Independent Health Medicare HMO plans rated 5 out of 5 Stars

BUFFALO, N.Y. (October 21, 2025) – All of Independent Health’s Medicare HMO plans have received the highest possible rating – 5-Stars –  by the Centers for Medicare and Medicaid Services (CMS) for 2026. The Williamsville-based company is the only insurer in Western New York, and one of only 18 plans nationally, to offer a 5-Star Medicare Advantage plan in 2026.  

“This recognition from CMS is reflective of our unrelenting drive and commitment to provide our members with high-quality service, coverage and value, and a testament to our collaborative efforts with health care providers to ensure our members receive the care they need,” said Michael W. Cropp, M.D., President & CEO, Independent Health. 

The annual Star Ratings assess the quality, value and performance of every Medicare Advantage plan throughout the nation. CMS developed the Star Rating system to serve as a helpful and unbiased way for Medicare beneficiaries to compare their medical and prescription drug options during the Medicare Annual Enrollment Period, which runs from October 15 through December 7.

For 2026, Independent Health’s Medicare Advantage HMO plans earned 5 Stars, and its Medicare Advantage PPO plan earned 4.5 Stars. These high ratings mark the 16th consecutive year that Independent Health has achieved 4.5 or 5 Stars for its Medicare HMO plans and 11 consecutive years for its Medicare PPO plans.

Despite many Medicare Advantage plans’ CMS Star ratings remaining flat or decreasing¹, Independent Health improved in 25 measures and continued to deliver a 5-Star rating in several measures, such as Rating of Health Plan, Rating of Health Care Quality, Getting Needed Care, Customer Service and clinical measures related to staying healthy, such as Breast Cancer Screening, Care for Older Adults, and Diabetes Care.

How Medicare Star Ratings work

By using a 5-Star Quality Rating System, with 5 stars being the highest rating, CMS measures Medicare beneficiaries' experience with their health plans and the health care system on an annual basis. Health and pharmacy services are rated together through information gathered from clinicians, member surveys and other trusted sources. Each plan’s overall rating is based on how it performs across the following categories:

• Staying healthy: Rates how often members got various screening tests, vaccines and other checkups to help them stay healthy.
• Managing chronic (long-term) conditions: Rates how often members with different conditions got certain tests and treatments to help them manage their condition.
• Member experience with the plan: Rates member satisfaction with the plan based on how easy it is to get needed care, appointments, information and help from the plan (customer service).
• Member complaints and changes in the plan’s performance: Measures how many complaints Medicare received about the plan, the number of members who chose to leave the plan and how the plan’s quality improved or declined from the previous year.
• Customer service: Rates the timeliness and fairness of the plan’s appeals decisions.
• Drug safety and accuracy of drug pricing: Rates how well the plan prices prescriptions and provides updated information on the Medicare website. Also rates information on how often members with certain medical conditions get prescription drugs that are considered safer and clinically recommended for their condition.

“Independent Health is deeply rooted in this community, and our RedShirts are dedicated to delivering caring service and one-on-one attention to our members, which is especially important during this time of significant changes in the Medicare Advantage market,” said Cathy Aquino, Vice President, Sales, Medicare & Small Business Markets.

In addition, for the fifth consecutive year, Independent Health’s subsidiary, Pharmacy Benefit Dimensions (PBD), received a 5-Star Rating for its Medicare Employer Group Waiver Plan (EGWP) Prescription Drug Plan (PDP). 

Pharmacy Benefit Dimensions is one of only two PDPs in the nation to earn 5 Stars for 2026. PBD partners with employers and union groups to offer its EGWP PDP to Medicare-eligible retirees and covered Medicare-eligible dependents beyond the standard benefits typically offered by other Medicare prescription drug plans.

1 Medicare Advantage star ratings 2026: Winners and losers, Modern Healthcare, October 13, 2025

Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-POS, HMO-SNP and PPO plans. Enrollment in Independent Health depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system, Based on 2024 Medicare Star Ratings data as of 10/9/2025.