Which Medicare Advantage plan has the best customer reviews?

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No single Medicare Advantage plan has the "best" customer reviews nationwide, because customer satisfaction varies heavily by state, region, and whether a plan is a regional or national carrier.

However, independent industry studies highlight the top-scoring providers based on official member satisfaction and government ratings:

Regional Leaders for Member Satisfaction (J.D. Power Study)

According to the J.D. Power U.S. Medicare Advantage Study, customer satisfaction scores vary significantly by state. Regional health plans often score much higher in local customer reviews than massive national chains:

  • Tennessee: Blue Cross Blue Shield of Tennessee (highest scoring state plan overall)
  • Pennsylvania: UPMC for Life (ranked #1 in state customer satisfaction for four consecutive years)
  • Michigan: Blue Cross Blue Shield of Michigan
  • California: Kaiser Permanente and SCAN Health Plan
  • North Carolina & Florida: UnitedHealthcare

Top National & Overall Insurers (NerdWallet & U.S. News)

When evaluated nationally across customer service, network size, costs, and government metrics:

  • Humana: Frequently ranks near the top for broad major-carrier availability and $0-premium plan options, though satisfaction scores vary widely by state.
  • Aetna (CVS Health): Stands out for high federal CMS Star Ratings and government quality metrics, with $0-premium options available to a large percentage of beneficiaries.
  • UnitedHealthcare: Offers one of the largest national provider networks and strong regional satisfaction scores in several markets.
  • HealthSpring (formerly Cigna): Scores well for low-cost plan availability and high customer satisfaction ratings in specialized prescription and service segments.
  • Devoted Health & UPMC for Life: Frequently top lists for specialized care coordination, chronic condition management, and member experience.

How to Find the Best Review for Your Area

National averages do not always reflect local service quality. To check reviews and performance specific to your zip code:

  1. Visit Medicare.gov and use the plan finder tool to look up the Star Ratings (1 to 5 stars) for local plans. Star ratings directly incorporate real patient surveys regarding customer service and complaint resolution.
  2. Confirm whether your specific doctors, specialists, and local hospitals are inside the plan’s network before enrolling.

What are the most highly rated Medicare Advantage plans?

The highest-rated national Medicare Advantage providers based on recent federal Star Ratings and independent analyses from sources like NerdWallet and U.S. News & World Report are Humana, Aetna, and UnitedHealthcare.

Because Medicare Advantage (Part C) plans are sold by private companies and vary heavily by location, the "best" plan depends entirely on your specific ZIP code, preferred doctors, and medical needs.

Top-Rated National Providers

  • Humana: Consistently ranks at the top for nationwide availability, member experience, and widespread $0 monthly premium options.
  • Aetna: Stands out for high average quality Star Ratings from the Centers for Medicare & Medicaid Services (CMS), with a large percentage of its plans earning 4 stars or higher.
  • UnitedHealthcare: Operates the largest provider network in the country and offers extensive coverage access to a vast majority of U.S. beneficiaries.
  • HealthSpring (formerly Cigna): Scores well for low-cost plan availability and solid preventive care metrics.
  • Regional/Specialty Standouts (like SCAN Health Plan and Kaiser Permanente): Frequently achieve top marks for customer satisfaction and high CMS star ratings, though they are restricted to specific states or regions.

How to Evaluate Plans

  • Check the CMS Star Rating: The government rates plans from 1 to 5 stars based on customer service, chronic condition management, and member complaints. Aim for plans with 4 or 5 stars.
  • Verify Your Doctors: Always confirm directly with your current doctors and local hospitals whether they actively accept a specific plan's network (HMO vs. PPO).
  • Review Out-of-Pocket Costs: Compare the annual maximum out-of-pocket spending cap, co-pays, and prescription drug tier costs rather than just looking at the monthly premium.

Which Medicare Advantage plans have the lowest ratings?

Government and consumer satisfaction data show that plans receiving the lowest overall ratings include specific regional and national contracts scoring a 2-star or low satisfaction mark.

