Medicare Choice Group

What Are Medicare Star Ratings?

Medicare Star Ratings are one factor that can help you decide on a Medicare plan. Both Medicare Advantage and Part D Prescription Drug plans are rated on a Five-Star Rating System, with one star being the lowest score and five stars the highest.

Medicare rates each Medicare Advantage plan in five categories:

  • Staying healthy: This metric takes into account whether the plan includes various preventative screenings, vaccines, and check-ups to help members stay healthy.
  • Managing chronic illnesses: The score in this category is based on how often members with certain chronic conditions receive the recommended tests and treatments needed to treat their conditions.
  • Member experience: Members of the plan rate their experience with the plan, from which this score is calculated.
  • Member complaints and changes in the plan: This metric measures how frequently members submitted complaints or had problems with the plan. It also includes how the plan’s performance has improved from year to year.
  • Customer service: The score given to each plan in this category is based on how the plan handles member calls and questions.

Prescription Drug plans are rated in similar categories:

  • Member experience
  • Member complaints
  • Customer service
  • Drug safety and drug pricing accuracy

Medicare releases overall ratings for each plan, but they also break down the ratings more specifically. How a plan is rated based on these more specific categories can help you decide which plan is best for you based on your needs. Ratings can change from year to year, like the plan itself, so it is important to review your plan’s star rating every year. For more information on Star Ratings, visit the Medicare site that outlines everything that is considered in creating a rating.

Star Ratings can be helpful when evaluating a Medicare Advantage or Prescription Drug plan, but they are not the only thing you should consider. Pricing, the provider network, drug formularies, and other factors are also important to think about. For help in making the decision about which plan is right for you, contact us here.

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