What Are Medicare Advantage Star Ratings in Johnson City, Tennessee?

What star ratings measure

Star ratings for plans serving Johnson City are based on a wide range of factors including preventive care rates, chronic condition management, member complaints, plan responsiveness, and customer service call quality. A 5-star plan represents the highest quality tier CMS assigns nationally.

Why this matters beyond a number. Plans rated consistently higher in Johnson City tend to have smoother claims processes, more responsive customer service, and stronger preventive care coordination.

A special enrollment perk for 5-star plans. If a 5-star Medicare Advantage plan becomes available in Johnson City, Medicare allows a one-time Special Enrollment Period to switch into it outside the standard Annual Enrollment or Medicare Advantage Open Enrollment windows.

Where to check current ratings

Star ratings update annually each fall and are published on Medicare.gov's plan finder tool alongside detailed category breakdowns; a licensed agent serving Johnson City can also pull current ratings for the specific plans available at your address.

How ratings interact with cost. A higher-rated plan available in Johnson City isn't automatically more expensive — star ratings measure quality and member satisfaction, not premium, so it's entirely possible to find a $0-premium plan that also carries a 4- or 5-star rating in your county.

Local context for Johnson City

Ballad Health dominates the provider landscape across the Tri-Cities, which means network differences between plans in Johnson City often come down to which Ballad facilities and affiliated physicians are included.

How county lines affect what you can buy. Johnson City sits in Washington County, and that matters differently depending on which kind of coverage you're shopping. Medicare Advantage plan availability is set at the county level by CMS, so the lineup available to you is Washington County's lineup specifically. ACA Marketplace carrier participation is set at the ZIP code level instead, which means two addresses within Johnson City can occasionally see slightly different carrier options. Our Washington County guide covers the county-level picture in more depth.

Where Tennessee's rules differ from most states. Tennessee has not expanded Medicaid, so adults in Johnson City without children or a qualifying disability generally cannot get TennCare regardless of income. Statewide, an estimated 81,000 to 95,000 Tennesseans fall into the resulting coverage gap. Children frequently still qualify for CoverKids even where a parent qualifies for nothing, and both programs are applied for through TennCare Connect at tenncareconnect.tn.gov rather than through HealthCare.gov.

What to have ready before requesting a quote. Whatever direction you lean in Johnson City, the same handful of details makes any quote meaningful: your exact ZIP code, the ages of everyone being covered, a realistic estimate of household income for the year, and a short list of the doctors, hospitals, and prescriptions you want covered. Averages are a starting point, but the final number always comes down to those specifics, and a licensed Tennessee agent can run them at no cost to you.

Why it pays to re-check every year. Coverage decisions in Johnson City are not set-and-forget. Carrier participation, provider networks, drug formularies, and premiums all reset annually, and Tennessee insurers received one of the largest average rate increases in the country for 2026 at roughly 37.5% on full-price individual premiums. Roughly 77% of Tennessee Marketplace enrollees still receive a premium tax credit, averaging about $455 a month, which absorbs much of that increase for subsidized households but none of it for those above the cliff. A plan that was the best value last year may not hold that position now, and letting coverage auto-renew without comparing is the most common way households here quietly overpay.