5 Star Special Enrollment Period

Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. A plan can get a rating between 1 and 5 stars. A 5-star rating is considered excellent. These ratings help you compare plans based on quality and performance. Medicare updates these ratings each fall for the following year. These ratings can change each year.  Medicare star rating system

The number of unique quality and performance measures change with plan type: Medicare uses 53 criteria for star ratings but they do not use all 52 toward each plan type. Part C and D star rating fact sheet

• MAPD: 38 Quality and performance measures
• MA: 28
• PDP: 12

Plan Changes  with the 5 star SEP?

You can move to a 5 star Medicare Advantage plan as long as you have Medicare A and B.  A move is alloed to a 5 star stand alone drug plan as long as you have Medicare Part A.  Enrolling in a 5 star drug plan will automatically cancel any current PDP, MA, or MAPD in place. Enrolling in a 5 star MA, MAPD or will cancel any existing MA, MAPD or PDP in place.   Keep in mind, if someone moves from an MAPD to an MA only plan, they will no longer have drug coverage.   A stand alone PDP are not allowed with an MA plan.

Check plans eligible for a 5 star special enrollment period:

There is a list of all the 5 star plans avaialble for 2022 on the CMS site.  CLICK HERE FOR INFORMATION

Check for 5 star plans on Connecture and Sunfire

Agents can use Connecture and Sunfire to search for 5 star MAPD and PDP plan in their area.  Both platforms show the star ratings for each company.  Sunfire also has a filter to see only 5 star rated plans.

CLICK TO LEARN MORE ABOUT CONNECTURE AND SUNFIRE

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