Healthcare Educators


Medicare Star Ratings – What You Need to Know

by | Nov 15, 2021

Medicare Advantage and Medicare Part D prescription drug plans are offered by private insurance companies. According to Healthcare Finance, a poll found that 95% of the seniors surveyed think it’s important to have coverage options other than traditional Medicare. Satisfaction with these options is also high: 98% of respondents are satisfied with Medicare Advantage’s coverage and 97% are satisfied with the provider networks.

At the same time, the fact that different insurance companies offer plans means that there is a lot of variation from plan to plan. When selecting a plan, it’s important to compare the costs, benefits, and networks to make sure you’re choosing a plan that meets your needs. It’s also important to think about the level of customer service and plan quality. This is where Medicare’s Star Ratings come into play.

Five-Star Plans

Medicare Advantage and Medicare Part D plans receive a Star Rating. Plans receive between one and five stars, with a five-star rating indicating that the plan provides excellent quality and performance, and a one-star rating indicating poor performance and quality.

The rating is updated each year, and the new ratings are usually announced in early October, ahead of the Annual Election Period that runs between October 15 and December 7 each year.

Using the Star Ratings

As a Medicare beneficiary, you have many options. KFF says that the average Medicare enrollee has 39 Medicare Advantage plans to choose from for 2022.

Many of these plans have earned high ratings. According to CMS, 68% of Medicare Advantage Prescription Drug plans have earned four or more stars for 2022, up from 49% in 2021.

When you compare plans using the Medicare Plan Finder or with the help of an insurance broker, you will be able to see the Star Rating of each plan. There’s a good chance that you’ll have multiple highly rated plans to choose from, but the Star Rating is just one factor to consider. You also need to think about your personal budget and coverage needs. In addition to the Star Rating, review the plan’s costs, benefits, provider network and prescription drug coverage.

What If You Don’t Like Your Plan?

Medicare offers a Special Enrollment Period that lets enrollees switch to a five-star plan. If there is a five-star plan in your area, you may be able to use this Special Enrollment Period to join it. The Special Enrollment Period can be used once between December 8 and November 30. Before switching plans, make sure you’re not losing health coverage or prescription drug coverage, as some plans only include one.

The Medicare Advantage Open Enrollment Period is another opportunity to switch plans. This period runs from January 1 to March 31 each year. Medicare beneficiaries who are currently enrolled in a Medicare Advantage plan can use this period to switch to another Medicare Advantage plan or to Original Medicare.

Need Guidance?

Contact Medicare Educators. Our network of licensed insurance agents will help you understand the options available so you can make an informed decision. Best of all, our services are available at no cost to you.