Local PPO · observed 2026 → 2026 · 75 months of CPSC history · 5 active CY 2026 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| PriorityMedicare Edge (PPO) H4875/020 | MA-PD | $0 | $6,000 | 4.0 | 38 | 42,576 |
| PriorityMedicare Vital (PPO) H4875/022 | MA-PD | $0 | $6,300 | 4.0 | 38 | 23,839 |
| PriorityMedicare Thrive (PPO) H4875/024 | MA-PD | $0 | $6,200 | 4.0 | 68 | 23,354 |
| PriorityMedicare Thrive Plus (PPO) H4875/018 | MA-PD | $49 | $5,600 | 4.0 | 68 | 9,361 |
| PriorityMedicare Merit (PPO) H4875/016 | MA-PD | $105 | $4,200 | 4.0 | 68 | 7,421 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 4.0 |
| C02 | Colorectal Cancer Screening | 4.0 |
| C03 | Annual Flu Vaccine | 4.0 |
| C04 | Improving or Maintaining Physical Health | 4.0 |
| C05 | Improving or Maintaining Mental Health | 4.0 |
| C06 | Monitoring Physical Activity | 4.0 |
| C07 | Special Needs Plan (SNP) Care Management | — |
| C08 | Care for Older Adults – Medication Review | — |
| C09 | Care for Older Adults – Pain Assessment | — |
| C10 | Osteoporosis Management in Women who had a Fracture | 2.0 |
| C11 | Diabetes Care – Eye Exam | 4.0 |
| C12 | Diabetes Care – Blood Sugar Controlled | 4.0 |
| C13 | Kidney Health Evaluation for Patients with Diabetes | 4.0 |
| C14 | Controlling High Blood Pressure | 4.0 |
| C15 | Reducing the Risk of Falling | 2.0 |
| C16 | Improving Bladder Control | 4.0 |
| C17 | Medication Reconciliation Post-Discharge | 4.0 |
| C18 | Plan All-Cause Readmissions | 3.0 |
| C19 | Statin Therapy for Patients with Cardiovascular Disease | 2.0 |
| C20 | Transitions of Care | 4.0 |
| C21 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3.0 |
| C22 | Getting Needed Care | 5.0 |
| C23 | Getting Appointments and Care Quickly | 4.0 |
| C24 | Customer Service | 4.0 |
| C25 | Rating of Health Care Quality | 5.0 |
| C26 | Rating of Health Plan | 4.0 |
| C27 | Care Coordination | 4.0 |
| C28 | Complaints about the Health Plan | 5.0 |
| C29 | Members Choosing to Leave the Plan | 5.0 |
| C30 | Health Plan Quality Improvement | 4.0 |
| C31 | Plan Makes Timely Decisions about Appeals | 5.0 |
| C32 | Reviewing Appeals Decisions | 2.0 |
| C33 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D01 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D02 | Complaints about the Drug Plan | 5.0 |
| D03 | Members Choosing to Leave the Plan | 5.0 |
| D04 | Drug Plan Quality Improvement | 3.0 |
| D05 | Rating of Drug Plan | 3.0 |
| D06 | Getting Needed Prescription Drugs | 4.0 |
| D07 | MPF Price Accuracy | 5.0 |
| D08 | Medication Adherence for Diabetes Medications | 3.0 |
| D09 | Medication Adherence for Hypertension (RAS antagonists) | 4.0 |
| D10 | Medication Adherence for Cholesterol (Statins) | 3.0 |
| D11 | MTM Program Completion Rate for CMR | 4.0 |
| D12 | Statin Use in Persons with Diabetes (SUPD) | 3.0 |