Medicare Star Ratings: Why they matter.

Taking the guesswork out of selecting a Medicare plan

Finding a plan that best suits your health and financial needs is only part of the equation when choosing Medicare Part D prescription drug coverage. It’s important to select a plan that you can trust ― one that will support your treatment plan, and help make the management of your prescription medications safer, easier and more affordable.

With so many plans to choose from, and so much information online, it’s hard to know if you are choosing a high-quality plan. You may also hear from family and friends about their experiences with certain plans, which only adds to the confusion.

Star Ratings: Your Medicare GPS

Just as you might use a GPS device to find the best route from point A to point B on the road, Medicare’s “Star Ratings” system can help you identify the best Medicare plans. The rating system compares quality and performance among Medicare Part C (Medicare Advantage) plans and Medicare Part D plans. A plan can earn between 1 and 5 stars. Five stars represent “excellent” quality, and 1 star represents “poor” quality.

Medicare determines a plan’s Star Rating each year, providing consumers with a current and unbiased measurement of a plan’s performance. For Part D prescription drug plans, Medicare determines the Star Rating based on how plans perform in more than 50 areas, grouped into these 4 categories:

  1. Customer service: How well does the plan handle calls from members? How quickly does the plan make decisions about coverage appeals?
  2. Member complaints: How often do members file complaints? How many members chose to leave the plan?
  3. Member experience:  How do members rate the overall plan? How easy is it to get your prescriptions filled? Can you get information from the plan about prescription drug coverage and cost without difficulty?
  4. Patient safety and accuracy of pricing:  Does the plan provide accurate pricing on its website? Do members of this plan take their medications as directed? Do members with certain medical conditions, such as diabetes, get prescription drugs that are considered safer or more effective?

How to Use Star Ratings

A plan can earn between 1 and 5 stars:★★★★★(5) = Excellent★★★★(4) = Above Average★★★(3) = Average★★(2) = Below Average★(1)= Poor

According to a report from the Kaiser Family Foundation, many Medicare consumers are unaware of the Star Ratings and do not use them in making their decisions. This is a missed opportunity to find out if a plan is likely to offer high quality.

In general, you should look for plans with a Star Rating between 3 and 5. At Medicare.gov, you can view the details of a plan’s rating to see how well it performs in each category. If the plan you like has a low rating, review the Star Ratings details to make sure it’s a good choice for you.

Bottom line: Selecting a Medicare Part D plan is an important, yet difficult task. Star Ratings help take the guesswork out of choosing a high-quality plan and can give you peace of mind with your plan choice.

Posted on: October 13, 2014
by
Senior Director of Medicare Solutions Ms. Mahon specializes in providing seniors with the resources they need to make more informed coverage decisions. Topics include how to use star ratings.

Tags:

Print Friendly

Stay Up-to-Date

Get the most out of Medicare with monthly email newsletters that give you the latest news and helpful tips for managing your healthcare and planning for the future.

> Sign Up Now