Medicare Star Rating System

Can I Use the Medicare Star Rating System to Help Me Compare Plans?

When it comes to choosing your Medicare health plan, the number of choices available can quickly become overwhelming. To prevent yourself from decision paralysis, you can take advantage of the Medicare Star Rating System to help you find the Medicare plan that’s right for you.

What is the Medicare Star Rating System?

The Centers for Medicare and Medicaid Services (CMS) does an annual review of how different Medicare plans compare. CMS uses survey data from members and health care providers to get an idea of how each plan has performed over the last year.

CMS looks at five key categories when evaluating plans to give an accurate rating. The five categories look at preventative health care members receive, how chronic conditions are handled, member satisfaction, praise and complaints, and how well the plan provides fast and helpful customer service. CMS also looks at Medicare Advantage drug plans and Medicare Part D to measure accuracy and pricing.

Once this data has been collected, CMS then assigns a rating based on a five-star scale, with five being the best performance and one being the worst.

If your plan has consistently received a low rating over the course of three years, you will be contacted to see if you’d like to explore other options. If your plan isn’t considered to be low-performing, but you’d still like to upgrade to a higher-rated plan, you have the opportunity to switch. Suppose you want to switch to a five-star rated plan. In that case, there is a Special Enrollment Period, which takes place between December 8 and November 30, during which you can switch to a five-star plan if there is one in your area.

What are the Downsides to the Medicare Star Rating System?

Medicare plans are not one-size-fits-all. While the star rating system can give you a good starting place to know which plans you may want to explore, you will need to take your own health care needs into consideration. For example, if you have a chronic illness, you’re going to want to see how a plan holds up against others in how they manage chronic conditions.

Get Your Medicare Plan Today With KBI Solutions!

Essentially, the Medicare star rating is a tool you can use, but you shouldn’t let it be the only thing to guide your decision. The ratings can point you in the right direction and narrow your choices down to a manageable level, but working with a Medicare expert can help you choose the plan that is truly right for you. Call KBI Solutions today and get the Medicare plan you need!