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CMS Assigns 5 Star Rating To 11 Advantage Plans

Only 11 Medicare Advantage plans made the grade

Of all the Medicare Advantage plans available nationally, CMS rated only eleven as top performers.

Medicare Advantage plans are rated on over 50 items when assessing quality and performance.

Although there are more four and five star plans for 2013 compared to 2012, it still leaves the majority of Advantage plan members without the option of exercising the Special Enrollment Period for 5 star rated plans.

If you have 5 star rated plans available in your service area you may be able to enroll at any time of the year, not just during the Open Enrollment Period.

Included below is a list of companies offering Medicare Advantage plans that are rated five stars.

Five star rated Medicare Advantage plans are available from these companies for 2013

Both medical and prescription benefits were rated as five stars for the following for select plans from these companies:

  • Humana Wisconsin Health
  • Group Health Plan Inc. – Minnesota and Wisconsin
  • Baystate Health Inc – Health New England – Massachusetts
  • Group Health Cooperative – Washington
  • Gundersen Lutheran Health System Inc. – Wisconsin
  • Kaiser Foundation Health Plans – California, Colorado, Hawaii, Oregon, Ohio, Washington and Mid-Atlantic regions

CMS states that 37% of all Medicare Advantage members have access to a four or five star plan for 2013. They neglect to indicate what percentage have access to five star rated plans.

Although having four star rated plans available may be nice, it doesn’t meet the criteria for the five star Special Enrollment Period.

Keep in mind that Medicare Advantage plans are offered County by County and and even though the above companies are offering plans in your State, five star rated plans may not be available in all Counties.

Does it really matter if you don’t have 5 star rated plans available?

Information on how many Medicare beneficiaries take advantage of the five star Special Enrollment Period is hard to come by. It makes you wonder if this Special Enrollment Period is really needed or if it is more of a PR stunt. If all the CMS press releases tout the number of four and five star plans available, why not make it a four and five star Special enrollment Period?

Your best course of action is to compare plans during the Open Enrollment Period and choose what you believe will be your best option.

The fact is that there is not a universally best plan and a five star rating does not guarantee that a plan will be your best option.

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2 comments

  1. THIS MESS IS SO CONFUSING.I CALLED AND STAYED ON THE PHONE WITH MEDICARE PERSON NEARLY 2 HOURS LAST NIGHT. IT DID NOT HELP ME CHOOSE A PLAN. I COULD NOT AFFORD WHAT THE INSURANCE SAID WOULD BE MY PART. ONE GROUP W ANTED ME TO $33,OOO TOWARDS WHAT WOULD BE MY PART TO PAY. I ONLY GET ABOUT 2/3 OF THAT TOTAL FOR A YEAR. SO MEDICARE ALONE WANTS MORE FOR MY DRUGS THAN I MAKE A YEAR. ANNY SUGGESTION’S?//

  2. Linda, I would recommend speaking with someone from your local Area Council on Aging. They are well versed in available plans and can help.

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