Close  

Why Are Medicare Star Ratings Important?


Medicare star ratings are important because they give you insight into which plans in your area have the highest satisfaction ratings among those on Medicare. However, Medicare star ratings only pertain to Medicare Advantage and Medicare Part D plans.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

For both types of coverage, star ratings provide a way to compare the options in your area beyond cost.

What are Medicare Star Ratings?

The Centers for Medicare & Medicaid Services (CMS) developed a five-star rating system for those on Medicare to compare Medicare Advantage and Medicare Part D prescription drug plan options. Medicare reviews the plans’ performances each year and assigns each policy a star rating, between one and five.

The five-star quality rating system measures the experiences of those on each plan. Below is a list of the plan quality indicated by each star rating.

  • 5-star: Excellent
  • 4-star: Above Average
  • 3-star: Average
  • 2-star: Below Average
  • 1-star: Poor

However, newer plans are more challenging to rate since they may not yet have enough feedback from beneficiaries.

The star rating system helps consumers identify the best Medicare Advantage plans and the best Medicare Part D plans. You have the right to know if a plan has been low-performing for several years. Likewise, if a plan is well-liked by its enrollees, the star rating will also reflect this trend.

Medicare considers a plan below average if it gets a rating of fewer than three stars for three consecutive years. Each October, CMS releases Medicare star ratings – just in time for the Annual Enrollment Period. Thus, they help you understand which plan may be best for you in the upcoming year.

How Are Medicare Star Ratings Calculated?

CMS calculates Medicare star ratings using five categories for Medicare Part C plans. These categories are:

  • Staying healthy (preventive services)
  • Plan responsiveness
  • Managing chronic conditions
  • Customer service
  • Management of member complaints.

Medicare Part D Star Rating Factors

The following are the three factors that are a part of a Medicare Part D plan star rating.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

Plan’s Customer Service

Quality customer service is essential, especially when something goes wrong. You want your insurance company to help you through any issues as quickly as possible. The last thing you want is to be on a telephone hold for hours when there is an issue.

Member Experience

Medicare cares about the experience you have with your plan. When many members rate high satisfaction, the star rating reflects that. Those who file a complaint could impact the ratings of their plan. Further, rating factors consider the improvement a plan makes yearly based on
customer feedback.

Accuracy of Drug Pricing and Drug Safety

Prescription drug policies with accurate price information are more likely to have higher ratings. Further, Medicare monitors plans for drug safety.

When Can You Enroll in a Five-Star Medicare Plan?

If you have a Medicare Part C or Part D plan that is not five stars, but a five-star plan is available in your area, you will get a Special Election Period to enroll in that plan.

Therefore, if you want to enroll in a five-star Medicare Advantage or Part D plan outside the Annual Enrollment Period, you can do so. Remember that you can only use this Special Enrollment Period once a year. If you decide to leave the five-star plan, you will need to wait for the fall Annual Enrollment Period to re-enroll.

How Do You Become Eligible for

Five-Star Medicare Plans?

You are eligible to enroll in a five-star Medicare Advantage plan if one is available in your area and you have Medicare Part A and Part B.

You only need Medicare Part A to enroll in a five-star Medicare Part D plan in your area.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

Medicare Star Ratings FAQs

Who sets the standards for Medicare star ratings?
The Centers for Medicare & Medicaid Services (CMS) sets plan ratings.
When does CMS issue star ratings?
The ratings for Medicare 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 Enroll in a Five-Star Medicare Plan

When you look at your plan options online, you will notice ratings for each policy. Plans with higher ratings have a history of working well for past and current beneficiaries. Also, if you are choosing between two plans, the Medicare star rating can help you determine which plan will be better for you.

If you find a five-star Medicare Part C plan, it is wise to compare it to a Medigap plan available in your area. For many, Medigap plans provide superior coverage compared to Medicare Advantage, so comparing the best plan in your area will help you better understand how the plans stack up against one another.

To compare quality coverage options, call us at the number above. You can also fill out an online rate form to see your rates now.

Enter ZIP Code

Enter ZIP Code

Enter your ZIP code to pull plan options available in your area.

Compare Plans

Compare Plans

Select which Medicare plans you would like to compare in your area.

Get Quote

Get Quote

Compare rates side by side with plans & carriers available in your area.

Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. CMS Releases 2022 Medicare Advantage and Part D Star Ratings to Help Medicare Beneficiaries Compare Plans, CMS. Accessed June 2022.
    https://www.cms.gov/newsroom/press-releases/cms-releases-2022-medicare-advantage-and-part-d-star-ratings-help-medicare-beneficiaries-compare
  2. 5-star special enrollment period, Medicare. Accessed June 2022.
    https://www.medicare.gov/when-can-i-join-a-health-or-drug-plan/5-star-special-enrollment-period
  3. Medicare Advantage in 2021: Star Ratings and Bonuses, KFF. Accessed June 2022.
    https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2021-star-ratings-and-bonuses/

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

Comment

Your email address will not be published.