Using Medicare Advantage Ratings and Reviews

• by Christian Worstell
• March 8, 2021
• Reviewed by John Krahnert

There are several things you may want to consider when shopping for a Medicare Advantage plan (Medicare Part C), such as plan cost, coverage and availability.

You can get some help as you compare Medicare Advantage plans by using plan ratings and insurance company reviews.

Use the guide below to learn how to research Medicare Advantage reviews and find the best plan for your needs.

You can also get help comparing Medicare Advantage plans by calling to speak with a licensed insurance agent who can help you review ratings and reviews of plans available where you live.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

Medicare Star Rating system

One place to look for Medicare Advantage plan reviews is the Medicare Star Rating system.¹

Each fall, the Centers for Medicare & Medicaid Services (CMS) releases a ratings report for Medicare Advantage and Medicare Part prescription drug plans (Medicare Part D).

Plans are rated on a five-star system using the following breakdown:

The Medicare Star Ratings are assigned to Medicare plans based on five aspects of each plan:

• Screening tests and vaccines
  This criterion evaluates the type of access that plan members have to preventive services such as annual physicals, screenings, and vaccines.
  
  
• Management of chronic conditions
  This measures how efficiently care is coordinated for plan members with chronic conditions and how often they receive treatment for long-term health issues.
  
  
• Member experience with the plan
  Plan members’ overall satisfaction with the plan is factored into this rating criteria.
  
  
• Member complaints and changes in plan performance
  This reflects how often plan members issued complaints about the plan, experienced problems receiving covered services or opted out of the plan entirely. It also measures how the plan’s performance improved from the previous year.
  
  
• Customer service
  Medicare evaluates the quality of service at the plan’s call center and how efficiently appeals and enrollments were processed.

If a plan receives fewer than three stars for three consecutive years, Medicare determines it to be a low-performing plan and reserves the right to remove it from its coverage. Current members of the plan will be notified and given a Special Enrollment Period to enroll in another Medicare plan.

Insurance company reviews

In addition to analyzing a plan’s Medicare Star Ratings, you can read reviews about particular insurance companies that sell Medicare Advantage plans.

These insurance company reviews are presented by review agencies such as:

• Consumer Affairs
• J.D. Power
• Better Business Bureau

You may also want to consider doing some of your own research on private insurance companies that offer Medicare Advantage plans, such as:

• Cigna-HealthSpring
• UnitedHealthcare
• Aetna
• Humana
• Kaiser Permanente
• Anthem Blue Cross and Blue Shield

What to consider when reviewing Medicare Advantage plans

When reviewing a Medicare Advantage plan, it’s helpful to not only read the reviews and ratings of others, but to also to review the plan details yourself. Because each plan can vary so much, the right plan for you may be quite different than the right one for someone else.

When shopping for a Medicare Advantage plan, take time to review the following:

• Cost
  Cost is obviously an important thing to consider as you compare Medicare Advantage plans. Plans may come with monthly premiums, deductibles, coinsurance and other costs you will want to consider.
  
  
• Benefits
  Medicare Advantage plans may offer a variety of benefits that are not covered by Original Medicare, and these additional benefits can differ from one plan to the next. Review your health care requirements and find a plan that covers what you need most.
  
  
• Network participants
  You may want to look for a Medicare Advantage plan that includes your preferred doctor or the nearest health care facilities as part of the plan network, if the plan has one. The list of participating providers can differ from plan to plan.
  
  
• Type of plan
  There are several types of Medicare Advantage plans, and it may be wise to review how each type of plan works in general so that you may enroll in the best plan for you.

Review other Medicare Advantage plans during Open Enrollment

If you are enrolled in a Medicare Advantage plan and you wish try a different plan, you will have several weeks to review additional plans and enroll in a new plan during the Open Enrollment Period, also called the Annual Election Period.

This period lasts from October 15 to December 7 each year.

Get help enrolling in a Medicare Advantage plan

Another valuable resource to use while shopping for a Medicare Advantage plan is the knowledge of a licensed insurance agent. An agent can help you review which plans are available in your area and help you compare the costs, benefits, network providers and other important details of each plan.

Call today to speak with a licensed insurance agent who can help you review Medicare Advantage plans and to find the best coverage for your needs.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!