 Personal Finance PowerPoint Presentation Medicare Star Rating System Prepare to get financially fit by practicing personal finance Insurance is part of our long-term risk mitigation strategy where we follow the adage of measure twice cut once put in a formal process in place look in something like setting the goals develop a plan to reach the goals put the plan in action review the result repeat the process periodically most of this information can be found at Investopedia Medicare Star Rating System which you can find online take a look at the references resources continue your research from there this is by James Chan updated January 31st 2022 and prior presentations we've been talking about insurance in general moving on over to the medical insurance which can be a little bit more confusing due to the complexity of the medical field laws and regulations relations related to it and insurance for it and now we're talking about Medicare in a specific in relation to the insurance discussion so what is the Medicare Star Rating System the Medicare Star Rating System is a method for consumers to evaluate and compare Part D drug plans and Medicare Advantage plans which vary greatly in terms of cost and coverage so we've talked a lot about Medicare we've looked at Medicare Part A we looked at Medicare Part B and then now we're looking at the Medicare Part B in the Medicare Advantage thinking about the system for choosing the rating system or a rating system so Medicare reviews the performance of plans one a year and publishes once a year and publishes new star ratings each fall so what does it mean then understanding the Medicare Star Rating System each January Medicare Part D drug plans and Medicare Advantage plans can change their coverage and costs for the new calendar year therefore users of the plans should review their coverage and compare their plans with other available plans to ensure their coverage is optimal the Medicare Star Rating System is a method that consumers can use to evaluate the different coverage options making it easier to determine which policies are among either the best Medicare Advantage plans or Part D plans currently available so it's one tool of course you want to do your homework with relation to it but they can update these things we know that there's constant changes in terms of the laws and regulations for the medical field and the insurance related to it and so it could quite be the case that you want to review from time to time and one of the tools that you might be using to do so it might be the Medicare Star Rating System so you can find a plan star rating system star rating using Medicare's plan finder tool or by calling 1-800-Medicare so you got the star rating tool you can check out how the Medicare Star Rating System works how does it put together how does the magic happen you might be asking well the Medicare Star Rating System measures the performance of plans based on several categories including quality of care and customer service the categories are ranked between one to five stars with five being the highest and one being the lowest so you got one to five star rating as you would expect then five is like the best because stars in the rating system are good we like stars so more stars better if we can get one with like all the stars completed that would be good less stars not as good according to the Medicare Interactive Medicare Advantage plans are rated on their performance in the following five different categories you got category number one staying healthy screening testing vaccines kind of some some of the more like preventative type of stuff you would think possibly number two category managing chronic long-term conditions category number three plan responsiveness and care so how responsive are they are they good and responsive and are they nice with a smile on their face they're kind of like rude rude I would think that would be important four member complaints problems getting service and choosing to leave the plan so people are taken off because the plan people are mean they're mean people they're not they're not providing good service number five health plan customer service so again obviously the customer service being a big component their part D plans are related on how are rated on how well they perform in the following four categories you got four of them here number one this is the part D so of course we got the drug plan customer service customer service being important you want someone to be your drug dealer needs to give you your merchandise with a smile so number two member complaints problems getting services and choosing to leave the plan so obviously the complaints are a big factor and if you're leaving the plans that's not a very good sign for the plan number three member experience with the drug plan so what's their experience with those drugs is trippy man I'll tell you it's trippy number four drug pricing and patient safety poor performance plans a plan is found to be low performing if it receives fewer than three stars from Medicare for three consecutive years so if you got three years under three three under three then your poor performer I'm sorry to say and you're not gonna be ranking high on our on our rating system because we like stars and you got you don't have many of them Medicare note notifies individuals in their plan has has been found to be low performing so if you are low performing if you're in a low performing plan they might tell you hey you know you don't got many stars you know you're not getting much stars for your for your cost that you have enroll these can change plans during specific times or during specific enrollment periods so then you got to say well where's the window where's the switch up plan if I've got a poor performing if I'm not getting the stars I deserve then you want to look for when you can change that's change it up so which are times outside normal enrollment periods that are triggered by specific circumstances so there could be specific circumstances so you got to determine when is it that you can switch up on the plan possibly if that's what you're looking to do which you might want to do if you don't if you're not getting your stars right so plan enrollment in general you can change your plan or enroll in a new one only during a special enrollment period you can choose a SEP to join or switch to a five star Medicare Advantage or Port D plan that if you're below three for the whole time that's at least a two-star bump up at least right which was that seems worthwhile however an SEP can only be used once a year the SEP begins December 8th of the year before the plan is considered a five-star plan rating comes out in October it lasts through November 30th of the year the plan is deemed a five-star plan enrollments in December are effective January 1st and enrollments from January to November are effective the month following the enrollment request