Medicare 5 Star Programs

Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to Medicare health and prescription drug plans. The overall plan rating gives you a single summary score that makes it easy for your to compare plans based on quality and performance.

Medicare Health Plans and Medicare Drug Plans carrying a 5 Star rating provide a special enrollment period. This special enrollment period means there is no date restriction to enroll. You can enroll in these plans anytime between December 8th and November 30th of any following year, provided you meet the plan’s enrollment requirements (e.g. living within the service area, meeting requirements regarding end-stage renal disease, etc.).  People enrolled in a plan with a 5-star overall rating may also switch to a different plan with a 5-Star overall rating.

You may also use this Special Enrollment Period to disenroll from a Medicare Advantage Plan or Medicare prescription drug plan and enroll in an open Medicare Cost Plan that has a 5-Star rating. A Medicare Cost plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. In a Medicare Cost Plan, if you go to a non-network provider, the service are covered under Original Medicare.

Please be careful-you may lose your prescription drug coverage if you switch from a Medicare Advantage Plan that has drug coverage to a Medicare Advantage Plan that does not have drug coverage.  You would then need to wait until the next Open Enrollment Period to get drug coverage, and you may have to pay a late enrollment penalty.