Think about the last time you booked a hotel or went to see a movie. You probably checked to see how highly it was rated. But have you ever thought to check the rating on your Medicare Advantage (MA) plan? If you said no, you're not alone.
Need a crash course in Star Ratings? Read on.
The Medicare Star Rating System is an important indicator of a health plan's quality and services. All MA plans are rated annually on a scale of one to five stars. Five is the highest a plan can rate and one is the lowest. These ratings come from the Centers for Medicare & Medicaid Services (CMS) and they're released every October.
Here's how Star Ratings work. MA plans are rated in five categories:
- Staying healthy: Measures whether members got preventive care like the flu shot or regular screenings and checkups to keep them healthy
- Managing chronic conditions: Measures how often members with chronic conditions got recommended tests and treatments
- Member experience with the health plan: Measures how members rated their overall satisfaction with the plan
- Member complaints and changes in plan performance: Measures how often members have problems and choose to leave the plan. It also shows if the plan's performance has improved from the previous year.
- Customer service: Evaluates how well the plan handles member calls and requests
Every plan receives a score in each of the above five categories. The categories carry different weights, but they all contribute to an average that becomes the health plan's overall Star Rating. Anyone can find these ratings online using the plan finder tool on the government's Medicare website, cms.gov.
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Why Star Ratings matter
Star Ratings can give you insight into the parts of a health plan you care most about. For example, maybe you're considering two similarly rated plans, but you notice one has a higher score in customer service. If this is an area that's important to you, it's likely you'll choose the plan with a better customer service rating. In this way, Star Ratings can serve as a tiebreaker, giving one plan a slight edge over another depending on your unique health care needs. Overall, Star Ratings can be an important tool in helping you choose the right Medicare plan for you.
Chrissy Costa is a health care writer at Aetna with experience in senior wellness, Medicare, commercial health care, and consumer engagement. When Chrissy isn't at the gym, she enjoys spending time with her husband and daughter, trying out new restaurants, and watching too much TV. Chrissy lives in Marlborough, Massachusetts and has a degree in journalism from Emerson College.
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