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How the Worst Medicare Advantage Plans Keep Reappearing Each Year With a Slightly Different Name

Key Takeaways

  • Medicare Advantage plans with low CMS star ratings or a pattern of rebranding can reappear annually with slight name changes, making them harder to track and avoid.

  • You should look beyond marketing and advertisements and carefully review plan details, especially the CMS star rating and history of plan changes, to avoid ending up in a substandard plan.

Why Some Plans Keep Reappearing Under Different Names

Each year during Medicare’s Annual Enrollment Period (October 15 to December 7), plans are introduced, updated, or discontinued. What many enrollees don’t realize is that some of the worst-performing Medicare Advantage plans don’t disappear altogether. Instead, they often resurface under new names or slightly revised plan IDs.

This pattern allows these plans to escape the negative associations they’ve built. While the Centers for Medicare & Medicaid Services (CMS) does penalize poorly performing plans through reduced star ratings and public flagging, there’s no formal barrier preventing these plans from being reintroduced with a different label.

Understanding the CMS Star Ratings System

The CMS star rating system evaluates Medicare Advantage plans annually based on:

  • Quality of care

  • Member satisfaction

  • Customer service

  • Access to care

  • Chronic condition management

Plans are rated on a scale from 1 to 5 stars:

  • 5 stars: Excellent

  • 4 stars: Above Average

  • 3 stars: Average

  • 2 stars: Below Average

  • 1 star: Poor

Plans rated fewer than 3 stars for three consecutive years are flagged as low-performing. However, these ratings are only one tool for identifying problem plans, especially when rebranding obscures a plan’s historical performance.

How Rebranding Circumvents Accountability

By slightly modifying a plan’s name or ID and filing a new contract with CMS, some providers effectively wipe the slate clean. The plan may:

  • Drop or add a single word in the name

  • Shift from an HMO to a PPO model

  • Change service regions

  • Merge with another plan

The result is a plan that appears new but may be carrying the same poor network, coverage limitations, and administrative practices that caused issues previously.

In 2025, this trend continues. Some plan providers are using technicalities to relaunch similar plans while distancing themselves from past criticisms or low CMS ratings.

Red Flags That Signal a Problem Plan

While rebranding makes identification harder, there are still warning signs you can watch for:

  • Sudden Name Changes: If a plan you recognize from last year is no longer available but something similar appears with only a small naming tweak, dig deeper.

  • No Star Rating Available: New plans are unrated for their first year. This does not automatically mean it is bad, but if the plan resembles a previously poor performer, proceed with caution.

  • Shrinking Networks: A plan may advertise a broad network but lose providers throughout the year. You may find that the local specialists or hospitals you rely on are no longer covered.

  • Complicated Prior Authorization Requirements: These plans often require more steps to approve essential care, which delays treatment.

  • High Out-of-Pocket Costs for Basic Services: Despite looking affordable, these plans may result in higher total costs due to copayments, coinsurance, or specialist access restrictions.

Timeline: How the Reappearance Pattern Unfolds Each Year

From January to September, CMS collects and analyzes plan performance data. Then:

  • October: CMS releases the updated star ratings.

  • October to December: The Annual Enrollment Period begins, and rebranded plans are marketed heavily.

  • January: Enrollees begin coverage under their chosen plans.

If a plan underperforms and is likely to be flagged or lose members, its provider may:

  • Withdraw the contract before renewal

  • Submit a new plan with slightly revised benefits or structure

  • Re-enter the market under a different CMS contract number

This cycle allows some of the worst plans to keep resurfacing, avoiding scrutiny and maintaining enrollment numbers.

Why Marketing Can Be Misleading

In 2025, Medicare Advantage marketing is still aggressive. Plan ads focus on the most appealing benefits, such as dental, vision, or fitness programs, while glossing over limitations in coverage or network.

Rebranded plans often invest heavily in marketing during the enrollment period. But even with CMS oversight, misleading impressions persist. If a plan spends more on ads than care coordination, that’s a serious red flag.

You should always compare the Summary of Benefits and Evidence of Coverage (EOC) documents rather than relying solely on promotional materials. These documents explain the plan’s actual structure, provider access, cost-sharing, and approval processes.

What Happens When You Join a Poor Plan

If you enroll in a low-performing or rebranded problem plan, you may face:

  • Delays in receiving specialist care

  • Frequent denials for services that should be covered

  • Increased out-of-pocket expenses

  • Difficulty switching mid-year (outside of certain qualifying events)

CMS does allow a special enrollment opportunity if a plan receives fewer than 3 stars for three years in a row, but many rebranded plans avoid this flag by resetting their rating clock. That means you might be stuck until the next Annual Enrollment Period.

How to Protect Yourself

To avoid enrolling in a plan that has rebranded to avoid scrutiny, take the following steps:

  • Check the CMS Star Rating: Use the Medicare Plan Finder tool to confirm a plan’s current rating.

  • Ask About Plan History: Ask a licensed agent if the plan existed under a different name in previous years.

  • Compare Plan Documents Side by Side: Review the Evidence of Coverage to spot recycled policies.

  • Examine the Provider Directory: Make sure your preferred doctors and hospitals are in-network.

  • Understand the Prior Authorization Process: Learn what services require pre-approval.

The Role of a Licensed Agent

Navigating plan options alone can be overwhelming. Licensed agents track plan changes, name swaps, contract numbers, and year-over-year policy adjustments.

An experienced agent can:

  • Inform you if a plan is essentially a rebranded version of a previously poor plan

  • Help you identify real differences between similar-sounding plans

  • Assist with enrollment and explain potential pitfalls

This level of insight is difficult to gain through research alone, particularly when companies deliberately make it harder to track their records.

Why This Issue Persists in 2025

Despite increased transparency efforts by CMS, loopholes in the system remain. Plans can legally rebrand, refile, and re-enter the market as long as they comply with CMS filing deadlines and standards.

In 2025, there is still no mandatory carryover of star ratings or performance flags to new plan contracts. This gap allows companies to present their plans as “new and improved” even if only minor administrative changes were made.

Unless CMS updates its policy to track the history of entities behind the plans (not just plan names or numbers), this pattern is likely to continue.

What You Should Do Right Now

Now is the time to review your current plan, especially if it has undergone a name or structural change in the past year. Don’t assume the new plan is an upgrade.

If you’re approaching the next enrollment window, start preparing:

  • Request updated plan documents early

  • Review your previous year’s healthcare usage

  • Compare other plan options with higher CMS star ratings

  • Contact a licensed agent listed on this website for professional guidance

Avoid Getting Caught in the Rebranding Trap

The worst Medicare Advantage plans don’t always go away. They evolve, disguise themselves, and re-emerge when you’re most vulnerable to marketing spin.

You deserve consistent, transparent, and reliable healthcare coverage. Don’t let slight name changes or vague promises mislead you into selecting a plan that has already proven problematic under a different banner.

To make a confident decision, get in touch with a licensed agent listed on this website who can help you look past the labels and into the substance of your options.

Find a Medicare Expert.

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Working with an independent licensed agent can help you gain a better understanding of which Medicare Plan is best for you. You don’t need to do this alone.

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