I saw somewhere online the 2022 Medicare Star Ratings were released. I want a highly rated plan. How do I find out what Star Rating my plan got? Should I even care about this?
Thanks for the question, Craig!
On October 8, Medicare released a press release outlining Medicare Advantage and Medicare Part D Prescription Drug Plans awarded the coveted 5 Star rating for 2022. I give an in-depth look into the Medicare star rating system in chapter two of my book, Prepare for Medicare – The Insider’s Guide to Buying Medicare Insurance (2021-2022 Edition).
There’s an updated link on my website that outlines all of the plans Medicare awarded 5 and 4.5 stars for 2022, and you can find that by clicking here. The article attaches a nice grid at the bottom showing all the plans, and they’re listed with under four headings.
- Contract Name
- Organization Marketing Name
- Parent Organization
- 2022 Overall (Star Rating)
In total, 73 specific Medicare health insurance policies were awarded five stars for 2022.
Notice I said Medicare health insurance policies. That’s an important distinction to make. When a Medicare insurance company has five-star plan listed, it doesn’t mean that all of their plans carry the five-star designation, it just means one particular plan they offer did. Just because the Parent Organization or Organization Marketing Name displays a company name, that doesn’t mean all of their plans made the five star rating – just the ones listed in the Contract Name. The contract name (outlined below) usually gives it away – you’ll notice a lot are state-based contracts.
You’ll find the Parent Organization tab including some of the usual suspects – larger, national Medicare insurance plan companies like Aetna, Humana, Centene and United Healthcare. But you’ll also see some smaller, regional companies like Kaiser Foundation Health Plan, Intermountain Health, Ucare, Essence Healthcare, HealthPartners, and many more. This goes to show there are many smaller, regional Medicare insurance companies out there that put out high-quality Medicare insurance products right alongside the larger national Medicare insurance companies!
What is the Medicare Star Rating System?
The Medicare star rating system is the federal government’s attempt to tap into a consumer-friendly five-star rating system concept. This star rating system only applies to Medicare Advantage and Medicare Part D Prescription Drug Plans—Medicare Supplement plans are excluded.
The Medicare Star rating system is numbered from one to five, with five being the best and one being lowest in terms of quality of service:
Four Stars—Above Average
Two Stars—Below Average
To determine these ratings, Medicare Advantage plans are rated in five different categories:
- Staying healthy: screenings, tests, and vaccines
- Managing chronic (long-term) conditions
- Plan responsiveness and care
- Member complaints, problems getting services, and choosing to leave the plan
- Health plan customer service
Medicare Part D Prescription Drug Plans are rated in four different categories:
- Drug plan customer service
- Member complaints, problems getting services, and choosing to
- leave the plan
- Member experience with the drug plan
- Drug pricing and patient safety
Star Ratings – Why Should You Care?
First of all, five-star plans get a Special Enrollment Period (SEP) and can enroll Medicare consumers outside of the normal October 15-December 7 Annual Election Period (AEP) and January 1-March 31 Open Enrollment Period (OEP) windows. (This SEP) can only be used once between December 8 and November 30.) That means you can switch to a five-star plan outside of the normal enrollment and election windows. Five-star plans get to play by different (looser) rules.
Second and probably more importantly for you, star ratings are important to you because ultimately, if your plan is rated three stars or below, it generally means you’ll pay more money for your policy, or your benefits won’t be as rich as plans with four stars or higher. This is because Medicare insurance companies get bonuses and rebates from the federal government for higher star ratings. When they get this bonus money, they have to spend much of it to improve the insurance benefits or lower the monthly premiums for the Medicare insurance plan. So, if you have a five-star rated plan, odds are you have better benefits available to you as compared to a two-star rated plan.
Hope that helps, Craig!
I love answering Medicare questions. Send me yours at firstname.lastname@example.org and I’ll pick a few for a future blog post!
To your wealth, wisdom and wellness!
Author Bio: Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development and strategy for over 20 years. Matt holds a BA from Virginia Tech and an MHA from Washington University in St. Louis.