Star ratings for Medicare Advantage plans are an easy way to know if you are enrolling in a plan that offers excellent healthcare and customer service. Medicare Advantage (or Part C) plans are rated from one to five stars, with the 5-star plans earning the highest  “excellent” rating.

But what exactly does that mean? What’s so special about these plans? This article will explain more about 5-star Medicare Advantage plans and the special enrollment period available.

What does a 5-star rating mean?

As we mentioned, a 5-star rating means the plan offers excellent health benefits and the insurance carrier has excellent customer service. To compare, this list of ratings tells you what each one means.

  • 1 Star = Poor
  • 2 Stars = Below Average
  • 3 Stars = Average
  • 4 Stars = Above Average
  • 5 Stars = Excellent

Many Medicare Advantage plans include prescription drug coverage. If the plan being rated is given five stars, it also means that the drug formulary within the plan offers safe prescriptions at fair prices.

How are Medicare Advantage plans rated?

Ratings are not handed out without a rigorous review process by the Centers for Medicare & Medicaid Services (CMS). CMS has many quality and performance categories, and each plan must meet certain standards in each of those categories.

CMS also considers member surveys, monitoring by the Medicare program, information submitted by plans and healthcare providers, and billing information for prescription drug coverage. Ratings are posted for consumer viewing every fall, usually in October.

Special Enrollment Periods for 5 Star Medicare Advantage Plans

The period when everyone can make a change to their Medicare enrollment options is during Medicare’s Annual Election Period (AEP) from October 15th to December 7th. This is when you can add, change, or drop a Medicare Advantage or Part D Prescription Drug plan. Outside of AEP, you must qualify for a Special Election Period (SEP) if you want to make a change. Luckily, there is a Special Enrollment Period (SEP) for anyone who lives in an area with a 5-star Medicare Advantage plan. If a Medicare Advantage plan with a 5-star rating is in your area of service, you can make a change outside of the Annual Election Period if you choose to add or change to a 5-star plan. You can add the 5-star plan even if you do not currently have a Medicare Advantage plan and have Original Medicare. This Special Enrollment Period is available from December 8 to November 30. You may make a ONE-TIME change to a 5-star plan during this time.

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