Highmark | 5-Star Plan Ratings for 2023

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HIGHMARK SENIOR MARKETS

Highmark Achieves 5-Star Plan Ratings for 2023

The Centers for Medicare & Medicaid Services (CMS) recently announced Highmark’s 2023 Star Ratings for Pennsylvania, West Virginia, and New York Medicare Advantage (MA) plans. Our scores were strong again this year, with most plans achieving a 5-Star Rating – the highest score possible!

Pennsylvania HMO: 5 Stars
Pennsylvania PPO: 5 Stars

Highmark’s Community Blue Medicare HMO & PPO, Complete Blue PPO, Freedom Blue PPO, and Security Blue HMO-POS MA plans have again achieved the highest possible quality rating from CMS. These plans achieved 5 out of 5 Stars for the second consecutive year!

West Virginia PPO: 5 Stars

Highmark’s Medicare Advantage Freedom Blue PPO plans were scored by CMS and scored a 5 out of 5 stars for the first time. We are the only Direct Pay 5-Star product offering in West Virginia for 2023!

Western and Northeastern
New York PPO: 5 Stars

Western and Northeastern
New York HMO: 4 Stars

In Western and Northeastern New York, Highmark’s MA PPO plans were scored by CMS and scored 5 out of 5 stars for the third year in a row! Highmark’s MA Health Maintenance Organization (HMO) plans were also scored by CMS and scored 4 out 5 stars.

What about Delaware?

Star Ratings are not on a typical one-year planning cycle, where what we do this year impacts next year. Instead, the annual Star Ratings reflect performance from two years prior. How we performed in calendar year 2021 was used by CMS for our 2023 star ratings. Highmark Delaware's Medicare Advantage plans were launched in 2022, and therefore have not been rated yet.

5-Star Special Enrollment Period

If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating becomes available, MA members can use the 5-star Special Enrollment Period to switch from their current Medicare plan to a Medicare plan with a “5-star” quality rating. Members can use this Special Enrollment Period only once between December 8 and November 30.
If an MA member moves from a Medicare Advantage Plan that includes prescription drug coverage to a stand-alone Medicare Prescription Drug Plan, they will be disenrolled from their Medicare Advantage Plan, including the health benefit. They will be returned to Original Medicare for coverage of their health services. Members can only switch to a 5-star Medicare Prescription Drug Plan if one is available in their area.
If an MA Member moves from a Medicare Advantage Plan that has drug coverage to a 5‑star Medicare Advantage Plan that doesn’t, they may lose your prescription drug coverage. They’ll have to wait until their next enrollment opportunity to get drug coverage, and they may have to pay a Part D late enrollment penalty.