What are Medicare Part D Star Ratings? Are they important?

Medicare created the Star Ratings system to help you compare quality and performance among Medicare Part C (Medicare Advantage) plans and Medicare Part D prescription drug plans (PDPs). Medicare determines the ratings each year, evaluating a plan’s performance in more than 50 areas across 4 broad categories. These categories range from customer service to patient safety. Medicare assigns them a rating of 1 to 5 stars. This provides a current and unbiased measurement of a plan’s overall performance.

Star Ratings are an important factor to consider when choosing a plan. They take the guesswork out of selecting a trustworthy plan by telling you if the plan is likely to offer high quality.

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

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Avoiding the Medicare Part D Coverage Gap

3 Simple Steps to Stay Out of the Medicare Donut Hole

In a standard Medicare Part D plan, the third stage of coverage is the Coverage Gap (also known as the “Donut Hole”), when you will pay more for your brand-name and generic medications. You’ll want to avoid entering the Gap completely or at least delay your entry as long as you can. To learn more about the Coverage Gap and the other coverage stages for Medicare Part D plans, please watch this video.

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What Are Medicare TrOOP Costs?

Keeping Track of Your Out-of-Pocket Drug Expenses

It’s likely you’ve heard the term “out of pocket,” which refers to the Medicare expenses that aren’t reimbursed by insurance. A less familiar term, but one that is extremely important to Medicare Part D prescription drug plan members who enter the Coverage Gap, is “true out-of-pocket” or “TrOOP” costs. Your Medicare TrOOP expenses determine when you’ll leave the Coverage Gap, which is the third stage of the standard Medicare Part D benefit, and when you’ll enter Catastrophic Coverage, the fourth and final stage of the benefit. To better understand these coverage stages, please watch this video.

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Breaking Down Medicare Part D

A Closer Look at the Stages of Part D

All Medicare Part D plans are designed with four stages of coverage. You move from the first stage to the next based on what you and your plan spend for your prescription drugs. Medicare sets the limits for each stage every year. It’s important to understand how the stages work and what you will pay out-of-pocket each year. (more…)

Getting to Know Your Part D Plan’s Drug List

What Medications Are Not Covered by Medicare Part D

A plan’s drug list or “formulary” is an important consideration when choosing your Part D coverage. The drug list changes each year depending on the rules and guidelines released by the Centers for Medicare & Medicaid Services (CMS) which prescription drug plans (Part D) and Medicare Advantage Plans must follow. These formulary guidelines state that plans must base their decisions on scientific evidence and well-established guidelines to cover today’s most widely used medications. This ensures that beneficiaries like you will be covered by the most commonly used and effective medications available to protect your health. (more…)

Learning the ABD and Cs of Medicare

Being Educated About Medicare Plans Will Make You a Smart Shopper

Nearly 54 million Americans are covered by Medicare health insurance. For many who are just retiring, it can be an overwhelming and complex process.

Medicare is composed of four parts, with each offering a specific type of coverage. Take the time to educate yourself about Medicare so you’ll be able to make more informed decisions that fit both your health needs and your budget.

It’s important that you understand the A, B, D and Cs of Medicare coverage, so let’s begin with some eligibility guidelines. (more…)

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