“The rebates that will go to four-star and higher plans are to be used to provide additional benefits, such as lowering beneficiary premiums or reducing co-pays for doctor visits. Lower-income seniors are, arguably, more in need of those benefits. But not all plans are available in all counties. The report notes that four-star plans are offered in less than 14% of the counties where at least 25% of residents are below the federal poverty level. Thus, poorer Medicare beneficiaries are less likely to have access to the plans that receive the rebates and have better benefits.”