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Medicare developed its star rating system to give people with Medicare an objective measure of a plan’s performance. The rating system gives people a way to consider quality as well as cost as they make enrollment decisions. Medicare evaluates plans every year and scores them on a scale of 1 to 5 stars, with 5 stars indicating the highest performance. The results are posted every fall, usually in October.
When most people shop for a Medicare plan, they look at benefits and cost. But be sure to check the plan’s star rating. It tells how well the plan is performing and how satisfied members are with the plan. A higher star rating means a higher quality plan.
Much of the information Medicare uses to rate a plan is based on data, like member records and claims. But an understanding of member experience can’t be found in data alone. For that, Medicare goes straight to the source and surveys actual plan members. Where can people find information on a plan’s star rating?
Medicare takes into consideration a range of items, including:
How well the plan helps members stay healthy and improve their health
How well the plan helps members with long-term conditions manage their care
The quality of call center services and how well the plan processes appeals and new enrollments in a timely manner
How many members left the plan, submitted complaints or had issues getting services
Including drug plan pricing and patient safety
How satisfied members are with the plan
Star ratings for HMO-POS plans under contract H1961:
Star ratings for PPO plans under contract H4544:
Star ratings for dual-eligible special needs plans under contract H1961:
Star ratings for 2024 updated by Medicare in October 2023.
Star ratings for HMO-POS plans under contract H1961:
Star ratings for PPO plans under contract H4544:
Star ratings for dual-eligible special needs plans under contract H1961:
Star ratings for 2025 updated by Medicare in October 2024.
* Every year, Medicare evaluates plans based on a 5-star rating system. Peoples Health plans under Medicare contract H1961 are rated 4 out of 5 stars for 2025.