Medicare Star Ratings
Star Ratings: 5 Stars versus 3 Stars … how to see the rating, why it matters to you.
Every year the Centers for Medicare & Medicaid Services (CMS) releases Star Ratings for Medicare Advantage (Medicare Part C) and Medicare Part D prescription drug plans.
The information can be an essential piece of information especially for Medicare beneficiaries currently in plans that received average (3 stars) or poor ratings (1 or 2 stars).
The 2022 ratings issued in early October can help individuals compare plans during Medicare Open Enrollment that began on October 15. Plans are rated on a 1-to-5 scale. A 1-star rating represents ‘poor’ performance with 5 stars signifying ‘excellent’ performance.
Star Ratings for Medicare Advantage Plans (MA-PD)
Good News: In October 2021, CMS issued their latest annual ratings. Just over two-thirds (68%) of Medicare Advantage plans that offer prescription drug coverage (MA-PD) have an overall rating of 4 stars or higher. This marks an increase from 49% in 2021 but still means 32% of plans received 3.5 stars or less.
Bad News: CMS estimates that 10% of MA-PD plan enrollees are currently in plans that received between 1 and 3 stars.
Star Ratings Change From Year To Year: Some plan ratings get better. Others are lowered and that could be an indication of an issue. If you have a Medicare Advantage plan, it really pays to check each year — especially during Open Enrollment.
What does CMS Evaluate? They look at as many as 38 very specific categories. Some are obviously important and expected. For example, ‘customer service’ , ‘reviewing appeals decisions’ and ‘members choosing to leave the plan’. But others may seem less important but when it comes to your health, they can be vitally important. For example, ‘Colorectal Cancer Screening’ or ‘Breast Cancer Screening’.
Finding The Ratings For Your Plan: Individuals can find the Star Ratings on the medicare.gov website. You can also ask the Medicare agent or broker you are working with. Use the association’s online directory to find a local Medicare agent / broker for your Zip Code.
Ratings for Medicare Drug Plans (Part D)
Bad News: According to the 2021 CMS report, the majority (58%) of individuals are in plans rated with between 1 and 3 stars. The balance, some 42% are in plans receiving 4 or more stars.
Good News: The number of drug plans rated 5 stars doubled from the year before. The number of plans receiving 4 stars increased by 40%.
What That Means For Millions with Stand-Alone Drug Plans. It simply means that you need to compare. Not only may you find a plan with better drug coverage, you may find one that costs less. And, you may just find one with a better rating. That’s truly one of those win – win – wins.
Reasons To Compare Your Medicare Drug Plan
1. You can save money.
2. You can get better drug coverage.
3. You can switch plans yearly.
4. Comparing can be quick and easy.
5. You can do it yourself.
Medicare Open Enrollment (October 15-December 7) is the important time to compare plans. Ask the Medicare insurance agent you work with to compare plans for you. Or, access the online drug plan comparison tool. Simply click the banner on the right to access.
What does CMS Evaluate? When it comes to drug plans, CMS evaluates 10 different measures. This includes ‘complaints’, ‘getting needed prescription drugs’ and ‘members choosing to leave the plan’.
Read More About Finding Best Medicare Drug Plan
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