There are 3,550 Medicare Advantage plans available for purchase in 2021.1 With such a large number of plans from which to choose, how can you identify one that might fit your unique health care coverage needs?
The Centers for Medicare & Medicaid Services (CMS) uses a star rating system to rate the performance of Medicare Advantage plans each year.2 The system is used to measure Medicare Advantage and Medicare Part D stand-alone prescription drug plans, and it rates plans from one to five stars:
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
Speak with a licensed insurance agent
The star rating system used for Medicare Advantage plans provides an overall review of each plan’s quality and performance based on five key metrics:
In addition to an overall rating, each Medicare Advantage plan is rated in each individual category. Medicare Star Ratings are released in October of each year for the upcoming calendar year.
If a plan receives a rating of fewer than three stars for three consecutive years, it becomes flagged as a low-performing plan. If the plan continues to underperform, Medicare may remove the plan entirely from the marketplace.
To find out the ratings of plans that are available where you live, contact a licensed insurance agent at TTY Users: 711 (24 hours a day, 7 days a week) or request more information online.
The star rating system provides an overall glimpse at which Medicare Advantage plans are deemed to be “the best.” But a plan’s star rating doesn’t necessarily determine whether or not a plan will work for you.
Everyone has different needs, and the right plan for one person may be quite different than the plan that fits someone else’s needs.
By following the five-step process below, you may be able to better determine which Medicare Advantage plan may be the right fit for you.
One thing to note while shopping for a Medicare Advantage plan is that not all plans are available in every state.
For example, California has 311 plans available in 2021, while Wyoming only has six available Medicare Advantage plans.1
Plan selection can vary greatly from one state to the next, and not surprisingly, Medicare Advantage enrollment rates can vary widely between states.
When shopping for a Medicare Advantage plan, you should find out which plans are available where you live. A licensed insurance agent can help you do just that.
Medicare Advantage plans require applicants to already be enrolled in both Medicare Part A and Part B, and most plans might typically do not offer coverage to people who have end-stage renal disease (ESRD).
You also need to live within the service area of the plan you want to purchase.
It may be helpful to consult with an insurance agent to make sure you are eligible for your desired Medicare Advantage plan.
Medicare Advantage plans come in several types, and you may want to consider the structure of a given plan to determine if it’s best for your situation.
Some of the Medicare Advantage plan types include:
Learn about how each type of plan works and decide which plan type may be best suited for you.
Once you have found out which plans are sold in your area, confirmed your eligibility and determined which type of plan you’d like to enroll in, it’s time to review the Medicare Star Ratings.2 When doing so, you may want to take note of the categories that are important to you.
For example, a plan may have received a four-star overall rating but only received two stars for its management of chronic conditions. If you have a chronic condition, you may want to consider a plan with a stronger rating in this area.
A licensed insurance agent can share the star ratings with you for each plan sold in your area.
By law, Medicare Advantage plans must provide at least the same level of coverage as Original Medicare (with the exception of hospice care coverage, which you continue to receive through Medicare Part A).
Beyond that minimum requirement, Medicare Advantage plans may then offer additional benefits that can help distinguish one plan from the next.
Some common extra benefits offered by some Medicare Advantage plans include things like prescription drug coverage, dental, vision and hearing benefits.
Some Medicare Advantage plans may also offer perks such as gym memberships, home-delivered meals, non-emergency transportation like trips to your doctor's office and improvements to your home like installing bathroom grab bars.
When shopping for the best Medicare Advantage plan for you, you may want to consider these extra benefits and find one that offers services you are most likely to utilize.
A monthly premium is only one of the potential costs associated with Medicare Advantage plans. Medicare Advantage plans may have deductibles and out-of-pocket spending limits, along with cost-sharing measures such as copayments or coinsurance.
When deciding which plan may be best for you, you may want to carefully consider all costs associated with the plan and determine how well it will work within your budget.
Find out which Medicare Advantage plans are considered the best by the CMS — and determine which plan might be best for you individually — as you take your first steps toward enrolling in a plan that fits your needs.
Call today to speak with a licensed insurance agent and find the best 2021 Medicare Advantage plan for you.
Explore Medicare Advantage plan benefits in your areaCompare plans now
Or call 1-800-557-6059 (TTY: 711) to speak with a licensed insurance agent. We accept calls 24/7!
1 Fuglesten Biniek J., et al. (Oct. 29, 2020) Medicare Advantage 2021 Spotlight: First Look. Kaiser Family Foundation. www.kff.org/medicare/issue-brief/medicare-advantage-2021-spotlight-first-look.
2 Every year, Medicare evaluates plans based on a 5-star rating system.
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
Where you've seen coverage of Christian's research and reports: