiser Permanente Medicare Plus Basic w/o D (AB) (Cost) - (H2150-017-0)9
VAKaiser PermanenteKaiser Permanente Medicare Plus High w/o D (AB) (Cost) - (H2150-021-0)9
VAKaiser PermanenteKaiser Permanente Medicare Plus Std w/o D (AB) (Cost) - (H2150-022-0)9
VAKaiser PermanenteKaiser Permanente Medicare Plus Basic w/D (AB) (Cost) - (H2150-033-0)9
WICare Wisconsin Health Plan, Inc.Care Wisconsin Partnership Plan (HMO SNP) - (H5209-002-0)8
WICare Wisconsin Health Plan, Inc.Care Wisconsin Medicare Dual Advantage Plan (HMO SNP) - (H5209-004-0)31







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