You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.
Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
How to Enroll
Forms & Documents
KelseyCare Advantage Plan News
Medicare Plan Compliance
Frequently Asked Questions
Compliance and Fraud
Multi Language Service
For Second Year in a Row, KelseyCare Advantage awarded 5 stars by the Centers for Medicare & Medicaid Services (CMS)
KelseyCare Advantage is the only Medicare Advantage plan in Texas to be awarded 5-out-of-5 stars, the highest possible rating for service and quality by CMS
HOUSTON (Oct. 23, 2017)
— On Oct. 11, 2017, the Centers for Medicare and Medicaid Services (CMS) announced that KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area Medicare beneficiaries, earned five out of five stars in an annual assessment of all Medicare Advantage plans for the second year in a row. This 5-out-of-5 star rating applies to the 2018 plan year which begins on Jan. 1. Achieving five stars is challenging and is the highest overall rating for quality and service.
KelseyCare Advantage is the only 5-star rated Medicare Advantage plan in Texas for the 2018 plan year. No other Medicare Advantage plan achieved an overall 5-star rating.
“KelseyCare Advantage has repeatedly earned the highest rating for quality and service from CMS, but to achieve a 5-star rating two years in a row is rather remarkable,” said Marnie Matheny, president of KelseyCare Advantage. “A 5-star rating demonstrates our commitment to quality, value and customer service. Everyone from our call-center employees to our medical staff works daily to strive for excellence, and it has paid off. From the inception of our plan in 2008, our patients have received high-quality care that is value-driven and focused on the individual – our 5-star rating from CMS proves that.”
Each year, Medicare uses information from member satisfaction surveys, clinical data, and healthcare providers to give overall performance ratings to Medicare health and prescription drug plans. These ratings help Medicare beneficiaries choose a plan based on quality and performance. A plan can earn from one to five stars. A 5-star rating is considered excellent. The 2018 overall plan rating is based on over 40 healthcare and service quality measures including: detecting illness and keeping members healthy, managing chronic conditions, member satisfaction and customer service.
“When we developed the strategy and plan that would later become KelseyCare Advantage 10 years ago, we knew we had the people, the tools and the desire to create a Medicare Advantage plan that could help improve health outcomes for our patients,” said Donnie Aga, M.D., Medical Director for KelseyCare Advantage. “We have found that by engaging patients, working with them to manage chronic conditions, offering healthcare innovations like telemedicine and eliminating barriers to care, we are better able to serve our Medicare Advantage patients."
KelseyCare Advantage has held a contract with Medicare since 2008, and currently serves more than 30,000 Texans in the counties of Fort Bend, Harris, Montgomery and portions of Galveston. The plan is affiliated with Kelsey-Seybold Clinic, a group of doctors based in Houston that have been serving Houston-area families for more than 65 years. KelseyCare Advantage plans provide all Medicare Part A and B coverage, and some plans include Part D prescription drug coverage, to Houston-area Medicare beneficiaries who want more coverage than traditional Medicare provides.
Medicare-eligible residents in these areas can enroll in a KelseyCare Advantage plan during the Medicare enrollment period between Oct. 15, 2017 and Dec. 7, 2017, with a start date of Jan. 1, 2018. In addition to receiving high-quality care and service, 5-star excellence means that Medicare beneficiaries may enroll in a 5-star plan between Dec. 8, 2017 and Nov. 30, 2018, without having to wait until the next annual enrollment period.
Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next. To learn more about KelseyCare Advantage, or about the Medicare Star Quality Ratings, visit: www.kelseycareadvantage.com or www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).
KelseyCare Advantage is offered by KS Plan Administrators, LLC, a Medicare Advantage HMO with a Medicare contract. Enrollment in KelseyCare Advantage depends on contract renewal. You must continue to pay your Medicare Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/co-insurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Understand Medicare Advantage
Compliance and Fraud
How to Enroll
Cost Sharing, Copayments,and Deductibles
Appeals / Grievances
Part D Coverage Determination
©2015 KelseyCare Advantage. All rights reserved.