Quality ratings of health plans on HealthCare.gov
HealthCare.gov offers a health insurance plan quality ratings (or “star ratings”) program.
Overall health insurance plan quality ratings
Each rated health plan has an “Overall” quality rating of 1 to 5 stars (5 is highest), which accounts for member experience, medical care, and health plan administration.
This gives you an objective way to quickly compare plans, based on quality, as you shop.
What the health plan star ratings are based on
A plan's overall rating is based on 3 categories, each with its own star rating:
- Member experience: Based on surveys of member satisfaction with:
- Their health care and doctors
- Ease of getting appointments and services
- Medical care: Based on how well the plan's network providers manage member health care, including:
- Providing regular screenings, vaccines, and other basic health services
- Monitoring some conditions
- Plan administration: Based on how well the plan is run, including:
- Customer service
- Access to needed information
- Network providers ordering appropriate tests and treatment
All health plan ratings are calculated the same way, using the same information sources.
More on health plan star ratings
- The ratings are based on information the plans provided in the previous year. The Marketplace confirmed the information and assigned the ratings.
- In some cases — like when plans are new or have low enrollment — ratings aren’t available. This doesn’t mean the plans are low quality.