How We Review Medicare Companies

Investopedia is dedicated to helping people find the right Medicare provider for their health needs. We’ve completed in-depth research into nine companies that provide Medicare plans, comparing them across five key categories to score and weight factors like cost, availability, plan coverage, and more. This guide will explain these categories and each criterion we used to evaluate each Medicare plan and provider.

Our editors and researchers independently evaluate all recommended products and services. If you click on links we provide, we may receive compensation. Our advertising partnerships are not a factor in how we evaluate products, though they may affect the order of products you see listed in our articles.

How We Collect Information About Medicare Plans

To identify which health insurance companies to review, we analyzed business and market insight databases including Statistia, Plunkett, and Gale. We also considered user-generated data from Google to determine public interest and trends in Medicare plans.

We collected data from third-party rating agencies like the credit rating agency AM Best and the National Committee for Quality Assurance (NCQA), an independent organization that rates health insurance plans on quality and customer satisfaction. We also gathered data from government websites and databases provided by the Centers for Medicare and Medicaid Services (CMS) such as CMS.gov and HealthCare.gov, and directly from companies via websites, media contacts, and existing partnerships. The data collection process spanned Sept. 15 to Sept. 29, 2023.

We then developed a quantitative model that scores each Medicare plan based on five major categories and 22 criteria that are crucial in evaluating the plan’s offerings and benefits.

Data was verified to ensure data integrity and accuracy by cross-referencing the records and adding citations that correspond to each data point with our primary sources.

Data Collection and Scoring?

• Data points are scored on a 0.00 - 1.00 scale
• Binary criteria received a 0 or 1 score
• Scaled criteria (e.g., 5-point) were scored as such: [0.00, 0.25, 0.50, 0.75, 1.00]
• Continuous criteria were scored such that the minimum value in the database was re-scaled to 0.00 and the maximum value was re-scaled to 1.00

Medicare Evaluation Categories

After determining five key categories with which to evaluate Medicare plans and providers, we weighted them differently depending on the article:

These categories were then broken down into 22 criteria, resulting in 198 data points that make up our scoring rubric.

Customer Satisfaction

We scored customer satisfaction on a continuous scale using Medicare star ratings and NCQA ratings. We then found the average of the two for the final score and weighted it differently when needed.

• For the best Medicare Advantage plans, this was 30% of the total weighted score in our evaluation (15% for Medicare star ratings and 15% for NCQA ratings).
• For the best Medicare Part D plans, this was 30% (10% for Medicare star ratings and 20% for NCQA ratings).
• For the best Medicare supplement plans and Medicare Plan G providers, this was 20%, with only NCQA ratings being considered.

To evaluate customer satisfaction, we looked at the following features.

Medicare Star Ratings

The Centers for Medicaid and Medicare Services produces Medicare star ratings, which score the quality of Medicare plans on a one-to-five scale to help people compare plans during open enrollment. We scored this on a continuous scale.

NCQA Ratings

NCQA (National Committee for Quality Assurance) star ratings measure the performance of managed care plans and member satisfaction on a scale of one to five stars. We gathered NCQA ratings for each company's plans that were rated, averaged them together, and then scored this on a continuous scale.

These criteria helped us understand how satisfied customers are with the different companies considered for our rankings. Though the NCQA does not rate Medicare Supplement (Medigap) policies, the ratings for other types of Medicare plans still help indicate a provider's overall quality. Two companies had no NCQA ratings, so they received a 0 for that criteria, but editors used their judgment and expertise to make the final call about their placement within our lists.

Plan Features

Plan features measured types of plans (HMO, PPO, other types), plan benefits (looking at seven specific benefits), special needs plans, and additional coverage offered in the Medicare gap (whether Medicare high-deductible Plan G was offered and the types of Medigap plans offered).

For the best Medicare Advantage plans, this was worth 35%, and the criteria included types of plans, plan benefits, special needs plans, and additional coverage.?

For the best Medicare Part D plans, this measured whether providers offered additional coverage offered in the gap and was worth 25%.

For the best Medicare supplement plans, this only measured the number of Medigap plans offered, and was worth 30%.

For the best Medicare Plan G providers, this measured only whether Medigap high-deductible plan G was offered, and was worth 30%.

Types of Plans (HMO, PPO, Other)

We scored each plan first with a binary scale (0 for no, 1 for yes) and then assigned subweights for each plan type: 40% for HMO, 40% for PPO, and 20% for other types. We multiplied each binary score by the percentage weight, took the sum, and got a weighted average on a scale of 0 to 1 to get a total plan availability score for each company.

