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Star Ratings

Learn about Star Ratings and why they matter.

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What’s a Star Rating?

Each year the Centers for Medicare and Medicaid Services (CMS) measures the quality and value of certified health plans. Medicare certified health plans, both Part C (Medicare Advantage) and Part D (Prescription Drug), are rated on a star scale. The scale ranges from one to five stars, with five stars representing the highest quality. Scores are based on more than 50 care and service quality measures across several categories. Some examples of the categories include:

  • Staying healthy: How well the plan covers and helps its members receive recommended health screenings, vaccinations, and other check-ups, including programs that encourage wellness and help members stay healthy.
  • Managing chronic (long-term) conditions: How often members with different chronic conditions receive certain tests and treatments that help them manage their condition.
  • Member experience: How members rate their satisfaction with plan benefits (e.g., coverage, copays, and customer service).
  • Member complaints and plan performance: How often Medicare found problems with the plan and how often members had problems with the plan, including how well the plan handles member appeals and new enrollment requests.

Why Is It Important to Know?

Medicare uses information from member satisfaction, plan, and provider surveys to determine overall performance star ratings. It also uses reviews of claims and other information that plans submit to Medicare, as well as results from Medicare’s regular monitoring and auditing activities.

Medicare incentivizes plans to qualify for four- and five-star ratings with a revenue bonus that the plan must reinvest in its programs in the form of better benefits and lower premiums and copayments for its members.


Star Ratings Can Help You Make An Informed Choice

As a Medicare beneficiary, you have the opportunity to evaluate your current plan each year from October 15 to December 7 (the annual election period). This is the time to make sure your plan will meet your healthcare needs for the coming year and make any necessary adjustments. The CMS Star ratings can help you compare different plans’ quality and performance.

Visit other pages on this site to learn more about why SelectHealth Advantage has been recognized by CMS for quality and performance. To find out more about Medicare Star Ratings, visit CMS.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 877-486-2048. Plan performance summary Star Ratings are assessed each year and may change from one year to the next.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.


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