Finding the right Medicare Advantage or Medicare Part D plan can be incredibly challenging. There are different costs, coverages, networks, and pharmacies. But what are the star ratings and how can I use them to choose the best plan?
What the Medicare Star Ratings Mean
Medicare Advantage and Medicare Part D plans are rated in individual categories as well as given an overall star rating based on their performance. Plans with five stars have the highest rating and those with one star have the lowest.
The Medicare Plan Finder identifies plans that are low-performing, meaning they receive fewer than three stars for three years in a row. If you want to sign up for a low-performing plan, you have to do so directly instead of using Plan Finder.
How Plans Are Rated
Medicare Advantage plans are rated based on:
- Staying healthy: screenings, tests, and vaccines
- Managing chronic (long-term) conditions
- Plan responsiveness and care
- Member complaints, problems getting services, and choosing to leave the plan
- Health plan customer service
Medicare Part D prescription drug plans are rated based on:
- Drug plan customer service
- Member complaints, problems getting services, and choosing to leave the plan
- Member experience with the drug plan
- Drug pricing and patient safety
Comparing with the Rating System
Before looking at a plan’s ratings, you need to review a few things first. Look at a Medicare Advantage plan’s additional benefits, its costs, and its network of health care providers. Look at a Part D plan’s coverage, its costs, its drug coverage, and the pharmacies it uses. Once you have examined all of those things and narrowed the available Medicare plans down to only a few, you can compare the remainder based on their Medicare star rating.
Five-Star Special Enrollment Period
Medicare has a special enrollment period for people who want to join or switch to a five-star Medicare Advantage or Medicare Part D plan. Once during the calendar year you can make this change. The enrollment period begins December 8 of the year before a plan is considered a five-star plan and lasts through November 30 of the five-star year for the plan. If you enroll in December, your coverage will begin on January 1. If you enroll between January and November, your coverage will begin one month after your request has been made.
Comparing plans has never been a walk in the park. But with the help of Medicare star ratings, you can more clearly see how a particular Medicare Advantage or Medicare Part D plan is performing. The Medicare star rating given to a plan is best considered after you have looked into the plan’s coverage, costs, and network. Hopefully, the individual ratings can give you a better understanding of what you might be getting yourself into.
For more guidance about choosing a Medicare plan, contact Medicare with Jake.
