5 Star Medicare advantage plan ratings in 2024
One of Medicare’s most important goals is to make the quality of Medicare advantage plans transparent. In this effort, Medicare advantage plans are each year rated on a scale ranging from 1 to 5 stars. While a 5-star rating is considered excellent, a one-star rating represents poor performance. The overall score makes it easy for Medicare beneficiaries to compare plans, based on quality and past performance.
Medicare Advantage Plan Ratings are published each year in fall, before the open enrollment period begins, and beneficiaries may enroll in or switch plans.
How are 5-Star ratings for advantage plans in 2024 determined?
For 2024, Medicare uses different quality signals for MA-PDs (Medicare advantage plans that include prescription drug coverage) and stand-alone PDP contracts.
The criteria for Medicare Advantage plans (also referred to as ‘Medicare Part C’) include, but are not limited to the following topics:
- Staying healthy, including how often members got various screening tests, vaccines, and other check-ups that help them stay healthy.
- Managing chronic (long-term) conditions, including how often members got certain tests and treatments that help them manage their condition
- Health plan responsiveness and care, including ratings of member satisfaction with the plan
- Member complaints and appeals, including how often members filed a complaint against the plan
- Customer service, including how well the plan handles calls from members
The criteria for MA-PDs covers these topics:
- Customer service, including how well the plan handles calls and makes decisions about member appeals
- Member complaints and Medicare audit findings, including how often members filed a complaint about the drug plan and findings from Medicare’s audit of the plan
- Member experiences with the drug plan, including member satisfaction
- Drug pricing and patient safety, including how well the drug plan prices prescriptions and provides updated information on the Medicare website, and how often members with certain medical conditions get prescription drugs that are considered safer and clinically recommended for their condition.
High Performing Medicare advantage plans 2024
Low Performing Medicare advantage plans 2024
You can find the official list with high and low performing Medicare Advantage Plans, published by CMS.gov here.
The 5-star Special Enrollment period
Medicare beneficiaries may enroll in, or switch between 5-Star rated advantage plans at any time during the year, provided they meet the requirements of the plan (having Medicare Part A and B, living within the plan’s service area, even with a pre-existing condition).
Attention: If you switch from MA-PD (an advantage plan that includes drug coverage) to a plan that doesn’t, you will have to wait until the next open enrollment period (Oct 15-Dec 7 each year) to enroll in a drug coverage plan, and you may have to pay a late enrollment penalty!
