Medicare Plan Star Ratings
Each fall, the Centers for Medicare and Medicaid Services rates Medicare Advantage plans for the following year based on quality and performance. Medicare uses member surveys, information from the plans, and information from health care providers to compose overall star ratings.
Star ratings for Medicare Advantage plans measure 5 categories: staying healthy screening tests and vaccines, managing chronic conditions, member experience with the health plan, member complaints and Medicare problems, and the handling of customer appeals.
For Part D prescription drug plans, the categories used are: drug plan customer service, member complaints and changes in the drug plan’s performance, member experience with the plan’s drug services, and drug safety and accuracy of drug pricing.
For plans that cover both health and drug benefits, the ratings encompass all of these categories. Plans are rated on a scale of 1 star (poor) to 5 stars (excellent).
5-Star Special Enrollment Period
Did you know there is a Special Enrollment Period to enroll in 5-star rated Medicare Advantage plans? With the 5-star Special Enrollment Period, you can:
- Switch to a 5-star rated Medicare Advantage (MA) Plan or Medicare Prescription Drug Plan if one is available in your area. You can do this by:
- Disenrolling from Original Medicare and enrolling in a 5-Star MA plan
- Switching from any MA plan to a 5-Star MA plan
- Switching from a 5-star MA plan to a different 5-star MA plan
- Switching from a Medicare Prescription Drug Plan to a 5-star Medicare Prescription Drug Plan
- Switching from a 5-star Medicare Prescription Drug Plan to a different 5-star Medicare Prescription Drug Plan
- You can use this SEP once during the time frame between December 8 and November 30, assuming you meet the plan’s enrollment requirements (usually having Medicare Parts A and B and living in the plan’s service area).
- After the plan receives your application, coverage begins the first day of the following month.
5-Star Medicare Advantage and Prescription Drug Plans for 2018
To see a list of all the Part C (Medicare Advantage) and Part D Star ratings for 2018, click here. Or, use Medicare’s Plan Finder to search by your zip code. The star rating will be listed for each plan available to you.
Things to Note
There may not be a 5-star plan available in your area. Also, make sure that you consider whether the plan you choose includes Part D coverage. If not, you could end up paying a penalty the next time Open Enrollment comes around.
Also note that you can’t have a Medicare Advantage plan that includes Part D and also a stand-alone Part D plan. If this occurs, you will be switched back to Original Medicare.