Seniors Advised To Ask About Medicare Advantage Plan Star Ratings During Open Enrollment

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Contributor, Benzinga
October 19, 2022

Medicare Open Enrollment begins October 15, providing millions of seniors with the opportunity to compare and switch their Medicare plan coverage. The 53-day window is an incredible benefit provided to Medicare recipients, especially those with Medicare Advantage (MA) or Part C coverage. Over 26 million individuals are enrolled in MA plans, currently the most popular form of Medicare health plan coverage. Also benefiting are the 23 million seniors with standalone Medicare drug plan (Part D) coverage. 

Experts note that a majority of those with MA coverage fail to take advantage of the annual plan review even when they report being dissatisfied with their current plan and benefits. According to reviews by the American Association for Medicare Supplement Insurance, individuals often think that the problems they face are unique to their specific case and cannot be resolved. However, experts say that this is not usually the case.

Plan Dissatisfaction And Added Benefits Prompt Switching

Surveys of consumers with Medicare Advantage plans report several reasons individuals consider switching from their current coverage. The first is dissatisfaction with the current plan, including factors such as perceived unreasonable cost sharing or a limited network of health professionals.

The second reason is related to additional MA plan benefits that are aggressively promoted today via television advertisements. Free dental plan coverage may sound attractive but there is a significant difference between what various MA plans actually cover. The problems only become apparent when the plan participant seeks dental care.

Medicare recognizes the importance of customer satisfaction. In 2007, the Centers for Medicare & Medicaid Services (CMS) created the Star Rating System for Medicare Advantage plans. Star Ratings evaluate MA plans on 1 to 5 scale, with a 5-star rating being the highest quality. Star ratings are released annually and reflect the experiences of people actually enrolled in the many Medicare Advantage and Part D prescription drug plans.

2023 Star Ratings Drop For Many Plans

For 2023, just over half (51%) of people choosing Medicare Advantage plans that include prescription drug coverage will have a star rating of 4 or more. This rate marks a decline compared to 68% of plans with such a rating or higher for 2022. 

CMS reported that 72% of people currently in an MA drug coverage plan are enrolled in one with 4 stars or higher, a drop compared to 90% for 2022. That means that over a quarter of plan participants are enrolled in plans earning 3 or fewer stars. The organization also reported that just 31% of stand-alone Medicare Part D plans active in 2023 received a star rating of 4 or more. 

Some professionals familiar with Medicare’s Star Ratings system note that the decline from 2022 to 2023 can be attributed to certain conditions, including COVID-19. CMS has noted that it will remove a disaster provision put in place to help plans in response to the COVID-19 pandemic. 

Finding The Best Plan Options For 2023

Medicare provides the Open Enrollment time period encouraging consumers to determine if better or less expensive coverage is available. For example, the American Association for Medicare Supplement Insurance recently reported that seniors who switch Medicare Part D prescription drug plans save between $500 and $700 annually.

The average Medicare beneficiary has access to 39 Medicare Advantage plans. That is up from 28 in 2020 and from 16 in 2016. In some counties, such as Los Angeles, there are 70 different MA plans available. With so many available options, it often pays to do your own research along with consulting a local Medicare insurance agent in your area. They often will know the most about current plan satisfaction and can share the latest Medicare Star Ratings for area plans.

In terms of finding the best Medicare drug plan, local agents can be a valuable resource. In addition, online tools compare plans available. Look for one that does not require your personal information before providing plan information to help you avoid being the recipient of spam and unwanted phone solicitations.

About Jesse Slome

Medicare Expert – Director Long Term Care Insurance Association, Medicare Supplement Insurance & Critical Illness Insurance Association