Medicare Advantage Star Ratings – Not all Medicare Advantage plans have the same coverage and benefits. In fact, you’ll be hard-pressed to find even two Medicare Advantage plans that have the same coverage. To make it easier to sort through the “good” and “bad” plans, each year, the Centers for Medicare and Medicaid Services (CMS) publishes star ratings.
What Are Medicare Star Ratings?
CMS uses star ratings to rate Medicare Advantage plans, Medicare Cost plans, and Medicare Part D prescription drug plans. Star ratings range from one star, meaning it has poor performance, all the way up to five stars, which indicate excellent plan performance.
Medicare scores the plans using several categories, including customer service and quality of care. They’ll use an overall star rating to score the plan as a whole, but you should look at how the plan performs in each individual area. Each plan is reviewed annually, which means a plan’s rating can change from one year to the next. If you are looking for a rating, be sure you’re looking at the most up-to-date information.
Medicare Advantage plans are rated in the following five categories:
- Customer service
- Member complaints, service availability, disenrollment
- Care and responsiveness
- Management of chronic conditions
- Preventive care (vaccines, tests, screenings)
Medicare Part D plans are rated in the following four categories:
- Customer service
- Member complaints, service availability, disenrollment
- Member safety and prescription pricing
- Member experience
None of this means you should only choose a plan based on its star rating. Before enrolling in any plan, you need to take a close look at the coverage, network, costs, and extra benefits. Choosing a 5-star plan your doctor doesn’t accept or one that doesn’t cover your prescriptions won’t do you any good.
Special Enrollment Periods for 5-Star Plans
Generally, you can only join or switch your Medicare Advantage plan during certain times of the year. For example, the Annual Election Period runs from October 15 through December 7 each year. You can join or change your current plan during this period, and your new plan will take effect on January 1. You can also make a one-time change to your Medicare Advantage plan during the MA Open Enrollment Period, which runs from January 1 through March 31. You must already be enrolled in an MA plan to use this OEP.
In addition to those options, there is a Special Enrollment Period for 5-star plans. You can change your Medicare Advantage plan or Part D plan to one that has five stars if one is available in your area. You can use this SEP one time between December 8 and November 30 of the next year. If utilized, your new plan will start on the first day of the following month.
Before making a change, be sure to talk with the advisors at Carolina Senior Benefits. Make sure switching plans won’t cause you to lose any coverage. For example, if you switch to a Medicare Advantage plan that doesn’t include prescription coverage, you may lose your prescription coverage for the year. In addition, you might end up paying a late enrollment penalty for Part D when you finally enroll.
To find out if there are any 5-star Medicare plans in your area, call Carolina Senior Benefits today. We are happy to help you understand your current coverage, and shop for plans that might better suit your needs.
