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Matt,

 

I’m curious about the star ratings for Medicare for 2023. What’s different about next year, if there is a difference for Medicare star ratings?

 

Thank You,

 

Grace


Grace,

 

This can be complicated, but let me explain some of the details which will help you understand how Medicare Advantage and Medicare Part D plans are rated. Here is the scoop on Medicare Star Ratings for 2023. 

 

Medicare Star Ratings for 2023

The institution that runs Medicare, the Centers for Medicare and Medicaid Services (CMS) have released the Medicare Advantage and Part D Star Ratings for 2023.  Each year, Medicare insurance companies file bids for Medicare Advantage and Medicare Part D and CMS either accepts them, or does not.  Every Medicare Advantage and Part D plan for sale today had to go through a bid process and be allowed to offer their plans.

Medicare also publishes annual STAR ratings, which are supposed to be a consumer-friendly way one can evaluate the quality of the Medicare insurance plan. One star represents poor performance, and five stars represents excellent performance.

2023 Medicare Advantage Star Ratings Lower

In all, 57 contracts earned five stars, down significantly from 74 last year. There were 67 contracts that earned 4.5 stars (down from 96 last year); 136 that earned four stars (compared to 152); 116 that earned 3.5 stars (compared to 122); and 90 that earned three stars, up from 25 last year.

Some of the major parent companies earning five stars are Kaiser Foundation Health Plans and UnitedHealth Group. Five Kaiser plans earned five stars this year, while nine five-star plans belong to companies owned by UnitedHealth Group. Humana and Highmark also boasted numerous five-star plans.

Significantly, 37 plans earned 2.5 stars, compared to just two last year; at the same time, four plans earned two stars, compared to none last year. All four two-star plans are Wellcare branded plans, offered by Centene Corporation.

Medicare Star Ratings Rules Change Annually

People with Medicare can compare quality through the star ratings, along with other information such as cost and coverage, on the online Medicare Plan Finder tool available on Medicare.gov.

The star ratings are important to both insurers selling private Medicare Advantage plans and to beneficiaries who are looking for Medicare coverage. Star ratings reflect a plan’s performance and are related to quality bonus payments.

CMS changed the methodology for the 2023 star ratings and also removed guardrails that protected plans during the height of the pandemic. Star ratings affect 5% quality bonus payments made to plans.

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Author Bio Matt Feret is the author of the Prepare for Social Security -The Insider’s Guide and the Prepare for Medicare – The Insider’s Guide book series and launched PrepareforSocialSecurity.com to help people get objective answers to questions about Social Security and Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.