Published October 8, 2020
The Centers for Medicare & Medicaid Services (CMS) released its annual Star Ratings for Medicare Advantage plans, Medicare Advantage Prescription Drug (MA-PD) plans and stand-alone Medicare Part D (PDP) plans on Oct. 8.1
Medicare Star Ratings are awarded on a scale of one to five stars, based on plan quality for the 2021 plan year. Many Medicare beneficiaries may be able to enroll in, switch or drop their MA-PD or PDP coverage during the Annual Enrollment Period (AEP, also called the fall Medicare Open Enrollment Period) which lasts from Oct. 15 to Dec. 7.
The Star Ratings reflect the experiences of beneficiaries enrolled in the plan, and they are awarded based on various quality metrics related to plan features and benefits. A rating of five stars is “excellent,” while a rating of one star is considered “poor.” A three-star rating is “average.”
Highlights from the 2021 Medicare Star Ratings
Some of the highlights from the 2021 Star Ratings include:
- MA-PD plans average 4.06 stars overall for 2021, with 49 percent of all MA-PD plans being rated at least four stars. Plans that are rated four stars or higher are considered “top-rated” plans.
- Approximately 77 percent of current MA-PD beneficiaries are enrolled in a plan rated four stars or higher. 96 percent of beneficiaries are enrolled in a plan rated 3.5 stars or better, and more than 99 percent are enrolled in plans rated three stars or higher.
- The average PDP plan Star Rating is 3.58 stars in 2021, up slightly from 3.50 in 2020.
- 42 percent of all PDP plans in 2021 are rated four stars or higher.
- Nearly 98 percent of PDP beneficiaries are currently enrolled in a plan rated 3.5 stars or higher.
About the Medicare Star Ratings
Medicare Advantage plans are measured using 32 different metrics that address the following areas:
- Staying healthy
This category rates a plan beneficiary’s access to preventive services such as physical exams, vaccinations and screenings. - Chronic conditions management
Plans are evaluated on care coordination and the frequency at which members received services for long-term health conditions in the past year. - Member experience
Overall member satisfaction with the plan is included in this rating category. - Member complaints
Medicare measures the frequency with which plan members submit complaints, leave the plan or report issues accessing covered services. Plan performance from one year to the next is also considered. - Customer service
Plans are also evaluated on the quality of call center services and the processing of plan appeals and enrollments.
MA-PD plans are scored using 44 unique metrics, and PDP plans are measured using 14 different data points, including the above categories along with various drug safety and drug pricing accuracy measures.
You can review a fact sheet summarizing the Star Ratings from the CMS.
MedicareAdvantage.com will soon publish a detailed report of 2021 plan data for MA-PD plans and PDP plans in every state. The report will include average plan costs, plan selection, enrollment figures and more.
If you want to learn more about the Star Ratings of Medicare plans in your area, you can call to speak with a licensed insurance agent today. A licensed agent can help you compare plans available where you live, including their Star Ratings, costs, benefits, the drugs they may cover and more.
You can also compare plans online, right from your home. It’s free to compare plans, and there’s no obligation to enroll.
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1 Every year, Medicare evaluates plans based on a 5-star rating system.
