What States Have 5-Star Medicare Advantage Plans in 2023?
Medicare Advantage Plans with a 5-star rating from Medicare are considered excellent plans that provide high quality care and services. 5-star plans have premium benefits that can greatly benefit Medicare beneficiaries. This blog post will look at what 5-star Medicare Advantage Plans are available in different states for 2023.
What is a 5-Star Medicare Advantage Plan?
Medicare Advantage, also known as Medicare Part C, allows beneficiaries to receive their Medicare benefits through private insurance plans instead of Original Medicare. These Medicare Advantage Plans contract with Medicare to provide Part A and Part B coverage. Many plans also include Part D prescription drug plans.
Each year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage Plans on a 5-star scale based on factors like member satisfaction, quality of care, and health outcomes. Plans rated 5 stars are considered excellent while plans with 4 stars are above average. Plans with 3 stars or below are considered average to poor.
5-star Medicare Advantage Plans offer the best benefits and highest quality care of all plans. Benefits of being enrolled in a 5-star plan include:
- Lower out-of-pocket costs
- Access to enhanced benefits
- Highest quality of care and services
- Prescription drug coverage with low copays
- Coverage for vision, dental, hearing services
- Health and wellness programs
- Allowance for gym memberships
- Over-the-counter benefit allowance
- Transportation to medical appointments
The 5-Star Special Enrollment Period
One major perk of 5-star plans is access to the 5-star special enrollment period. This enrollment period allows Medicare beneficiaries to switch their coverage to a 5-star plan outside of the typical enrollment periods.
Most people on Medicare can only change their Medicare Advantage Plan during the Medicare Advantage open enrollment period from January 1 to March 31 each year. There are also other special enrollment periods like losing employer coverage.
But the 5-star special enrollment period allows people to switch to a 5-star plan anytime between December 8 to November 30. This gives more flexibility to change coverage.
To use the 5-star special enrollment period, you must be switching from a lower rated plan or Original Medicare. You cannot use this period to switch between two highly rated plans. This special enrollment period allows switching one time only for the calendar year.
When are 2023 Medicare Advantage Star Ratings Announced?
The Centers for Medicare & Medicaid Services (CMS) releases new star ratings for Medicare Advantage Plans each October ahead of open enrollment. The star ratings help compare plans and see their quality.
The 2023 Medicare Advantage star ratings were released on October 7, 2022. These ratings allow people to compare plans and select the highest quality plan during open enrollment from October 15 to December 7. The 2023 star ratings will remain in effect for the full calendar year.
During Medicare open enrollment for 2023 coverage, you can use the newly released star ratings to find and enroll in a 5-star Medicare Advantage Plan. This includes both new enrollments or switching from another Medicare Advantage Plan or Original Medicare.
If you find a 5-star plan you want to switch to after December 7, you can use the 5-star special enrollment period to change plans until November 30, 2023. This gives you most of next year to take advantage of enrollment in an excellent, 5-star rated Medicare Advantage Plan.
States With the Most 5-Star Medicare Advantage Plans in 2023
Certain states have a higher number of top rated Medicare Advantage Plans available in 2023. The availability of 5-star plans can vary significantly by location.
Here are the states that have the most 5-star Medicare Advantage Plans available for 2023:
- Minnesota – Minnesota has the highest number of 5-star rated Medicare Advantage Plans for 2023, with 17 available. This includes major metro areas like Minneapolis.
- Wisconsin – Wisconsin has 10 plans rated 5 stars by Medicare for 2023. Availability includes metro Milwaukee and other cities.
- Michigan – There are 9 Medicare Advantage Plans in Michigan with 5-star ratings for the coming year. Many are available in Detroit and surrounding suburbs.
- Iowa – Iowa has 9 top rated plans available in 2023, covering cities like Des Moines and rural counties.
- Ohio – Medicare coverage awarded 5 stars to 8 Medicare Advantage Plans in Ohio for 2023. Most are concentrated around Cleveland, Columbus, and Cincinnati.
- Oregon – Seven 5-star plans will be available Oregon in 2023. Availability includes Portland and Salem metro areas.
- Hawaii – Five 5-star Medicare Advantage Plans will be available for Hawaii residents in 2023.
Along with these states, a handful of other states like California, Colorado, and Pennsylvania have at least 3 to 5 options for 5-star Medicare Advantage Plans available in 2023. Even if your state only has one or two 5-star plans, it can be worthwhile to compare them to other options.
You are not limited to just plans available in your county or state. Many nationwide Medicare Advantage Plans with 5-star ratings for 2023 are available in multiple areas.
Comparing 5-Star Medicare Advantage Plans for 2023
When evaluating 5-star plans during open enrollment, there are several factors to compare between the available options:
- Premiums – Some 5-star plans have $0 premiums while others may charge over $100 per month. Look for a plan with a premium you can afford.
- Out-of-pocket costs – These include copays and deductibles. The best 5-star plans will have the lowest out-of-pocket costs.
- Covered services – Look for a plan that covers all your medications along with dental, vision and hearing services if you need them.
- Provider network – Make sure your preferred doctors, hospitals, clinics and pharmacies are in-network.
- Drug coverage – If you want Medicare Part D Plan, compare the drug formularies between plans. Make sure all your prescription medications are covered.
- Supplemental benefits – Seek out a five star plan with benefits like transportation to appointments, fitness programs, and hearing and vision coverage.
- Service area – Check that the 5-star plan you want is available where you live. Some plans have limited state or county availability.
With these factors in mind, comparing 5-star plans can help you identify the ideal choice. Spend time during Medicare open enrollment reviewing your options.
Locking in a 5-star Medicare Advantage Plan for 2023 can provide stable, top rated coverage and benefits throughout the year.
Enrolling in a 5-Star Medicare Advantage Plan for 2023
If you find a 5-star Medicare Advantage Plan you want to enroll in for 2023, you have a few options to sign up:
- During annual enrollment period – Medicare’s open enrollment period from October 15 to December 7 is the main time to enroll in a new Medicare Advantage Plan for next year. Your coverage would take effect on January 1, 2023.
- Medicare Advantage open enrollment – From January 1 to March 31, anyone on a Medicare Advantage Plan can switch plans or go back to Original Medicare which includes prescription drug coverage.
- 5-Star special enrollment period – This allows you to switch to a 5-star Medicare Advantage Plan anytime from December 8, 2022 to November 30, 2023. It provides more flexibility to get 5-star coverage.
To enroll, you can contact the plan directly, work with an insurance broker, or enroll through the Medicare Plan finder tool online. Make sure to enroll by the end of open enrollment on December 7 to get your 5-star coverage started on January 1, 2023.
- Medicare rates plans on a 5-star scale – only the highest quality plans earn 5 stars
- 5-star plans offer enhanced benefits and lower out-of-pocket costs for members
- The 5-star special enrollment period offers flexibility to switch to a top rated plan
- Certain states like Minnesota, Wisconsin and Michigan have the most 5-star plans in 2023
- Compare premiums, covered services and drug coverage when selecting a 5-star plan
- Work to enroll by December 7 for coverage effective January 1, 2023
Medicare beneficiaries have excellent plan options to consider for 2023. Comparing and selecting a 5-star Medicare Advantage Plan this open enrollment can provide you with a year of top-rated coverage, savings, and care. Using star ratings to guide your enrollment decision can help ensure you find the optimal Medicare Plan.
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When does the fall Medicare open enrollment period begin?
The fall Medicare open enrollment period begins on October 15th and ends on December 7th. During this period, beneficiaries enrolled in a Medicare Advantage Plan that includes prescription drug coverage can drop or switch to another Medicare Advantage Plan or to Original Medicare and a stand-alone Medicare prescription drug plan.
How can I enroll in a 5-star Medicare Advantage Plan for 2023?
If you are eligible for both Medicare and medicaid, you can enroll in a 5-star Medicare Advantage Plan that includes prescription drug coverage during the Medicare annual enrollment period which runs from October 15th to December 7th each year. Make sure to check that the plan you want is rated as 5 stars or higher by Medicare in 2023.
What are the benefits of enrolling in a Medicare Advantage and Part D Plan?
A: Medicare beneficiaries enrolled in a Medicare Advantage Plan that includes prescription drug coverage don’t need a separate Medicare Part D Plan. These advantage and Part D Plans usually provide all of the benefits of Original Medicare parts a and b plus extra benefits like dental, vision, fitness benefits. They also provide prescription drug coverage which Original Medicare lacks. Many Advantage Plans may have lower out of pocket costs than Original Medicare as well.
When does the Medicare open enrollment period begin for 2023 plans?
The Medicare annual enrollment period for 2023 Medicare Advantage and prescription drug plans begins on October 15th and extends through December 7th. This is the time each year that beneficiaries enrolled in a Medicare Plan can drop or switch their current coverage. It’s also when beneficiaries with only Original Medicare can enroll in a Medicare Advantage Plan if they want the additional benefits those plans offer. The largest share of Medicare Advantage enrollment occurs during this period.
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