HMO · Special Needs Plan · Contract H1997 · 2026
Regence Blueshield
Regence Blueshield is a HMO Medicare Advantage plan from Regence BlueShield, available in 1 state. Here is its CMS quality rating, drug coverage, and benefits.
- 4.0★
- Above average
- $34.00
- Premium/mo
- 3.5★
- Average
- 1
- States available
The verdict
Regence Blueshield holds a 4.0-star CMS rating, placing it in the top quarter of 484 rated Medicare Advantage contracts nationwide, at $34.00/month.
- 78th pct.
- nationwide CMS rating percentile (of 484)
- 4.0★
- overall CMS star rating
- $34.00
- monthly premium
- $200
- annual drug deductible
Percentile is computed against every CMS-rated Medicare Advantage contract nationwide (contract_summary), not just plans sold in your area.
Where Regence Blueshield sits on CMS quality
This contract's overall CMS star rating, against every rated Medicare Advantage contract nationwide
4★ Top 22% higher than 78% of 484 CMS Medicare contracts
Each bar is a band; taller bars hold more CMS Medicare contracts. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Advantage Star Ratings 2026 · 2026-09-01
Regence Blueshield plan score
A single 0-100 verdict combining Regence Blueshield's nationwide standing on 4 of 4 CMS-filed measures: quality, affordability, cost protection, and supplemental-benefit richness, each from its own CMS source file. A missing filing drops out and redistributes its weight rather than deflating the score.
75/100
Percentile-weighted across 4 of 4 measures
- CMS quality (star rating)
- B 4 stars
78th percentile nationwide
- Affordability (premium)
- D 34 $/mo
42th percentile nationwide
- Cost protection (deductible)
- B 200 $/yr
88th percentile nationwide
- Benefit richness (supplemental coverage)
- A 5 benefits
100th percentile nationwide
Benchmarked live against every plan or plan-county row reporting each measure in the current CMS extract (CY2026 Star Ratings, Landscape file, and Plan Benefit Package). Not a CMS-endorsed score; PlainMedicare's own weighting (quality 40%, affordability 25%, cost protection 15%, benefit richness 20%).
What the CMS Data Shows About Regence Blueshield
Regence Blueshield operates under CMS contract H1997, issued by Regence BlueShield (parent organization Cambia Health Solutions, Inc.). The contract is classified as a HMO product, which governs how enrollees access care: HMOs require in-network providers and referrals for most specialist care, trading network flexibility for lower cost-sharing. 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 (WA) and 1 counties, a geography set at the CMS service-area definition level.
The overall CMS Star Rating for this contract is 4.0 out of 5.0, compared to 3.0 in the prior plan year (a +1.0-star movement). This rating synthesizes 31 individual quality measures spanning 7 CMS domains, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. The Part D drug-benefit portion of this contract carries a separate CMS Star Rating of 3.5, which reflects pharmacy cost, adherence to chronic medications, and drug pricing accuracy. 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 $34.00 (Part C + D combined) and an annual Part D drug deductible of $200.00, from the CMS CY2026 Landscape file; every enrollee also pays the standard Part B premium. Beyond standard Medicare Parts A and B, the contract documents 5 supplemental benefits in the CMS benefits file, coverage extras such as dental, vision, hearing aids, fitness programs, and OTC allowances that Original Medicare does not provide. 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.
