How we rank

Methodology: How We Rank Health Plans

Last updated: October 2026

Every plan in a ranking is scored the same way: what it would cost in a year at a stated level of medical use, using only the numbers the insurer filed with CMS.

Where the data comes from

• Medicare Advantage and Part D: the CMS plan landscape and plan benefit files for the plan year, published each fall before the Annual Enrollment Period. They list each plan’s premium, deductibles, maximum out-of-pocket limit and the counties it serves.
• Medigap (Medicare Supplement) premiums: there’s no federal Medigap price list, so we use the official rate tables that state insurance departments and State Health Insurance Assistance Programs publish. Each state page names its source and the date of the rates, and we copy every premium exactly as printed (no estimates or adjustments). A state is ranked only while its table is 12 months old or newer.
• Star ratings: the CMS Medicare Part C and D Star Ratings for the same plan year.
• ACA Marketplace plans: the CMS Qualified Health Plan landscape and public use files for states that use HealthCare.gov. States that run their own exchange publish separately, and each page says which states it covers.
• Program figures (Part B premium, IRMAA brackets, penalty rules, poverty guidelines, ACA limits): the agency that sets them — CMS, the Social Security Administration, HHS or the IRS. Every calculator lists its sources and the plan year.

How a plan is scored

• Medicare Advantage (general-audience plans with drug coverage): worst-case year = 12 × (the monthly plan premium − any Part B premium reduction, or “giveback,” the plan files with CMS) + the plan’s in-network maximum out-of-pocket. The giveback is money back on a premium everyone pays, so a plan with a large one can score below $0. Lower ranks higher; ties go to the lower premium, then plan name. Plans without drug coverage are listed separately, and plans CMS lists as under sanction aren’t ranked. The Part B premium itself is the same for everyone and drug costs have their own cap, so neither changes the order. Dental, eyewear, hearing aid and over-the-counter allowances are shown but not scored: their value depends on whether you use them.
• Part D drug plans: premiums + deductible = 12 × the monthly premium + the annual deductible, roughly a year with modest prescriptions. Ties go to the lower premium. We also show the worst case (premiums + the yearly out-of-pocket cap, the same for every plan).
• Medigap Plan G and Plan N: yearly premium at 65 = 12 × the monthly premium at 65 (or the yearly premium where the state publishes one), for standard plans open to any resident. Each insurer appears once per sex and rating area the state shows, at its best published rate class that isn’t a tobacco rate. Lower ranks higher; ties go to the lower premium at 75 where shown, then the insurer’s name. We show each insurer’s pricing method (attained-age, issue-age or community-rated) and older-age premiums next to the score, because a policy that’s cheapest at 65 can cost more later. High-deductible Plan G, Medicare SELECT and plans that require membership in an association are listed separately, not ranked.
• Massachusetts Medigap: Massachusetts sells its own Core, Supplement 1 and Supplement 1A plans instead of the lettered ones, so each of the three is ranked on its own by yearly premium = 12 × the monthly premium in the Division of Insurance list (one premium per insurer and plan; where the list shows an old and a new rate, the one in effect now). Ties go to the insurer’s name. Group, membership and employer-marketplace plans, and plans no longer sold to new customers, are listed separately, not ranked.
• ACA Marketplace plans (when the plan-year files are published): worst-case year = 12 × monthly premium + in-network out-of-pocket maximum, for one person of the chosen age (40 unless you change it) in the chosen county, non-tobacco, full price before any tax credit. The credit lowers every plan’s premium by the same dollar amount, so it doesn’t change the order. Ties go to the lower premium. Catastrophic plans are listed apart because only some people can buy them. The benchmark shown is the second-lowest distinct silver premium among the plans sold in the county.

Each Medicare Advantage and Part D plan also shows its CMS star rating for the plan year (1 to 5 stars, from the CMS Star Ratings Data Tables). Ratings belong to the company contract behind the plan, so plans under one contract share a rating. They’re shown for context and don’t change the cost ranking. New contracts show “too new to rate”.

What never affects a ranking

• Whether an insurer, broker or partner pays us.
• Ads shown on the page.
• Editors’ opinions. We don’t hand-place plans.

Updates

Plan data changes once a year, when CMS publishes the next plan year (usually late September). Program figures change when the agency announces them; each calculator shows the year its figures apply to. If a number on a page doesn’t match the source, tell us.