Why Trust This Research?
Since 2012, I’ve analyzed thousands of Medicare Advantage, Special Needs, Part D, and Medicare Supplement plans using raw data from the Centers for Medicare & Medicaid Services (CMS). As a former Director of Systems and Networks at HealthNet, and Vice President of Global Systems at Sony Pictures Entertainment, I bring a unique blend of healthcare, data science, and cybersecurity experience to my work at MedicareWire.
In my final tour with the U.S. Navy Reserve, I served as Command Chief at TACRON-11, where operational integrity was critical. That same discipline guides the Medicare plan analysis you see on this site.
Primary Data Sources
I believe in complete transparency. For this reason, I list all of my resources. The secret sauce mostly comes from files from the Centers for Medicare & Medicaid Services (CMS). They are the information originators, including:
- CMS Plan Benefit Package (PBP) files – for benefit details, premiums, and plan design.
- CMS Star Ratings – to evaluate plan quality based on consumer and clinical metrics.
- CMS Service Area files – for county-level availability and plan reach.
- CMS Landscape and Contract Reports – for historical tracking and contract info.
All data is retrieved from data.cms.gov, published on MedicareGraph™, and is updated monthly, quarterly, or annually as new datasets are released.
What MedicareGraph Offers
CMS data is complex, often not easy to find, and is full of idiosyncrasies and complex data dictionaries that are not easily translated. A few large organizations create their own internal systems to translate CMS data, but the MedicareGraph open API shares this data with others.
- ✅ Real-time Medicare Advantage and Part D plan data
- ✅ Annual CMS, FPL, and SSA benchmark cost data
- ✅ Fast, versioned RESTful API endpoints
- ✅ Human-readable OpenAPI docs powered by Redoc
- ✅ JSON-LD structured data integration for developers and publishers
- ✅ Designed for transparency, trust, and public health innovation
- ✅ Dynamic Structured Publishing System
Patent Pending (USPTO App #63/796,593 Filed April 29, 2025)
In the near future, MedicareGraph will offer a full suite of free tools to help publishers, analysts, and insurance professionals display MedicareGraph API data in meaningful ways (i.e., charts, tables, auto-updating CMS costs, etc.).
How I Construct Plan Pages
Data analysis is a lonely and highly technical job. Here are the basics:
- Normalize raw CMS data into structured tables using custom-built Python scripts.
- Match plan attributes with service area, star rating, and plan ID metadata.
- Cross-reference CMS source data to ensure consistency and reduce duplication.
- Manually verify plan notes, enrollment details, and data anomalies.
- Attach all relevant citations, references, and data update timestamps to each page.
All plan summaries are independently written and not influenced by compensation or partner relationships. Learn more about our compensation policy.
Data is one thing, and CMS makes volumes (truckloads!) available. My job is to turn that raw data into information. I translate the Plan Benefits Package (PBP) data dictionary, which allows me to break down the individual health services and costs.