Year-over-Year Star Rating
Quality Measures by Domain
Managing Chronic Conditions
11 measuresControlling High Blood Pressure
Diabetes Care – Blood Sugar Controlled
Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions
Getting Needed Care
Improving Bladder Control
Kidney Health Evaluation for Patients with Diabetes
Medication Reconciliation Post-Discharge
Plan All-Cause Readmissions
Reducing the Risk of Falling
Statin Therapy for Patients with Cardiovascular Disease
Transitions of Care
Complaints & Changes
3 measuresHealth Plan Quality Improvement
Members Choosing to Leave the Plan
Plan Makes Timely Decisions about Appeals
Customer Service
3 measuresCall Center – Foreign Language Interpreter and TTY Availability
Call Center – Foreign Language Interpreter and TTY Availability
Reviewing Appeals Decisions
Drug Plan Customer Service
1 measuresComplaints about the Drug Plan
Drug Safety & Pricing
5 measuresMedication Adherence for Cholesterol (Statins)
Medication Adherence for Diabetes Medications
Medication Adherence for Hypertension (RAS antagonists)
MTM Program Completion Rate for CMR
Statin Use in Persons with Diabetes (SUPD)
Tests & Vaccines
5 measuresAnnual Flu Vaccine
Colorectal Cancer Screening
Improving or Maintaining Mental Health
Monitoring Physical Activity
Special Needs Plan (SNP) Care Management
Member Complaints and Changes in the Drug Plan’s Performance
3 measuresDrug Plan Quality Improvement
Members Choosing to Leave the Plan
Rating of Drug Plan
Supplemental Benefits
| Benefit | Covered | Max Benefit |
|---|---|---|
| Dental (Preventive) | ✓ Yes | $1,000 |
| Hearing Aids | ✓ Yes | - |
| Hearing Exam | ✓ Yes | - |
| Vision, Eye Exam | ✓ Yes | - |
| Vision, Eyewear | ✓ Yes | - |
Medicare Advantage Guides
Official Medicare resources
Frequently Asked Questions
What is the star rating for Regence Blueshield?
Regence Blueshield (Contract H1997) by Regence BlueShield has an overall CMS star rating of 4.0 out of 5. The previous year's rating was 3.0 stars. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.
How much does Regence Blueshield cost per month?
Regence Blueshield has a monthly plan premium (Part C + D combined) of $34.00, with an annual Part D drug deductible of $200. Every enrollee also pays the standard Part B premium (about $202.90/month in 2026). Premiums are from the CMS CY2026 Landscape file and can vary by county; confirm current costs on Medicare.gov.
What type of plan is Regence Blueshield?
Regence Blueshield is a HMO Medicare Advantage plan offered by Regence BlueShield. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs. HMO plans generally require you to use in-network providers and get referrals for specialists.
Where is Regence Blueshield available?
Regence Blueshield is available in 1 state (WA) across 1 counties. Coverage area can vary, check with the insurer or Medicare.gov for exact availability in your ZIP code.
What supplemental benefits does Regence Blueshield offer?
Regence Blueshield covers 5 supplemental benefits beyond standard Medicare, including dental preventive, hearing aids, hearing exam, vision eye exam, vision eyewear. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.
How is Regence Blueshield rated on quality measures?
CMS evaluates Regence Blueshield across 31 individual quality measures spanning 7 domains, including DD1: Drug Plan Customer Service, DD2: Member Complaints and Changes in the Drug Plan’s Performance, DD4: Drug Safety and Accuracy of Drug Pricing 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: H1997. Last updated: 2026 plan year.
Related
Before you enroll in Regence Blueshield
Star rating and network fit matter more than the premium alone.
- This contract holds a 4.0-star CMS rating, in the top quarter of rated plans nationwide - see how star ratings are built before comparing plans. How star ratings work
- Check that your doctors and drugs are in-network before you enroll, and confirm the plan on Medicare.gov. Medicare Plan Compare
- This plan documents 5 supplemental benefits beyond Original Medicare - see how it stacks up against Original Medicare's coverage. MA vs Original Medicare
Figures are from CMS CY2026 public files for this contract; benefits and premiums can vary by the specific plan you enroll in and your county.
PlainMedicare is rendered directly from CMS Medicare Advantage and Part D public files, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a correction. Data current as of 2026-09-01.
CMS lists 131,985 Medicare Advantage and Part D plan records in the current public files. PlainMedicare refreshes this registry with each annual release.