Lowest-Rated Plans by Government Star Ratings

The Centers for Medicare & Medicaid Services (CMS) assigns star ratings from 1 to 5 stars. For recent evaluations, several national and regional insurance contracts received the lowest baseline score of a 2-star rating:

  • El Paso Health
  • Clear Spring Health
  • American Health Advantage of MS
  • HCSC (Blue Cross Blue Shield plans in Illinois, New Mexico, Oklahoma, and Texas)
  • Certain contracts under major providers like Aetna and UnitedHealthcare

Lowest-Rated for Member Satisfaction

In consumer insight studies like the J.D. Power Medicare Advantage satisfaction rankings, overall member satisfaction averages have trended downward due to administrative friction and coverage limits. Specific low-ranking products vary heavily by geographic market, but lower scores frequently affect regional subsidiaries or specific partner offerings like select Humana, Centene (Wellcare), and co-branded plans depending on the state.

Red Flags of Low-Rated Plans

Plans rated below 3 stars or flagged as low-performing typically exhibit:

  • High out-of-pocket costs or steep maximum spending caps
  • Frequent network changes or limited local physician availability
  • Poor customer service and complex prior authorization rules

Which Medicare Advantage plan denies the most claims?

Centene and UnitedHealthcare deny the highest share of prior authorization requests among major Medicare Advantage insurers, according to analyses from Kaiser Family Foundation (KFF) and Newsweek.

Prior Authorization Denial Rates by Insurer

Recent federal and industry data tracking private Medicare Advantage organizations show varying denial percentages for initial pre-approval requests:

  • Centene: ~13.6% denial rate (with a high appeal overturn rate of over 93%).
  • CVS Health (Aetna): ~11% denial rate.
  • Kaiser Permanente: ~10% denial rate.
  • UnitedHealthcare: ~9.1% to 17% denial rate depending on the specific service category and year analyzed, representing the highest overall volume of denials due to its massive market share.
  • Cigna: ~7.7% denial rate.
  • Humana: ~3.5% to 6.8% denial rate.

Post-Acute and Inpatient Care Denials

Federal watchdog reports from the U.S. Department of Health and Human Services (HHS) highlight that large insurers—specifically UnitedHealth, Humana, and CVS—disproportionately deny specialized post-acute care. They reject more than 70% of long-term care hospital requests and over 50% of inpatient rehabilitation facility requests. However, a very high percentage of these specific denials (up to 95% for skilled nursing care) are overturned when patients or providers formally appeal.

Are there any five star Medicare Advantage plans?

Yes, the Centers for Medicare & Medicaid Services (CMS) awards a top rating of 5 stars to a select group of high-performing Medicare Advantage plans each year.

Availability and Providers

  • Geographic Limits: Five-star ratings apply to specific contracts and vary significantly by state and county. Just because an insurance company offers a 5-star plan in one state or county does not mean it is available where you live.
  • Top-Rated Companies: Providers such as Humana, Kaiser Permanente, Alignment Health, and Essence Healthcare frequently secure 5-star contracts in select service areas. You can compare options using resources like Medicare Advantage or check broader reviews on NerdWallet.

Special Enrollment Perks

  • Year-Round Switching: If a 5-star plan is available in your specific area, you can use the 5-star Special Enrollment Period (SEP) to switch into that plan outside of the standard fall open enrollment window.
  • Quality Measures: CMS grades these plans on roughly 30 to 40 distinct measures, including chronic condition management, customer service response times, and preventive screenings.

Medicare Advantage Plan Reviews ⭐️ (from real people)

9 related questions found

Who is the biggest Medicare Advantage provider?

UnitedHealthcare is the largest Medicare Advantage provider in the United States, covering about one-third of all enrollees.

Market Leaders

  • UnitedHealthcare (UnitedHealth Group): Serves roughly 9.9 million enrollees and operates the largest national network.
  • Humana: Ranks as the second-largest Medicare Advantage provider nationwide.
  • Aetna (CVS Health): Holds the third position in overall national enrollment.

Why stay away from Medicare Advantage plans?

People advise staying away from Medicare Advantage plans because they often restrict care through narrow networks, require prior approvals, and can lead to high out-of-pocket costs when serious health needs arise.

Restricted Provider Networks

  • Local limitations: Unlike Original Medicare, which is accepted nationwide, Medicare Advantage plans use regional or local networks of doctors and hospitals.
  • HMO rules: Many plans require referrals from a primary care doctor before you can see a specialist.
  • Changing rosters: Networks can change from year to year, meaning your preferred doctor might suddenly be out-of-network.

Prior Authorization Delays and Denials

  • Approval hurdles: Plans often require prior authorization (advance permission) for surgeries, imaging, medical equipment, and specialty drugs.
  • Care delays: Waiting for approvals can stall urgent medical treatments.
  • Claim denials: Private insurers may deny coverage for services that would normally be approved under Original Medicare.

