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Providence Health Assurance Achieves 4-Star Rating for 2026 Medicare Advantage Plans

In a major achievement, Providence Health Assurance (PHA), a branch of Providence Health Plan, has secured an impressive 4 out of 5 Star rating from the Centers for Medicare and Medicaid Services (CMS) for its Medicare Advantage plans set for 2026. This rating places PHA among the top-tier plans not just locally but also nationally, especially impressive given the current marketplace's regulatory and financial hurdles.

CMS evaluates Medicare Advantage offerings annually, scoring them from one to five stars based on over 40 distinct criteria. These metrics span several important areas, including preventive care, chronic condition management, member satisfaction, and customer service quality. As of 2026, CMS increased performance thresholds in many categories, further intensifying the competition for high ratings.

Despite this challenging landscape, PHA demonstrated remarkable quality performance. Notably, it achieved the highest possible score—5 Stars—for Part D call center language services and accessibility. Additional areas of strength included substantial clinical quality measures, particularly in managing blood pressure and tracking physical activity among members.

Randi Escobedo, the head of healthcare experience and advocacy at Providence Health Plan, expressed pride over the recognition, stating, "This 4-Star rating reflects the dedication of caregivers who work and live in the communities Providence Health Assurance serves. Because we're an integral part of these communities, we know what matters most to the people we serve." This sentiment underscores the organization's ongoing commitment to delivering exceptional, personalized healthcare services that yield meaningful results.

The 2026 Medicare Annual Enrollment Period begins on October 15, 2025, and runs through December 7, 2025. During this time, prospective beneficiaries will have access to an array of Medicare Advantage plan options tailored to meet various healthcare needs and budgets.

Shannon Drotning, Providence Health Plan's consumer and market president, added, "This achievement signifies that our adherence to our Mission and values continues to bear positive results for the communities we serve. In a time when the Medicare Advantage sector faces unprecedented challenges, this 4-Star rating evidences that Providence Health Assurance stands out as a reliable, quality option for Medicare-eligible individuals seeking affordable, high-quality coverage." Her gratitude extended to all caregivers whose dedication paved the path for this honor.

Providence Health Assurance offers a diverse selection of plans designed to accommodate a range of healthcare needs, making it a preferred choice for Medicare-eligible individuals looking for affordable and quality coverage. Their offerings are rooted in the communities where Providence has built a legacy over generations.

For more information about PHA's 2026 Medicare Advantage Plans, please visit TheProvidenceAdvantage.com.

About Providence Health Assurance

Providence Health Assurance (PHA) and its affiliates are an essential component of a 160-year-old nonprofit healthcare collective, setting high standards for health and wellness for the communities it services. PHA provides affordable, high-quality coverage to its members through a variety of plans targeting small and large groups, self-insured plan sponsors, as well as Medicare and Medicaid beneficiaries, including individuals and families. PHA operates under contracts for Medicare, HMO, HMO-POS, and HMO SNP, with enrollment dependent on contract renewal.

Beneficiaries of PHA must continue to pay their Medicare Part B premium. CMS evaluates plans on a yearly basis using a standardized 5-star rating system, ensuring a transparent measure of performance across the healthcare landscape.