Medicare Star-Rating System

What Is the Medicare Star-Rating System?

The Medicare Star-Rating System is a method for consumers to assess and compare Part D medication plans and Medicare Advantage Plans, which shift enormously in terms of cost and coverage. Medicare surveys the performance of plans one every year and distributes new star ratings each fall.

Understanding the Medicare Star-Rating System

Every January, Medicare Part D medication plans and Medicare Advantage Plans can change their coverage and costs for the new calendar year. Hence, users of the plans ought to survey their coverage and compare their plans with other accessible plans to guarantee their coverage is optimal. The Medicare Star Rating System is a method that consumers can use to assess the different coverage options, making it more straightforward to determine which policies are among either the best Medicare Advantage Plans or Part D plans as of now accessible.

You can find a plan's star rating utilizing Medicare's Plan Finder instrument or by calling 1-800-MEDICARE.

How the Medicare Star Rating System Works

The Medicare Star Rating System measures the performance of plans in view of several categories including quality of care and customer service. The categories are positioned between one to five stars, with five being the highest and one being the most minimal. As per Medicare Interactive, Medicare Advantage Plans are rated on their performance in the accompanying five distinct categories:

1. Remaining sound: screenings, tests, and immunizations
2. Overseeing constant (long-term) conditions
3. Plan responsiveness and care
4. Member protests, issues getting services, and deciding to leave the plan
5. Wellbeing plan customer service

Part D plans are rated on how well they perform in the accompanying four categories:

1. Drug plan customer service
2. Member objections, issues getting services, and deciding to leave the plan
3. Member experience with the medication plan
4. Drug pricing and patient wellbeing

Poor Performing Plans

A plan is found to be low-performing in the event that it gets less than three stars from Medicare for three sequential years. Medicare tells people assuming their plan has been found to low-perform. Enrollees can change plans during specific times or during Special Enrollment Periods (SEP), which are times outside normal enrollment periods that are set off by specific conditions.

Plan Enrollment

As a rule, you can change your plan or sign up for another one just during a Special Enrollment Period. You can utilize a SEP to join or switch to a five-star Medicare Advantage or Part D plan. In any case, a SEP must be utilized one time per year. The SEP starts Dec. 8 of the year before the plan is viewed as a five-star plan (ratings turns out in October). It endures through Nov. 30 of the year the plan is considered a five-star plan. Enrollments in December are effective Jan. 1, and enrollments from January to November are effective the month following the enrollment request.

Features

• Medicare surveys plan performance consistently and distributes new star ratings in the fall.
• Medicare Advantage Plans and Medicare Part D plans shift significantly in terms of coverage and costs.
• The Medicare Star Rating System measures how well Medicare Advantage and Part D plans perform.