Seniors enrolling in Medicare often are surprised to discover that most Medicare health and prescription drug plans are measured by a five‑star rating system. Much like a reviewer guide to restaurants or hotels, Medicare plans are ranked from a low of one star to a high of five stars.

The overall ratings provide an easy and intuitive way to help people evaluate and compare both the quality of the product being offered and the overall experience of real consumers.

Star Rating categories

These ratings are based on the plan’s performance in five categories:

• Keeping people healthy: screening tests and vaccines. Includes whether members received appropriate preventative screening tests, vaccines, and other check-ups to help them stay healthy
• Managing chronic (long-term) conditions: Includes how often members with certain conditions got recommended tests and treatments to help manage their condition
• Member experience: Includes actual member’s ratings of the plan
• Member complaints and changes in the health plan’s performance: Includes how often Medicare found problems with the plan and how often members had problems with the plan
• Health plan customer service: Includes how well the plan handles member appeals

Developed by Centers for Medicare and Medicaid Services (CMS), the Star Rating system is based on member surveys as well as information provided by doctors, health care providers and Medicare's regular monitoring activities. The standards are evaluated on an annual basis and are built to drive continuous improvement in the health care system and better health outcomes for Medicare enrollees.

Shopping for a Medicare Plan

Evaluating a Medicare plan should take other factors into account as well, such as covered benefits and which doctors, clinics and hospitals are included in the network. Also, the Medicare Annual Enrollment Period (AEP) from October 15 to December 7 is a great time to review your plan selection each year and make sure it's still the best fit for your needs. Related reading: From networks to enrollment periods, get smart on Medicare Advantage plans.

Getting help sorting through your options is easy (and free!) with a licensed advisor. Blue Cross Advisors are available in your area for face-to-face meetings, telephone consultations or virtual visits. Appointment scheduling is available online at bluecrossmn.com/advisors.

Blue Cross is proud to have a service team of nearly 500 Minnesota-based Member Experience Advocates. More information about Blue Cross’ Medicare plans can be found at BlueCrossMN.com/medicare.

Editor's note:  Every year, Medicare evaluates plans based on a 5-star rating system.  Blue Cross offers PPO, HMO-POS, Cost and PDP plans with Medicare contracts. Enrollment in these Blue Cross plans depends on contract renewal.