You may have heard the term “5-Star Medicare Advantage Plan,” but what does it mean? In short, a 5-Star Medicare Advantage Plan is a health insurance plan that has been given the highest, or “excellent,” rating by the Centers for Medicare and Medicaid Services (CMS).
CMS calculates star ratings every year to guide consumers to the highest-rated plans. A five-star rating is used, with one star given to the lowest-rated plans and five to the highest-rated plans. Any plan that receives four stars or above is considered a “top-rated” plan.
But what goes into earning that coveted 5-Star rating? Let’s take a look.
There are five different factors that the Centers for Medicare and Medicaid Services look at when rating Medicare Advantage plans. Still, the two main ones are quality of care and patient satisfaction. To measure the quality of care, CMS looks at how well the plan works to prevent hospitalizations, how often its members get certain screenings and vaccinations, and how well the plan manages chronic conditions like diabetes or heart disease.
For patient satisfaction, CMS surveys enrollees about their experiences with the plan—things like customer service, how easy it is to get appointments, and whether or not they would recommend the plan to their friends or family.
Based on the five factors, the Centers for Medicare and Medicaid Services offers a ranking to guide your plan decision. You may want to avoid enrolling in a plan with one or two stars.
“If a Medicare Advantage plan is rated ‘excellent,’ it doesn’t mean it’s the right or best plan for you. You should choose a plan based on your healthcare needs and budget.“
Because the Centers for Medicare and Medicaid have rated a plan “excellent,” it doesn’t mean it’s the right or best plan for you.
When choosing a plan, there are many factors to consider, including your healthcare needs, prescription drug coverage, doctors and specialists, budget, and more. Connie Health recommends that you don’t get stuck on “choosing a 5-Star plan.” Instead, high-rated plans should be an option or guidance.
The best way to find a plan that’s right for your health and budget is to speak with a local licensed agent. To find the best Medicare Advantage plan in Florida for you, call (623) 223-8884 (TTY: 711) to speak with a local licensed agent.
Wondering if a 5 Star Medicare Advantage plan is offered in your area? We reviewed 5-Star plans throughout Florida and found two insurance companies frequently providing “excellent” health care according to CMS: Optimum HealthCare and HealthSun Health Plans.
Live in Broward County, Hernando County, Hillsborough County, Lake County, Miami-Dade County, Orange County, Osceola County, Palm Beach County, or Seminole County? Below, you’ll be able to preview 2023 Medicare Advantage plans in Florida that received a 5-Star rating where you live. Some plans include prescription drug coverage.
Because plans are based on the zip code that you live in, we recommend that you use the Connie Health plan tool to compare plans in your county. You can also click on any of the links below to review detailed plan information.
Source: Explore your Medicare Coverage Options, Medicare.gov
Every year, there are several opportunities for you to enroll in a 5-Star Medicare Advantage plan. You can enroll in a 5-Star plan:
If you’re enrolled in a Medicare Advantage plan rated lower than five stars and find a five-star plan in your area, you can change plans once between December 8 and November 30. This is called the 5-Star Special Enrollment Period.
A local licensed Connie Health agent can determine if you’re eligible for a 5-Star Special Enrollment Period.
Read more by William Revuelta
I am a Spanish-speaking Florida Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2009. I’m an avid sports fan and enjoy watching international soccer matches and college football. When not with my family, I listen to podcasts ranging from history to sports talk.