Plan Benefits Available

We measured whether companies that offer Medicare Advantage offered the following seven plan benefits: vision, dental, hearing, transportation, fitness, worldwide emergency, and telehealth. We then awarded scores of 7 out of 7 if a company offered all plan benefits, a 0 out of 7 if the company offered no plan benefits, and scores between 0 and 7 to those offering a select number of benefits.

Special Needs Plans (SNPs)

We measured whether special needs plans were offered on a binary scale, granting scores of 1 for those that did, and 0 for those that did not.

Additional Coverage Offered in the Medicare Gap

The coverage gap or "donut hole" refers to a period when there is a limit on drug coverage. During this time, members are responsible for up to 25% of brand-name and generic drugs. You may spend less on prescription drugs if your plan provides additional coverage during the gap. We scored this as a proportion for each company by dividing the number of Medicare Advantage plans from the company that includes drug coverage and offered additional gap coverage by the number of Medicare Advantage plans from the company that includes only drug coverage. We gathered this data from the Centers for Medicare and Medicaid Services.

Medigap High-Deductible Plan G Offered

We scored providers that offered Medigap high-deductible plan G on a binary scale of 0 for no and 1 for yes.?

Types of Medigap Plans Offered

We scored companies based on how many types of Medigap/Medicare supplement plans were offered by each company. We scored this criterion on a range from 0 to 1, in fixed increments of 1 out of 12, 12 being the total number of plans (10 regular plans and two high-deductible plans).

Cost

Cost measured Medicare providers’ monthly premiums, out-of-pocket maximums (co-pays and coinsurance), deductibles, gap coverage, and Medicare star rating (for specific plans) across two ZIP codes: 33012 (Miami) and 79936 (El Paso, Texas).?We also looked at nationwide cost data for premiums, out-of-pocket maximums, and deductibles.

For the best Medicare Advantage plans and the best Medicare Part D plans, this was worth 20%.

For the best Medicare supplement plans and the best Medicare Plan G providers, this was worth 40%.

Monthly Premium

We looked at the premium for each provider’s plan (and averaged multiple premiums for Blue Cross Blue Shields’ various companies). Premiums were then scored on a continuous scale, with the lowest cost earning a 1 and the highest a 0. Every other premium scored somewhere in between at non-fixed intervals. We looked at premiums for the specific ZIP codes as well as nationwide cost data.

Out-of-Pocket Maximum

This is the total dollar amount paid in co-pays and coinsurance before a plan pays for 100% of covered health insurance services. We scored this on a continuous scale in which the lowest cost was awarded 1 and the higher costs were scored at non-fixed intervals through 0, where 0 was the score for the highest cost. We looked at out-of-pocket maximums for the specific ZIP codes as well as nationwide cost data.

Drug Deductible?

We scored this on a continuous scale in which the lowest cost was awarded 1 and the highest cost received a 0, with every other score falling in between at non-fixed intervals. We looked at deductibles for the specific ZIP codes as well as nationwide cost data.

State Availability

This measure indicates how widely available plans are across the U.S. For the best Medicare Advantage plans and the best Medicare Part D plans, this was worth 15%. For the best Medicare supplement plans and the best Medicare high-deductible Plan G providers, this was not weighted or rated because of insufficient data.

Company Financials

We looked at AM Best ratings for each company to determine its financial strength. For the best Medicare Advantage plans, this was not weighted or rated because of insufficient data. For the best Medicare Part D plans, Medicare Supplement Plans, and the best Medicare Plan G providers, this was worth 10%.

Articles That Use Our Methodology

We have many articles about the best Medicare insurance companies for specific products or to meet the needs of particular readers. The research conducted and data collected to create this methodology have been used to compile our list of the Best Medicare Advantage Plans. Other articles that list the best Medicare insurance companies for certain products or readers (for example, Best Medicare Supplement Insurance, Best Medicare Supplement Plan G Providers, or Best Medicare Part D Plans) rely on information collected as part of the grading process described here. But selections and order of providers are based on additional product-specific criteria plus subjective insights from our editors and industry experts.

Meet the Research Team

Shanker Narayan

Research Analyst, Financial Product Reviews

As a Research Analyst for Investopedia's financial product reviews team, Shanker formulates evaluation criteria for various financial product categories, with a focus on consumer and small business insurance products. His responsibilities include overseeing the data collection, verification, and analysis processes that fuel our financial product reviews.Shanker's background in Applied Statistics has equipped him with both the tools and logical framework necessary to develop, refine, and execute research methodologies. Combined with his passion for reading and writing in his personal life, Shanker believes that the best, most meaningful content is generated when using both quantitative and qualitative techniques in research and delivery.

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