The Best Medicare Advantage and Part D Plans in 2016

Understanding Medicare's Five Star Scale

Medicare Five Star rating
Medicare rates Medicare Advantage and Part D plans on a five star scale. 07_av/ E+ / Getty Images

Picking the best Medicare plan can be confusing. It doesn't have to be. The government has set up a system to rate Medicare Advantage and Part D plans. On a scale of one to five stars, you can find out which plans offer the best coverage.

What Makes a Five Star Plan

Medicare Advantage and Part D plans have similar criteria when it comes to the star rating system. Customer service and member experience are important.

After all, if service is poor, even if coverage is top notch, you may end up frustrated. These are the criteria used to rate Medicare plans.

Criteria for Rating Medicare Advantage Plans

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 service

Criteria for Rating Medicare Part D Plans

1. Drug plan customer service

2. Member complaints, problems getting services, and choosing to leave the plan

3. Member experience with drug plan

4. Drug pricing and patient safety

Medicare reviews plan performance each year and releases new star ratings each fall. 

What Five Star Plans Are Available

There are only 24 Medicare plans rated as Five Star for 2016 and only one Five Star Medicare Part D Drug plan in 2016. This prescription drug plan is offered by WPS Health Insurance in Wisconsin.

2016 Five Star Medicare Part D Plans by State

Arizona

Cigna

 

California

Kaiser Permanente

 

Colorado

Erickson Advantage

Kaiser Permanente

 

District of Columbia

Kaiser Permanente

 

Hawaii

Kaiser Permanente

 

Illinois

Essence Healthcare

 

Iowa

Gundersen Health Plan, Inc.

 

Kansas

Erickson Advantage

 

Maryland

Erickson Advantage

Kaiser Permanente

 

Massachusetts

Erickson Advantage

Tufts Health Plan or Tufts Medicare Preferred

Michigan

Erickson Advantage

 

Missouri

Essence Healthcare

 

New Jersey

Erickson Advantage

 

Oregon

Kaiser Permanente

 

Pennsylvania

Erickson Advantage

 

Texas

Erickson Advantage

 

Virginia

Erickson Advantage

Kaiser Permanente

 

Washington

Kaiser Permanente

 

Wisconsin

Gundersen Health Plan, Inc.

HealthPartners

Not all states have Five Star plans available. If you are lucky, you may have access to one. Many other plans also rate high and can offer you excellent care and service.

The Five Star Special Enrollment Period

You can choose a Medicare plan during your Initial Enrollment Period. Alternatively, you can choose a plan or change to a new one once a year during the annual Open Enrollment Period.

What makes Five Star Plans special is that they open a new enrollment period for you. If at any time from December 8 to November 30 of the following year, you can change to a Five Star plan. You can not switch to a lesser plan during this enrollment period.

Picking the Best Medicare Plan

A Five Star rating alone does not mean a plan is right for you. A Medicare plan must meet your specific medical needs. Remember that no single plan offers "everything". Find a plan that covers the healthcare providers, services and/or medications you need at a price you can afford. Looking at these ratings can then help you pick the best plan for you.

  

Sources:

Centers for Medicare and Medicaid Services. Part C and D Performance Data. https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin/performancedata.html. Updated December 17, 2015.

Medicare.gov. Star Ratings. https://www.medicare.gov/find-a-plan/staticpages/rating/planrating-help.aspx. Accessed February 2, 2016.

U.S. News and World Report. Best Medicare Advantage Plans 2016. http://health.usnews.com/health-news/medicare/articles/2015/10/15/best-medicare-advantage-plans-2016. Published October 15, 2015.

U.S. News and World Report. Best Medicare Part D Plans 2016. http://health.usnews.com/health-news/medicare/articles/2015/10/15/best-medicare-part-d-plans-2016?. Published October 15, 2015.

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