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Why are Medicare Star Ratings Important?


Medicare star ratings are important because it gives you an idea on which plans have a higher satisfaction rating in your area. Also, star ratings have year-round enrollment opportunities. But, these ratings are only for comparison of Part D and Medicare Advantage plans. Either way, the ratings provide a way to consider your plan options beyond costs.

What are Medicare Star Ratings

When Medicare reviews plan performances each year, they give the policies a star-rating. The five-star quality rating system measures the experience other beneficiaries had on the plan. Plans will get a rating between one and five. However, new plans may be too new to determine a rating.

Why are Medicare Star Ratings Important

The star rating system helps consumers identify the best Advantage plans. If a plan is low performing for several years, you have the right to know. Medicare considers the plan low when a plan gets less than three stars for three years in a row.Also, the ratings make it easier to identify the best Part D plans.

How are Medicare Star Ratings Calculated

Medicare will calculate Part C star ratings in five different categories. Including; staying healthy, plan responsiveness, managing chronic conditions, customer service, and member complaints. For Part D plans, there are four different categories for ratings. Including; customer service, member experience, drug pricing, and member complaints.

What is the 5-Star Special Election Period?

If a plan in your area has 5-stars, you get a Special Election Period to enroll in that plan. So, if there is a 5-star plan in your area, you can sign up for it at any time. There is no need to wait for the Annual Enrollment or Open Enrollment Period.

How do you Become Eligible for 5-Star Plans?

As long as you have Part A and Part B, you’re eligible for a 5-star Advantage plan. But, with Part D plans, you need either Part A or Part B. Although, Medicare cost plans only require you to have part B. Also, you must reside in the service area of the plan to enroll.Some Medicare Advantage plans deny coverage to those with ESRD, but that might be changing in 2021.

FAQ’s

Who sets the standards for Medicare star ratings?
The Center for Medicare and Medicaid Services sets the ratings for plans.
When Does CMS Issue Star Ratings?
The ratings for Part C and Part D plans are released each fall.
Where can I find information on my plan’s star rating?
You can view star ratings on Medicare’s website, Medicare.gov.

How to Compare Plans Using the Medicare Star Rating System

When you look at your plan options online, you’ll notice ratings for each policy. Plans with higher ratings are policies that work well for past and current beneficiaries. Also, if you’re on the fence about two plans, seeing the score helps you determine the final choice.

Now, keep in mind all Medigap plans get 5 stars. So, if you’re having a hard time finding quality coverage, give us a call at the number above to get an expert opinion on your options. You can also fill out an online rate form to see your rates now!

Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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