Every Medicare Advantage (Medicare Part C or MA/MAPD) in addition to Medicare prescription drug plans (Part D or PDP) are rated annually by “star ratings” by the CMS or Centers for Medicare & Medicaid Services. These plans are ranked from a 1 Star Plan for low quality up to a 5-Star Medicare Advantage Plan.

Ratings can vary from one star all the way up to five being the highest rating a plan can be awarded. The star rating can change annually. Medicare Advantage, and Prescription Drug plans are rated on the same scale but not given their ratings by the same measurements.

Medicare Advantage Plans are rated on how well they perform in these 5 categories:

1. Staying healthy: screenings, tests, and vaccines
2. Managing chronic (long-term) conditions
3. Plan responsiveness and care
4. Member complaints, problems getting services, and choosing to leave the plan
5. Health plan customer services

Prescription drug plans are rated on how well they perform in four different categories:

1. Drug plan customer service
2. Member complaints, problems getting services, and choosing to leave the plan
3. Member experience with the drug plan
4. Drug pricing and patient safety

Besides how well a plan treats their member that is not all that star ratings have an affect on. If you have a 5 star Medicare Advantage or Part D plan in your area you actually get a one time Special Election Period (SEP) that you would be able to switch. Normally without a 5 star plan in the area of a senior they would have to wait till the Annual Election Period (AEP) to switch Medicare Advantage or Part D plans. This presents a big opportunity for agents in area’s with 5 star plans to create Medicare Advantage or Part D sales outside of AEP.