Why You Should Talk to Your Agent About Five Star Plans


Medicare plans receive star ratings each year on a scale from one to five. These star plans are ranked using survey information from Medicare plans, plan members, and providers. A ranking of one star reflects a poor plan, while a plan with five stars reflects an excellent plan.

Categories Covered in Star Rating

Health plan ratings cover 36 different topics in five categories. These categories are:

  1. Staying healthy: screenings, tests, and vaccines.
  2. Managing chronic (long-term) conditions.
  3. Plan responsiveness and care.
  4. Member complaints, problems getting services, and choosing to leave the plan.
  5. Health plan customer service.

By using these star ratings you can have an easy way of judging a plan’s caliber. Five-star plans also come with a special enrollment period that lasts from December 8 to November 30 of the following year before the star update in the fall.

Star Plans SEP

During the five-star SEP, you can only switch to a five star rated Medicare plan one time. During the period, you can:

  • Dis-enroll from Original Medicare (Part A and B) and enroll in a five-star plan.
  • Change from a Medicare Advantage plan to a five-star rated Medicare Advantage plan.
  • Switch from a stand-alone Medicare Part D Prescription Drug Plan to a five-star rated stand-alone Medicare Part D Prescription Drug Plan.
  • Change from a five-star rated Medicare Advantage plan to a different five-star rated Medicare Advantage plan.
  • Switch from a five-star rated Medicare Advantage Prescription Drug plan to a different five-star rated Medicare Advantage Prescription Drug plan.
  • Dis-enroll from a Medicare Advantage or Medicare Prescription Drug Plan and enroll in a five-star rated Medicare Cost Plan.*

How To Find Out if a Plan is Five Stars?

Plans that fall into this category are identified with a icon.  These health and drug plans can be found on the Medicare.gov website.  You can also call 1800-MEDICARE or even use the Medicare & You handbook. Be sure to check the book for being outdated since plans are updated each fall. Your agent will be able to help you discern if a plan is five-stars and if a switch is something you should consider. These plans could offer you not only a Medicare.gov approved plan but also a high-quality one approved in important categories.

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  If you have any questions, comment below and your question may be the topic of our next post!

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