The Star Rating for Medicare providers gives an overall rating of the plan’s quality and performance for the types of services each plan offers. There are two main services: health care services and drug services. Each have categories, which they are rated on to provide their star rating.
Health Care Services
- Staying health: screening tests and vaccines
- Managing chronic (long-term) conditions
- Member experience with the health plan
- Member complaints and changes in the health plan’s performance
- Health plan customer service
- Member survey done by Medicare
- Information from clinicians
- Information submitted by the plans
- Results from Medicare’s regular monitoring activities
- Drug plan customer service
- Member complaints and changes in the drug plan’s performance
- Member experience with plan’s drug services
- Drug safety and accuracy of drug pricing
- Member surveys done by Medicare
- Reviews of billing and other information that plans submit to Medicare.
- Results from Medicare’s regular monitoring activities.
Medicare reviews plan performances each year and releases new star ratings each fall. This means plan ratings change from one year to the next. Medicare sets the categories and reviews each plan the same way. You should look at coverage and plan costs, such as if the Part D plan covers all the drugs you take and has a premium you can afford before you consider the star rating.
5-Star Special Enrollment
A 5-star plan has been given excellent scores in each category. There is a special enrollment granted for 5-star plans. You are allowed to switch to a 5-star plan once from December 8th to November 30th.
A plan’s star ratings is only one factor to look at when you compare plans in your area, and it is not the most important factor in choosing your coverage. Even though a plan has a high star rating, it may not be right for you.
If you have questions or are confused about which company is best for you, book a meeting with an agent. The goal is to lower your potential cost as low as possible while still receiving great medical care when you need it.
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