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5 Star Medicare Plans

All Medicare Advantage plans and Medicare Prescription Drug Plans receive an overall quality rating from the Centers for Medicare and Medicaid Services (CMS). These ratings are updated annually and come in the form of stars. Five star plans have received the highest scores. Fewer stars means lower quality. CMS provides the following guidance regarding the different star ratings:

  • 5 Stars - Excellent
  • 4 Stars - Above Average
  • 3 Stars - Average
  • 2 Stars - Below Average
  • 1 Star - Poor

You can see the overall star ratings for each plan on our Medicare Plan Comparison Tool. Plans that are brand new, or have too few members for a reliable evaluation, do not receive star ratings.

Medicare Advantage plans are evaluated on over 50 items to produce their overall star ratings. These items include:

  • Care given to prevent illness or disease
  • Managing chronic medical conditions
  • Customer service
  • Member satisfaction
  • Drug pricing

Because Prescription Drug Plans only cover medications and don't offer other health services, they are evaluated on fewer items. These items include:

  • Customer service
  • Member satisfaction
  • Drug pricing
  • Member complaints

Special Enrollment Period (SEP)

Normally, Medicare beneficiaries can only change plans once a year during Annual Enrollment Period (October 15th and December 7th). However, if there is a five star plan in your area you could still switch to this plan between December 8th and November 30th using the 5 star plan’s Special Enrollment Period.1

Sources:

1http://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/five-star-enrollment/5-star-enrollment-period.html


 

 

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