During Medicare Annual Enrollment, I get asked the same question very often: “Am I in the best plan?” One way to tell how well a Medicare Advantage Plan or Medicare Prescription Drug Plan is doing is to check the Medicare Star Rating of the plan.
As an independent source, the Center for Medicare and Medicaid Services, also known as CMS, will rate Medicare Advantage Plans and Medicare Prescription Drug Plans on an annual basis. This is a good way for consumers to compare apples to apples, or oranges to oranges when they are looking at different plans available in their area. CMS uses several dozens of criteria when rating plans, including things like customer satisfaction, problem resolution, health screenings, health outcomes, chronic care management, etc.
CMS uses a 5 Star rating system, with 1 Star being Poor and 5 Stars being Excellent. If a Plan should ever receive a 2 Star rating, it will automatically be removed from the market and no longer be available for purchase.
The Overall Star Rating is a general indicator of how well the plan is performing. However, Medicare will provide a rating in two additional subcategories, Health Plan Services and Drug Plan Services.
For those consumers who are already enrolled in a Medicare Advantage Plan, a year-long Special Enrollment Period, in addition to the Annual Enrollment Period, is available for them enroll in a plan that has a 5 Star Rating from Medicare. This means that should there be a 5 Star plan available in a consumer’s area, they could make a one-time plan change to enroll in that plan at any point during the plan year.
Consumers can find the Star Ratings for plans at medicare.gov. Whenever consumers are discussing a plan with a sales agent, they should be sure to always inquire about the Star Rating of the plan being discussed as well.
Christine Gibson is a State Licensed Insurance Agent who helps local residents with Health and Medicare Insurance questions in Waynesville. For more information, call 828-246-9950.