S1E51 People look to the stars for answers…. But is that how to choose your Medicare?

There is more to choosing a plan than just how many stars it has. 

Besides looking at ratings, plans need to match your needs for doctors, and hospitals too.

Learn about star ratings in this week's 65 and Counting episode.

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Transcript

For thousands of years, man has looked to the stars for answers! Why not do the same when picking out a Medicare Advantage plan? Find out all about a Medicare Advantage plan’s “Star Rating”, this week on 65 and Counting!

Welcome back, everyone! This week we’re shining the Educational Spotlight on the Star Rating System associated with Medicare Advantage plans. Find out what they are, what they mean, how they’re rated, just what makes a plan “Five Stars” and if you’re eligible to change over to one!

Restaurants, Hotels, Airlines, Cars, pretty much everything out there has a star rating these days and medicare advantage plans aren’t much different! Medicare has a star rating system for these plans. The lowest of which being a one-star plan and the highest of which is five stars! It’s how you can tell the difference between poor all the way up to excellent when it comes to the quality of your care. The rating encompasses the health plan portion of a Medicare Advantage Plan and, if that plan has prescription coverage, the star rating considers that coverage as well! These star ratings are important in protecting you because they let you understand how a plan ranks up to its peers. 

Now, these plans don’t just get their ratings by simply wishing upon a star! CMS or the Centers for Medicare and Medicaid Services, the federal organization charged with running all things Medicare has all sorts of aspects they look at to rate a plan for quality and performance. Some of the main things they look at are how much effort a plan makes in keeping you healthy such as their coverage on health screenings and vaccines. Also how they do at managing long term chronic conditions like diabetes, COPD, etc. They take a look at members' experience by researching complaints and positive reviews about plans as well as changes in the health plans performance over the years. And obviously, they look at a plan’s customer service practices! Nothing is more satisfying than a quick call with a member services line where your problems are solved before you know it! The drug plan rating runs pretty much the same with the addition of drug pricing as a category. 

Where do they get this information to rate the plans? Well, they ask YOU. Most of this information comes from member surveys. They also check with healthcare providers, regular monitoring of the actual companies plans, and billing information that plans are required to submit to Medicare. 

You might be asking, what’s my plan’s “Star Rating” and can I get on to one of those five-star plans? Well, to check your plan’s rating you can always visit www.Medicare.gov or just give us a call and we’ll help you find out. 

As far as changing to a Medicare Advantage plan with a Five Star Rating, well the best place to start is to determine if it’s the right plan for you. Are your doctors and hospitals in the plan's network? What do the cost of your medications look like? Do the benefits of that specific plan fit your needs appropriately? Well, if you and one of our certified medicare planners sit down and discuss this and the answers to all of those questions point towards a “yes” then medicare allows for a Special Enrollment Period so let’s talk about that. 

It’s called the “5-Star Special Enrollment Period”. So, if a Medicare Advantage Plan with a five-star rating is available in your area, you can use this enrollment period to switch from your current Medicare plan to a Medicare plan with a five-star rating. You can only use it once per enrollment period and that goes from December 8 to November 30 of the following year! 

Remember, Certified Medicare Planners are always here to help you make the right decision, and while five-star plans may sound like they’re the best option they might not be for you specifically! 

I hope you learned a whole lot about the star rating system this week! Don’t forget to like this video and subscribe to our page so you get notified when we post new episodes and share them with all your friends, but most importantly have a great week!

Source links:

https://www.cms.gov/files/document/2021starratingsfactsheet-10-13-2020.pdf

https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/5-star-special-enrollment-period