Highmark’s Medicare Advantage plans once again earn high scores in federal quality program

PITTSBURGH (October 19, 2025) — Highmark announced today that its Medicare Advantage plans in Pennsylvania, Delaware and New York have achieved at least a 4.0 quality rating from the Centers for Medicare and Medicaid Services (CMS).

Highmark’s HMO and PPO plans in Pennsylvania achieved 4.5 quality ratings as did Highmark’s PPO plans in New York. Highmark’s Medicare Advantage PPO plans in West Virginia achieved a 3.5 quality rating. 

Highmark continues to be an industry leader in Medicare Advantage quality ratings.  Of the top ten largest Medicare Advantage carriers by enrollment, Highmark ranks #2, with 95% of members enrolled in a plan 4 Stars or higher*. 

Medicare Advantage Plans are evaluated on a scale of one to five. In arriving at the overall annual quality rating, CMS takes into account how well health plans score in five different categories including (1) keeping members healthy and up-to-date on preventive care measures, (2) managing chronic health conditions, (3) providing positive member health care experiences (4) handling problems and complaints, and (5) customer service.

CMS created its star rating system to provide consumers with an easy, unbiased way to compare Medicare Advantage plans and for consumers to better understand how well a plan is performing and how satisfied members are with it. A higher star rating means a higher quality plan.

“Despite many challenges facing insurers across the nations, such as increased utilization of health care services and federal reimbursements not keeping pace with the cost of care, Highmark remains committed to keeping our Medicare Advantage members healthy and to providing a remarkable customer experience.  These scores are a reflection of that commitment,” said Bill Rayball, Vice President, Government Quality at Highmark.

Unlike traditional Medicare, Medicare Advantage plans limit the amount of out-of-pocket contribution a beneficiary is required to make. In addition to covering the same hospital and medical services as Medicare Parts A & B, Highmark Medicare Advantage plans include benefits for preventive care, hearing aids, vision and dental care, as well as fitness and wellness tools.

Detailed descriptions of all Highmark Medicare Advantage plans, including network and pricing, are available at https://medicare.highmark.com/home.

^{* According to the CMS Monthly Enrollment by Contract and the 2026 Stars Ratings Data Tables.}

^{This information is not a complete description of benefits. Call the phone number on the back of your member ID card (TTY users may call 711) for more information. Every year, Medicare evaluates plans based on a 5- star rating system.}

^{Highmark Blue Cross Blue Shield and Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with Medicare contracts. Enrollment in these plans depends on contract renewal.}

^{Highmark Blue Cross Blue Shield, which serves western and northeastern Pennsylvania, Delaware, West Virginia and western New York, and Highmark Blue Shield, which serves central and southeastern Pennsylvania and northeastern New York, are independent licensees of the Blue Cross Blue Shield Association.}