2015 Medicare Part D Star Ratings

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2015 Medicare Part D (Prescription Drug Plans) Star Ratings

Each year the Centers for Medicare and Medicaid Services (CMS) rates all Medicare Advantage (Part C) plans and Medicare Prescription Drug Plans (Part D). Ratings are assigned based on a scale from 1 star to 5 stars:

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

There are currently over a dozen measures in four categories which contribute to Medicare Part D star ratings. Rating factors come from a number of sources such as member surveys, monitoring from CMS, and self-reported information from the plan’s carrier. The following table provides information on factors that determine the overall health plan quality rating for Medicare Part D plans:

Drug Plan Customer Service
  • How long pharmacists must wait on hold when they call the plan’s pharmacy help desk
  • How timely the plan handles new enrollment requests (within 7 days is the benchmark)
  • Whether hearing-impaired members have access to TTY (teletypewriter) / TDD (telecommunication device for the deaf) services
  • Whether those with a language barrier can receive foreign language interpretation
  • How fast and how well the plan handles appeals from members. Appeals are requests which are filed when a member disagrees with a plan’s decision regarding covered prescriptions or cost-sharing for covered prescriptions. An independent reviewer sometimes looks at decisions made by plans and thus plans are also rated based on whether the reviewer approves of the plan’s decision
Member Complaints, Issues Getting Services, and Performance Improvement
  • How often CMS found issues with the plan during audits
  • How many members out of 1,000 filed complaints
  • How many members chose to leave the plan
  • The degree the plan’s performance has improved or declined from one year to the next
Member Experience with Drug PlanIncludes scores from member satisfaction surveys on areas such as:

  • How often members could get drug prescriptions filled easily using the plan
  • Overall rating members gave the plan
  • How often the plan provides assistance or information when members need it
Drug Pricing & Patient Safety
  • Whether the drug pricing information provided to Medicare.gov’s plan finder website is accurate
  • Whether senior members ages 65 or older are taking drugs with a high risk of side effects when safer drug options may be available
  • Whether members with diabetes who also have high blood pressure are provided medication recommended for diabetics
  • Whether plan members are taking certain medications as directed

Star ratings are not currently available for 2015 Medicare Part D plans but they will be released in late September or early October 2014 and will be available to view through our Medicare plan comparison tool. Check this page again in October for additional information and analysis of 2015 Medicare Part D plans. For information on 2015 CMS star ratings for Medicare Advantage plans visit our Medicare Advantage Star Ratings page.