KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES
What the CMS Data Shows About KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES operates under CMS contract H2172, issued by Kaiser Permanente (parent organization Kaiser Foundation Health Plan, Inc.). The contract is classified as a HMO POS product, which governs how enrollees access care: the product rules govern provider access and cost-sharing for this contract. 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 2 states (MD, VA) and 24 counties, a geography set at the CMS service-area definition level.
The overall CMS Star Rating for this contract is 4.5 out of 5.0. This rating synthesizes 41 individual quality measures spanning 9 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 5.0, 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 not reported. Beyond standard Medicare Parts A and B, the contract documents 84 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.
Quality Measures by Domain
Managing Chronic Conditions
12 measuresControlling High Blood Pressure
Diabetes Care – Blood Sugar Controlled
Diabetes Care – Eye Exam
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
Member Experience
6 measuresCare Coordination
Complaints about the Health Plan
Customer Service
Getting Appointments and Care Quickly
Rating of Health Care Quality
Rating of Health Plan
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 Plan Experience
2 measuresGetting Needed Prescription Drugs
MPF Price Accuracy
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
6 measuresAnnual Flu Vaccine
Colorectal Cancer Screening
Improving or Maintaining Mental Health
Improving or Maintaining Physical 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 | Copay |
|---|---|---|---|
| Hearing Aids | ✓ Yes | — | — |
| Hearing Exam | ✓ Yes | — | — |
| Vision — Eye Exam | ✓ Yes | — | — |
| Vision — Eyewear | ✓ Yes | — | — |
| Dental (Preventive) | ✓ Yes | $1,500 | — |
Medicare Advantage Star Rating Distribution
Percentage of Medicare Advantage plans at each CMS star rating level (2026 plan year)
Source: CMS Medicare Advantage Star Ratings 2026. Distribution reflects national plan-county records.
County Availability
Medicare Advantage Guides
Related Healthcare Data
Frequently Asked Questions
What is the star rating for KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES?
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES (Contract H2172) by Kaiser Permanente has an overall CMS star rating of 4.5 out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.
How much does KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES cost per month?
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES has a monthly premium of data not available. Plan costs may vary by county.
What type of plan is KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES?
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES is a HMO POS Medicare Advantage plan offered by Kaiser Permanente. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs.
Where is KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES available?
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES is available in 2 states (MD, VA) across 24 counties. Coverage area can vary — check with the insurer or Medicare.gov for exact availability in your ZIP code.
What supplemental benefits does KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES offer?
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES covers 84 supplemental benefits beyond standard Medicare, including hearing aids, hearing exam, vision eye exam, vision eyewear, dental preventive. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.
How is KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES rated on quality measures?
CMS evaluates KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES across 41 individual quality measures spanning 9 domains, including DD1: Drug Plan Customer Service, DD2: Member Complaints and Changes in the Drug Plan’s Performance, DD3: Member Experience with the Drug Plan 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: H2172. Last updated: 2026 plan year.
Read our methodology — how this data is sourced, computed, and verified.