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5-Star Rated Medicare Advantage and Prescription Drug Plans

by Diana Wisniewski - 

In an effort to improve the quality of care for Medicare Beneficiaries, the Center for Medicare and Medicaid Services (CMS) developed a 5-star rating system for Medicare Advantage and Prescription Drug Plans.  Plans with a 5-star rating have an all year round enrollment period.  Medicare Beneficiaries can enroll in to a 5-star plan once from December 8th through November 30th of each year, as well as during the Annual Election Period which runs from October 15th through December 7th.

Medicare uses the data gathered from member surveys, plans and health care providers to determine the star rating.  A plan can get a star rating from 1 – 5, with 5 indicating excellent plan performance.  The ratings are updated each fall and can change each year.  CMS gives bonus funds, additional reimbursement and more marketing privileges to those Health Plans with higher ratings.  This helps restore some of the Medicare Advantage reimbursement cuts from the Affordable Care Act.  The star rating was developed to be an easy and quick way for a person researching plans to determine the quality of the plan.  Higher quality means that you will receive better care from the providers.

There are over fifty determining factors for star rating that fall in to one of the following categories:

Medicare Health Plans

1)      Wellness Visits: screenings, vaccines and tests

2)      Customer Service from the Health Plan

3)      Complaints, problems with service, and improvement of the health plan’s performance

4)      Member experience with the plan

5)      Managing long term or chronic health conditions

Medicare Prescription Drug Plans

1)      Accuracy of drug prices and patient safety

2)      Customer Service from the Drug Plan

3)      Complaints, problems with service, and improvement of the drug plan’s performance

4)      Member experience with the plan

CMS has been leaning towards giving heavier weight to both patient experience and outcomes more than other determining factors, according the CMS Deputy Administrator Jonathan Blum.

If a Medicare Beneficiary would like more detail about the plan’s rating, there are summary scores available, or you can “drill down” to one of the above mentioned categories.

Some plans may be too new or not have enough data collected to be rated.  For the plans that are rated, the ratings are described as follows:

AMAC is working diligently towards obtaining 5-star Medicare Health and Drug plans wherever available.  AMAC is happy to announce we have a 5-star Medicare health plan available in Wisconsin.  We are working towards getting    5-star plans in the following states where the 5-star health plans are available:

California     Colorado     Hawaii    Ohio     Oregon    Massachusetts     Minnesota      Washington     Mid-Atlantic Region

AMAC will send immediate updates on available states as they come in.

For more information on 5-star plans, please call

AMAC’s trusted Licensed Insurance Agents at

1-800-334-9330

 

Comments (37)

  1. Bob says:

    Where is the web site that I can go to where it lists all of the Medicare Advantage Programs and Supplement Programs that are rated by the 5 STAR rating system for your specific State, County, etc. I have been unable to find it.
    Thank you.

  2. caron says:

    What is the highest rated Medicare Plan in Collier Co, Naples, FL please?Suppl or advantage

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