Q1Medicare.com Reminds Seniors about the New Medicare Part D Prescription Drug Plan and Medicare Advantage Plan 5-Star Special Enrollment Period

Share Article

Starting this year, seniors have an opportunity to switch to a Medicare Part D plan or Medicare Advantage plan with a 5-Star quality rating at any time during the plan year using the new 5-Star Special Enrollment Period. To help seniors and other Medicare beneficiaries review Medicare plan star ratings and see if any qualifying 5-Star plans are available in their area, Q1Medicare.com has updated their online Medicare plan search tools, PDP-Finder and MA-Finder. For seniors who want to learn more, Q1Medicare.com now also provides answers to frequently asked star rating questions and a new Blog section dedicated to the Medicare Advantage plan and Medicare Part D prescription drug plan quality star rating system.

The new 5-Star SEP presents seniors with a great opportunity to change or upgrade to a higher quality rated Medicare plan outside of the annual Open Enrollment Period.

Starting with the 2012 plan year, Medicare offers a new Special Enrollment Period (SEP) providing Medicare beneficiaries with an opportunity to switch to a 5-Star rated Medicare Advantage plan or Medicare Part D prescription drug plan at any time throughout the plan year. However, to take advantage of this SEP, seniors and other Medicare beneficiaries must find a plan that services their residential area. To help beneficiaries review Medicare plan quality ratings and to see if any plans qualifying for the 5-Star Special Enrollment Period are available in their area, Q1Medicare.com has updated their online Medicare plan search tools, PDP-Finder and MA-Finder.

For seniors who wish to learn more about the Medicare Advantage and Medicare Part D prescription drug plan star rating system, Q1Medicare.com now also provides answers to frequently asked star rating questions and a Blog section dedicated to the topic of star ratings.

The Medicare star ratings measure the quality of services for both health services associated with Medicare Advantage plans and prescription drug services for stand-alone Medicare Part D prescription drug plans, as well as Medicare Advantage plans offering prescription drug coverage. Medicare measures 36 different topics in five categories for Medicare Advantage plan health-related services and 17 topics in four different categories for Medicare prescription drug services. Star ratings for each category are calculated based on information collected from various sources, including member surveys, Medicare plans, and health care providers. Ultimately, Medicare derives an overall summary star rating for a plan based on the category scores.

The plan rankings are from a low, one star rating to a maximum high score of five stars and stay in effect for the entire plan year. The Medicare plan star ratings can change each year and are determined prior to the beginning of the Fall Open Enrollment Period that starts on October 15th.

“The new 5-Star SEP presents seniors with a great opportunity to change or upgrade to a higher quality rated Medicare plan outside of the annual Open Enrollment Period,” notes Dr. Susan Johnson, Technical Director and co-founder of Q1Medicare.com. “But unfortunately, only a few Medicare plans earned a 5-Star quality rating during the 2012 plan year.”

This year, stand-alone Medicare Part D prescription drug plans with a 5-Star rating are only available in eight states; including the Simply Prescriptions plans in New York and the WELLMARK/Blue Cross Blue Shield plans available in Iowa, Minnesota, Montana, Nevada, North Dakota, South Dakota, and Wyoming.

Details on these 2012 stand-alone prescription drug plans can be reviewed using the Q1Medicare PDP-Finder tool by selecting the desired state and checking the box to shown only the 5-Star rated plans. Users of the PDP-Finder can also view the overall star quality rating of any Medicare Part D plan by selecting the state and choosing “Display the Plan’s Summary Star Rating” in the additional info field.

In addition, 5-Star 2012 Medicare Advantage plans are available on a limited basis from five different Medicare plan providers:
--    Kaiser plans – select counties in CA, CO, HI, OR and WA;
--    Group Health Cooperative plans – select counties in WA;
--    Gundersen Lutheran Health Plans – select counties in IA and WI;
--    Martin’s Point Generations plans– select counties in ME; and
--    Providence Health Plans – select counties in OR and WA.

Details of these Medicare Advantage plans can be viewed using the Q1Medicare MA-Finder found directly at MA-Finder.com.

One caution should be mentioned about the 5-Star Special Enrollment Period: If a person is currently enrolled in a Medicare Advantage plan (a plan that includes health benefits), and decides to join a stand-alone 5-Star Medicare Part D prescription drug plan (a plan that only provides prescription drug coverage), the person would automatically be dis-enrolled from their Medicare Advantage plan and be returned to Original Medicare Part A and Part B along with their newly selected Medicare Part D prescription drug plan.

Seniors are reminded that the Q1Medicare.com PDP-Finder and MA-Finder tools are available at no cost and site users have the option to receive a copy of their Medicare plan finder results via eMail. Like all Q1Medicare.com tools, the PDP-Finder and MA-Finder are designed to be accessible on PC, smartphone, or tablet platforms.

About the Q1Medicare.com Website
Q1Medicare.com is one of the largest independent online resources for Medicare Part D prescription drug plan and Medicare Advantage plan information. Q1Medicare offers a comprehensive section of Frequently Asked Questions, online tools, and a free Medicare Part D Newsletter, all designed to help Medicare beneficiaries, caregivers, advocates, advisers, and agents better understand the Medicare Part D and Medicare Advantage programs. Q1Medicare.com is operated by Q1Group LLC (Saint Augustine, Florida).

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Lynnea Christner

Susan Johnson MS-MIS, MBA, PhD
Visit website