On Friday (10/12/12) the U.S. Department of Health & Human Services released the 2013 quality ratings for Medicare Advantage and Part D prescription drug plans. These star ratings summarize how well the plans performed on well-established measures of quality such as access to care, responsiveness, and beneficiary satisfaction. Plans can earn up to 5 stars, from one star for poor performance to 5 stars for excellent performance. Star ratings are reviewed each year and the results are published by CMS in the fall.

HHS Secretary Kathleen Sibelius said, “People with Medicare have more high quality choices and the performance of Medicare Advantage plans is improving,” and there are “more four and five star plans than ever before.”

Four & Five Star Plans
Plans 2012 2013
Medicare Advantage 106 127
Part D 13 26

To encourage people to enroll in higher quality plans, CMS is notifying people who have been enrolled in low performing plans (plans that received less than 3 stars for the past three years) that they can enroll in a new plan if they want to. Star ratings, in addition to cost and coverage, help consumers compare plans and choose the right one for their needs and budget.

5-star plans are allowed to market and enroll people throughout the year, and thousands of people “took advantage of this opportunity to join a top performing plan,”  according to Sibelius. People can switch to a 5-star plan at any time during the year, but they can only do so once each year.

In addition to better quality, HHS announced that Medicare Advantage benefits are increasing and premiums are holding steady. According to HHS data, average premiums fell 10% and enrollment increased 28%. Premiums for Part D prescription drug plans are expected to remain steady with last year at about $30 on average for 2013.

Related Stores:

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New MA star ratings released by CMS

Preliminary CMS 2013 Medicare Advantage payment and policy guidelines

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.

The Centers for Medicare and Medicaid Services (CMS) has announced that 2013 will bring changes aimed at continuing to improve the quality of Medicare Advantage and Part D plans while helping seniors afford their prescription medications.

The Affordable Care Act Changes to Part D Prescription Drug Plans in 2013

The Affordable Care Act includes provisions that, over time, are reducing the cost of prescription drugs for people who fall into the coverage gap, or “donut hole.” In 2011 and 2012, the discount for brand name drugs was 50%; in 2013 and 2014, it will increase to 52.5%, and will grow after that until it reaches 75% in 2020.

The discount for generic drugs is increasing too; in 2013, it will be 21% so that you will pay 79% of the cost of your generic prescription medications. The generic drug discounts will also continue to increase, until they reach 75% in 2020, with the remaining 25% to be paid by you.

Other changes to Part D plans in 2013 include:

  • The standard Part D plan initial deductible will increase to $325 (up from $320 in 2012). Your deductible may differ.
  • Premium costs in 2013 are expected to remain at 2012 levels, around $30.00 per month on average. If you see a large increase in your Part D premium, you can make changes during the Open Enrollment Period.

Special Enrollment Period to switch to 5-star rated Medicare Part D or Medicare Advantage plans

CMS developed its quality rating system for Medicare Advantage and Medicare Part D plans a few years ago, basing it on well-established measures of health care delivery quality such as access to care, responsiveness, and beneficiary satisfaction. Plans can earn from 1 to 5 stars.

Although 5 star plans were few in 2012, forecasters are predicting they will be more widely available in 2013 as more insurance companies achieve the service levels necessary to earn the rating.

If you want to switch to a 5-star rated plan in your area, you can do so at almost any time during the year. The Medicare Advantage and Medicare Part D 5-star plan Special Enrollment Period this year runs from December 8, 2012 through November 30, 2013.

Special Enrollment Period to leave a consistently low rated Part D or Medicare Advantage plan

If either your Medicare Advantage or Part D plan has failed to achieve at least a 3 star rating from CMS over the last three years, you should expect to receive a letter from CMS offering you a Special Enrollment Period to leave your plan and choose a new one.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.