The Five-Star Rating System and Medicare Plan Enrollment

Part D drug plans and Medicare Advantage plans vary greatly in terms of costs and coverage.  Each January, plans change their coverage and costs for the new calendar year.  Every fall, you should go over your plan’s coverage and compare it with other plans in your area to make sure you have the coverage that is best for you. Examine a plan’s coverage, costs, drug coverage and the pharmacies in its network to see if it best meets your needs.  After considering those factors, you can use the plan’s star rating from Medicare to help you select a plan that’s right for you.

What are the Medicare Star Ratings?
Medicare uses a Star Rating System to measure how well Medicare Advantage and prescription drug (Part D) plans perform. Medicare scores how well plans did in several categories, including quality of care and customer service. Ratings range from 1 to 5 stars, with five being the highest and one being the lowest score. Medicare assigns plans one overall star rating to summarize the plan’s performance as a whole. Plans also get separate star ratings in each individual category reviewed. The overall star rating score provides a way to compare performance among several plans. To learn more about differences among plans, look at plans’ ratings in each category.

Medicare reviews plan performances each year and releases new star ratings each fall. This means plan ratings change from one year to the next. Medicare sets the categories and reviews each plan the same way. You should look at coverage and plan costs, such as if the Part D plan covers all the drugs you take and has a premium you can afford before you consider the star rating.

Medicare health plans are rated on how well they perform in five different categories: Staying Healthy: Screenings, Tests, and Vaccines, Managing Chronic (Long-Term) Conditions, Plan Responsiveness and Care, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Health Plan Customer Service

Medicare drug plans are rated on how well they perform in four different categories:
Drug Plan Customer Service, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Member Experience with Drug Plan, Drug Pricing and Patient Safety