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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

 

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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

  3. Sharon says:

    Suggest you do google search like “medicare supplement plans in ” your state or area.

  4. Cheryl Williams says:

    I have Medicare Advantage with AARP CompleteCare through United Healthcare and have had it for two years, very satisfied, since it pays for many things and lets me pick my own doctors (a PPO) as long as they are in the United Healthcare network (one of the biggest networks in medical care). I hate AARP and did not renew my membership, after joining AMAC. When I called my AARP CompleteCare customer service, they told me it was not necessary for me to belong to AARP to belong to that MAP. Maybe AMAC didnit name the plans because AARP is one of them, but the health care is NOT connected to them at all. It is through United Health Care.

    • Sharon says:

      Yeah they might “say” that BUT, United healthcare IS the prime Part B supplement of AARP and thereby you are giving money to an Org. I refuse to support in any way!

  5. Irene says:

    Why tell us about the 5 star plans without telling us what they are? I find that more and more opening your e-mails
    is wasting my time.

  6. Barbara Manzo says:

    I relinquished my membership with AARP in favor of AMAC. I e-mailed friends with your page hoping I could do my small part to increase membership – the more membership the more clout in Washington. Looking forward to any information on Medicare as I reside in Florida.

  7. Alan C Rohner says:

    I live in Cincinnati, Ohio and have NO insurance.
    I’m looking for prescription coverage as I have high blood pressure.
    I just turned 60…12/3/12.

    Does anyone have any suggestions? Thanks

    • Snitz Kabeebleve says:

      Yeah……Go have another cigarette and a beer
      Obama is going to rescue your dumass next year, but you are still going to have to pay for it.

  8. bob says says:

    I dont agree with aarp on a lot of things but I had been inrolled with humana advantage in 2007 and 2008 but changed to secure horizons for the last 4 years. it is also a advantage plan, it includes part D. I am really pleased with the program, so far. I’m sure my cost will go up when oboma care goes into place. I live in texas and we have many plans to choose from.

  9. Rick says:

    We are full time rv’ers and have our residence in South Dakota. Spend a lot of time in CA where grandkids are. I got Humana beause had doctors all over. Have been really pleased with them so far. Have not experienced ANY difficulties…so far. Regarding Obamanation Care, got notice my premium was going up 60%. Possibly this is why. But, at $40/month, still affordable.

  10. Carol Durand says:

    How silly of me not to mention the fact that Obamacare will be an imminently destructive force on Medicare and will probably make all of our questions a moot point. Certainly if our representatives in Washington don’t even really know the total impact of socialized medicine, how are seniors supposed to stave off calamity?? Thank you Obama voters for screwing all of us!

  11. Glenn Shannon says:

    The funny thing is an insurance company that is rated 5 stars in one state can be rated 2 stars in another. Why the difference I don’t know unless state law makes a difference.

  12. Carol Durand says:

    For information about Medicare supplemental plans, everything is so complicated for seniors to sort out, I wonder about seniors who are unable to make any sense of all of the information involved in choosing a plan! Every state is different, nothing is uniform, yet Medicare is a federal program. This past summer I was unable to move to Texas to live with my younger brother and his family because I couldn’t find a plan in Texas that was comparable to mine in Ohio. Unfortunately, I am on S.S. disability at age 64 which narrows my choices even more. I need to have all of this information diseminated so that I am able to find an appropriate choice of available plans. Please help!

    • Art Gardner says:

      Art Gardner You all want medicare supplements if you can possibly make the monthly mayment .They will pay all that medicare does not where ever you live or travel.

  13. Gayle says:

    I am a senior citizen and have “Original Medicare”, supplemented with BCBS of Florida and a stand alone Prescription Drug Plan from Wellcare. I was on one medication which in the beginning, cost me zero, the following year they informed me that I had a $20.00 co-pay. My drug plan costs $46.00 a month and BCBS costs me $187.80 a month. I hesitate to switch to an Advantage Plan for several reasons. My PCP, whom I have had for 40 years does not accept them and I remember hearing that people on the Advantage Plans would eventually lose their coverage. And now the medicare hospital co-pays have gone up tremendously, that an 8 day stay would be cost about $1000.00……………………Ya can’t win.
    Like a lot of you above , I too have cancelled AARP, so I am hoping that AMAC will be stepping up with more help for senior citizens on a fixed income. :)

  14. Arthur says:

    What about such provisions available in Texas?

