Highest-Rated Health Plans in Pennsylvania

Each year, NCQA rates commercial, Medicare and Medicaid health plans in all 50 states, U.S. territories and the District of Columbia. Ratings offer valuable insights into how well plans perform on key health measures and how satisfied members are with their care. By making this information publicly available, NCQA aims to empower consumers, employers and policymakers to make informed health care decisions and to encourage health plans to improve performance and prioritize member needs.

How Ratings Work

Health plans are rated on a scale of 0-5 stars. NCQA considers plans with 4.5 and 5 stars to be the highest-rated health plans in the nation. Ratings are based on three types of quality:

Measures of clinical quality from HEDIS^® and the Health Outcomes Survey (HOS).
Measures of patient experience using the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®).
Results from NCQA's review of a health plan's structure and quality processes (NCQA Health Plan Accreditation).

The overall rating is the weighted average of a plan's HEDIS, CAHPS and HOS measure ratings, plus Accreditation bonus points, if the plan is Accredited by NCQA.

Highest-Rated Plans

Below are the highest-rated health plans in Pennsylvania. View more details about each plan on NCQA's website.

Plan Name	Product Line & Reporting Product	Overall Rating
UPMC Benefit Management Services, Inc.	Commercial HMO	5
UPMC Health Coverage, Inc.	Commercial HMO	5
UPMC Health Plan, Inc.	Commercial HMO	5
Capital Advantage Insurance Company	Commercial HMO/POS Combined	4.5
Geisinger Health Plan	Medicare HMO	4.5
Geisinger Indemnity Insurance Company	Medicare PPO	4.5
Keystone Health Plan Central	Commercial HMO/POS Combined	4.5
Pennsylvania Health & Wellness, Inc.	Medicaid HMO	4.5
UPMC Benefit Management Services, Inc.	Commercial PPO/EPO Combined	4.5
UPMC For You, Inc.	Medicaid HMO	4.5
UnitedHealthcare Insurance Company (H1537)	Medicare PPO	4.5
Vista Health Plan DBA AmeriHealth Caritas Pennsylvania	Medicaid HMO	4.5
Vista Health Plan, Inc. aka AmeriHealth Caritas Health Plan (operating as AmeriHealth Caritas Pennsylvania Community HealthChoices)	Medicaid HMO	4.5

Ratings are based on NCQA's 2025 Health Plan Ratings. Plans that reported partial or no data did not receive a rating.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).