What’s The Deal With Five Star Medicare Plans?

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What are Top-Rated Five Star Medicare Advantage and Prescription Plans?

The Center for Medicare Services (CMS) allows for a special enrollment period only for Medicare Advantage and Part D plans that have earned the top five-star rating. This one-time change is allowed between December 8, 2014 through November 30, 2015 is the extended open enrollment time-period if the plan is a top-rated five-star rating.

The reason for the extended open enrollment time is to encourage Medicare beneficiaries to choose top-rated insurers. Anyone can move to a five-star Medicare Advantage or to a five-start Part D drug plan (or a plan that covers both) at any time during this period; this change can only be made once.

How Does Medicare Calculate Star Ratings?

Medicare uses a star rating system to measure how well their Advantage and prescription drug (Part D) plans perform. Medicare scores how well plans do in several categories, including quality of care, member complaints and customer service. Plans are rated from 1 to 5 stars, with five being the highest and one being the lowest score.

Plans are given separate star ratings for each individual category that’s reviewed. The average from those are then calculated and presented as the overall rating for each particular plan. The overall star ratings provide an easier way for people to compare the performance of several plans. Updated star ratings are released each fall to ensure the public has the latest plan performance information.

Medicare Advantage Plans are Rated on These Five Categories:

  1. Responsiveness and Care
  2. Customer Service
  3. Frequency of Screenings, Tests, and Vaccines
  4. Managing Long-Term Conditions
  5. Member Complaints, Problems and Disenrollments

Medicare Prescription Drug Plans are Rated on These Four Categories:

  1. Customer Service
  2. Member Experience with Plan
  3. Prescription Drug Pricing and Patient Safety
  4. Member Complaints, Problems and Disenrollments

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It’s Your Right to Request Accessible Formats

As a person with a visual impairment or a person who is blind you are entitled to equal access to all documents in alternative formats like braille, large print, audio and accessible electronic documents. Please contact your Medicare Insurance provider and ask for the format that will allow you equal access to review all of the associated documents needed to make an educated decision on the Medicare options that will best fit your needs.

We’ve compiled this short request-letter you can download and send to your provider. Simply fill in your insurance information up top, choose the accessible format you prefer and sign your name at the bottom. Mail the completed form to your insurance company. Download Letter Here

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