If you’re looking for a way to compare Medicare plans, you need to know about the Medicare Star Rating system. This system was created by the Centers for Medicare & Medicaid Services (CMS) as a means of comparing plan performance and quality for Medicare Advantage plans, Part D prescription drug plans, and Medicare Cost plans.
Through this system, Medicare plans are rated on a scale of 1 to 5. The lowest rating is 1, while the highest is 5. More stars are an indication of higher-quality plans.
We suggest you try to find a plan with a strong rating. Though, higher-rated plans may have higher costs. So is it really important to go for a 5-star plan? Here’s what we think.
What Do Star Ratings Rank?
For Medicare Advantage and Medicare Cost plans, star ratings give a summary of how well a plan is performing across a few different categories. These are the categories that are used currently:
- Health – This category assesses whether plan members have access to preventive services that keep them healthy. Services that will be observed here include physical exams, preventive screenings, and vaccinations.
- Management of chronic conditions – If a plan does a good job of helping members manage their chronic conditions, they will receive a higher rating in this category. The system ranks this category based on how frequently members were able to receive quality care for long-term health conditions.
- Member experience – Plans are also rated for the overall satisfaction of members.
- Complaints – If a plan has many complaints from its members, this will be accounted for in the rating. This category takes into account members submitting complaints or leaving the plan. It also assesses whether the plan’s performance improved from the previous year.
- Customer service – The quality of call center services also plays into the Star Rating. If people are able to successfully process appeals and enroll without trouble, a plan will receive a good rating in this category.
If you are enrolling in a Part D prescription drug plan, the Star Rating system is used to rank a different set of features. The categories for Part D plans are:
- Member experience
- Member complaints
- Customer service
- Drug safety
- Drug pricing accuracy
Drug safety and pricing accuracy are determined based on how often members with specific medical conditions are prescribed drugs in a way that is safe. Ratings will also assess whether a plan has up-to-date and accurate information about medications listed on their website.
Do Star Ratings Matter?
Star Ratings should matter to you if you want to get the highest quality coverage possible. A plan with a low Star Rating should raise a few red flags. Though, a low Star Rating doesn’t always mean that a plan is a bad option. At Eldridge Agency, we believe that the best way to find a high-quality plan is to shop around and compare quotes. Fortunately, we can help you get started. Just give us a call at (775) 328-1197 to schedule a free consultation.
