Contract H1181 Regional PPO Special Needs Plan

NETWORK HEALTH INSURANCE CORPORATION

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N/R
Overall Star Rating
Monthly Premium
1
States

What the CMS Data Shows About NETWORK HEALTH INSURANCE CORPORATION

NETWORK HEALTH INSURANCE CORPORATION operates under CMS contract H1181, issued by Network Health Medicare Advantage Plans (parent organization Network Health, Inc.). The contract is classified as a Regional PPO product, which governs how enrollees access care: PPO designs let members see out-of-network providers at higher cost-sharing, giving broader access than an HMO. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria — chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 1 state (WI) and more than 40 counties, a geography set at the CMS service-area definition level.

The overall CMS Star Rating for this contract is not yet published by CMS. This rating synthesizes 24 individual quality measures spanning 5 CMS domains, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.

On costs, this contract lists a monthly plan premium of not reported. Supplemental-benefit detail is not available in the public file for this contract. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.

Quality Measures by Domain

Managing Chronic Conditions

7 measures

Controlling High Blood Pressure

3

Diabetes Care – Blood Sugar Controlled

2

Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions

5

Getting Needed Care

4

Kidney Health Evaluation for Patients with Diabetes

4

Plan All-Cause Readmissions

5

Reducing the Risk of Falling

3

Member Experience

6 measures

Care Coordination

2

Complaints about the Health Plan

5

Customer Service

5

Getting Appointments and Care Quickly

4

Rating of Health Care Quality

5

Rating of Health Plan

2

Complaints & Changes

3 measures

Health Plan Quality Improvement

4

Members Choosing to Leave the Plan

5

Plan Makes Timely Decisions about Appeals

3

Customer Service

2 measures

Call Center – Foreign Language Interpreter and TTY Availability

2

Reviewing Appeals Decisions

5

Tests & Vaccines

6 measures

Annual Flu Vaccine

2

Colorectal Cancer Screening

1

Improving or Maintaining Mental Health

4

Improving or Maintaining Physical Health

1

Monitoring Physical Activity

5

Special Needs Plan (SNP) Care Management

1

Supplemental Benefits

No supplemental benefit data available.

Medicare Advantage Star Rating Distribution

Percentage of Medicare Advantage plans at each CMS star rating level (2026 plan year)

8%5-Star Plans
38%4-Star Plans
34%3-Star Plans
14%2-Star Plans
6%1-Star Plans

Source: CMS Medicare Advantage Star Ratings 2026. Distribution reflects national plan-county records.

Frequently Asked Questions

What is the star rating for NETWORK HEALTH INSURANCE CORPORATION?

NETWORK HEALTH INSURANCE CORPORATION (Contract H1181) by Network Health Medicare Advantage Plans has an overall CMS star rating of Not yet rated out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.

How much does NETWORK HEALTH INSURANCE CORPORATION cost per month?

NETWORK HEALTH INSURANCE CORPORATION has a monthly premium of data not available. Plan costs may vary by county.

What type of plan is NETWORK HEALTH INSURANCE CORPORATION?

NETWORK HEALTH INSURANCE CORPORATION is a Regional PPO Medicare Advantage plan offered by Network Health Medicare Advantage Plans. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs. PPO plans offer more provider flexibility, allowing you to see out-of-network providers at a higher cost.

Where is NETWORK HEALTH INSURANCE CORPORATION available?

NETWORK HEALTH INSURANCE CORPORATION is available in 1 state (WI) across more than 40 counties. Coverage area can vary — check with the insurer or Medicare.gov for exact availability in your ZIP code.

How is NETWORK HEALTH INSURANCE CORPORATION rated on quality measures?

CMS evaluates NETWORK HEALTH INSURANCE CORPORATION across 24 individual quality measures spanning 5 domains, including HD2: Managing Chronic (Long Term) Conditions, HD3: Member Experience with Health Plan, HD4: Member Complaints and Changes in the Health Plan's Performance and more. These measures cover clinical outcomes, patient experience, and plan operations.

Data Source

Data from CMS Medicare Advantage 2026 Star Ratings and Plan Finder datasets. Contract ID: H1181. Last updated: 2026 plan year.

Important: PlainMedicare provides CMS data for informational purposes only. This is not medical or insurance advice. Consult a licensed Medicare counselor or insurance agent for personalized guidance. Always verify current plan details with the insurer or Medicare.gov before enrolling.

Related

Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by Kiznis Studio Editorial