Financial Risks for Serious Illnesses

  • High out-of-pocket maximums: Annual limits can reach up to $9,250 for in-network care, which can be devastating during a major health crisis.
  • Expensive coinsurance: Treatments like chemotherapy or specialized injections often carry a 20% coinsurance rate under these plans.
  • No Medigap compatibility: You cannot combine a Medicare Advantage plan with a Medicare Supplement (Medigap) policy to help cover these extra costs.

Travel and Lifestyle Restrictions

  • No coverage while traveling: Routine care outside your local service area is generally not covered, making it difficult for frequent travelers or "snowbirds".
  • Difficult switching back: If you try to return to Original Medicare later, buying a Medigap supplement policy may require medical underwriting, meaning you could be denied or charged more based on your health.

What is the best insurance to have with Medicare for seniors?

The best insurance to have with Medicare depends on your health needs and budget, choosing between a Medigap (supplemental) policy for maximum doctor choice or a Medicare Advantage plan for bundled extra benefits.

You can learn more about evaluating these choices through the Consumer Reports Guide to Medicare Advantage or the Medicare.org Senior Insurance Overview.

Option 1: Original Medicare + Medigap (Supplement)

  • How it works: You keep government-managed Original Medicare (Parts A and B) and buy private supplemental insurance (Medigap) to pay for things like copays, coinsurance, and deductibles. You also need a separate Part D plan for prescription drugs.
  • Best for: People who want predictable medical bills and the freedom to see any doctor in the U.S. who accepts Medicare without needing referrals.
  • Top providers: Humana and Mutual of Omaha are widely trusted for Medigap plans.

Option 2: Medicare Advantage (Part C)

  • How it works: Private insurance companies replace Original Medicare with an all-in-one plan that bundles Part A, Part B, and usually prescription drug coverage (Part D).
  • Best for: People who want lower monthly premiums and extra perks like dental, vision, hearing, and fitness memberships.
  • Top providers: UnitedHealthcare, Humana, and Aetna lead the market in size, availability, and customer satisfaction ratings.

What does Dave Ramsey say about Medicare Advantage plans?

Dave Ramsey says that Medicare Advantage (Part C) bundles coverage into a single package, but it often limits provider choices and isn't the best fit for everyone.

The Pros of Medicare Advantage

  • All-in-one bundle: It combines Part A (hospital) and Part B (medical), and often Part D (prescription drugs) into a single plan.
  • Extra perks: Many plans include vision, dental, and hearing care that Original Medicare leaves out.
  • Out-of-pocket maximums: Unlike standard Medigap plans, Advantage plans feature a yearly limit on out-of-pocket costs.
  • Lower premiums: They often come with low or zero monthly premiums.

The Cons and Warnings

  • Network restrictions: They act like traditional health insurance with strict provider networks.
  • Less control: Enrollees face referral rules and may get denied coverage for out-of-network specialists, leaving them to pay the bill.
  • Sales pressure: Ramsey warns buyers to watch out for agents who push Advantage plans because they pay higher commissions.
  • Separate costs: Enrollees must still pay their standard Part B premium in addition to any plan costs.

Which health insurance company has the most complaints?

Because major health insurance companies vary vastly in size, total raw complaint numbers usually reflect market share rather than customer satisfaction. Large national providers like UnitedHealthcare and Elevance Health often record the highest absolute volume of total complaints filed with state insurance departments simply because they serve tens of millions more members than regional competitors.

To measure complaints accurately, regulatory bodies like the National Association of Insurance Commissioners (NAIC) use a complaint index ratio, which compares a company's share of complaints to its share of the market.

Key Insights on Health Insurance Complaints

  • Total Volume vs. Ratio: Large insurers handle the highest absolute number of grievances due to sheer size, while smaller or specialized regional plans may have higher or lower proportional ratios.
  • Common Grievances: Most consumer and provider complaints center on claim denials, delayed reimbursements, out-of-network billing surprises, and difficulties accessing specialized mental health care.
  • Industry Sentiment: Case managers and patient advocates on platforms like Reddit express a consensus that massive nationwide payers like UnitedHealthcare and Aetna are frequently the most difficult to navigate regarding prior authorizations and claims.

You can review state-specific department of insurance portals—such as the New York Consumer Guide to Health Insurers—to see localized complaint ratios and upheld grievance percentages for carriers operating in your area.