    • Kent Kammerlohr says:

      I think the only five star plan in Texas is Scott and White in Temple but it was announced last night on the news that Scott and White and Baylor Healthcare System were merging so maybe it will soon be available in the Dallas-Ft. Worth area.

    • Art Gardner says:

      There are plans everywhere if you are aware there are a lot of deductables and co pays with ALL of the advantage plans .Tthere are not with the med suppliments,but you have to be able to pay the monthly insurance!

  15. Paul Bopko says:

    Is Arizona part of this 5 star rating for Advantage Plans? I have a supplemental plan with USAA. I am afraid it will be increasing again for 2013 and coupled with the projected increase in Medicare deduction from my Social Security check in 2014, I am concerned about affordability. That is why I want to consider an Advantage Plan.

  16. Sharon says:

    I got my supplement thru Bankers Casualty and life (aka Colonial Penn) It is EXCELLENT! Offers a wide variety of plans , life insurance, and part D plans. I wouldn’t touch ANYTHING that says or is associated with AARP. If you continue to be a member of the “non-profit” progressive AARP them you are contributing to the left. The AARP is NOT a friend. They backed and lobbied FOR obamaocare b/c they wanted to sell more insurance.

    • Diane Carlin says:

      I am with you Sharon. We live in Pennsylvania and anything associated with AARP is not allowed in our house.

  17. Diana Haibel says:

    What about plans in Idaho please?

  18. Oldgene says:

    Why do we have to phone sales people? Wish there was an example of a state that we could look through.

  19. Patricia Campbell says:

    Because of the talk of Advantage plans going away I chose to continue my current policy with Aetna even though it’s very expensive. It would be very helpful to seniors if we could get a straight answer on whether the zero premium Medicare Advantage plans are going to be defunded or not.

  20. Gary says:

    I left aarp for these kinds of games???????? WHERE’s THE BEEF????????

    • Carol Durand says:

      Hello Gary. AARP was one of the small inner circle of large entities along with Big Pharma to concoct Obamacare in the first place. No games are being played by any legitimate providers of medicare plans. At this point, most of us outside of “the circle of elite players”, will know what lies ahead when it happens. This is not the America we thought we knew, sadly.

  21. Jerry says:

    Yor heading is misleading, it gives the impression that you have rated all of the medicare advantage plans. I also noted that you have no plans for the southern region of America. What gives? I have noticed that a lot of states have more choices than others as Alabama only has four company’s to compare while others have five or more. I did have healthspring but they raised their rate on the plan I had and I went to humana, I do not know if that will work out yet, after I received the plan booklet I discovered they do not cover a lot of things and I guess I should have scrunized them a little closer. What is really confusing is how these companies can offer more coverage than standard medicare at the same cost. I am talking about the advantage plans. As I understand it most seniors keep the standard medicare plan, since they have more people signed up than the insurance companies why can’t medicare have the same coverage and cut out the middleman. I am tired of these insurance companies deciding what care I can get and for how long and just what drugs they will pay for, this should be decided by a person’s Doctor. Why can’t medicare negociate cost with hospitals and physicians and the drug companies, it seems to me that with all that purchasing power they could get a better deal than the insurance companies, and with out all the deductibles and high copays.

  22. Jeffro says:

    Where is the list?

    This is why I let my subscription lapse..

  23. Richard Matthews says:

    More info please. I am totally confused.

  24. Mary K says:

    Question: I thought under the Obamacare legislation that Medicare Advantage was being unfunded? Can you shed some light on this issue?

    • GENE REESE says:

      what advantage plan can be used anywhere in the United states of America

  25. Gini Engleman says:

    I have Humana Choice supplemental through AMAC, is there an upgrade? Is Humana Advantage an upgrade and if so, is it available to members?

    Will this 5 Star replace supplemental and will it be available to Virginia Members?
    Is it also through Humana?

  26. Joe Revell says:

    Ditto.

  27. Jim Moore says:

    Where can we find a list of the 5 star plans mentioned above?

    • Ginethea McDowell says:

      I have Freedom Health out of Bradenton, Florida. Could you apply your evaluation to this company and let me know how it stacks up?
      Thank you.

    • Bobbie says:

      I have Christian Fidelity Supplement Plan F, which I understand is not available any longer to new applicants. I also have Humana prescription plan. My concern is that it does not cover any wellness visits but is very expensive. Can you give me a list of 5 star plan for Texas and an evaluation of my present coverage?