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Medicare News

Medicare Enrollment is Still Open to Switch to 5-Star Medicare Advantage Plan

Medicare has new Special Enrollment Period for joining 5-star plans all year long

Dec. 15, 2011 – Just because Medicare kept us well informed about the Open Enrollment Period that ended Dec. 7 with an unrelenting flow of promotion, you may think enrollment is closed. It may even puzzle you that you are still seeing advertising from Medicare Advantage plans. Guess what? You can still switch plans, as long as it is to a 5-star plan.

In fact, under new Medicare rules this 5-Star Special Enrollment Period is now open all year.

There are few seniors that know of this opportunity, since Medicare has done little to inform beneficiaries about this option, or the other special enrollment period that will start on January 1. But, let’s don’t confuse the issue about the SEP that is open now.

Right now, you can switch plans if you go to a 5-star Medicare Advantage Plan. Here is about all you will find on the Medicare website about this opportunity –

NEW - Medicare's 5-Star Special Enrollment Period

Now you can switch to a 5-star Medicare plan at any time during the year.

  • You can only switch to a 5-star Medicare plan if one is available in your area. Find plans in your area.
  • You can only use this period to switch to a 5-star Medicare plan one time each year.

This 5-Star Special Enrollment Period is mentioned in the Medicare and You 2012 handbook provided to all senior citizens – see page 79 in the book.

 

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It mentions that these star ratings are available at www.medicare.gov/find-a-plan. This is just the regular “plan finder” system you may have used in choosing your drug or health plan during Open Enrollment. It takes multiple steps and often comes up with no 5-star plans available to you.

Many insurance companies that have 5-star plans, like Kaiser Permanente, are spreading the word, too. Kaiser has this on their website:

“Beginning on December 8, 2011, you can enroll in a 5-star Medicare health plan any time of year for any reason, as long as you meet all Medicare Advantage enrollment requirements. Now, you’re completely in control.

“Take advantage of this new Special Enrollment Period and get the confidence of having a plan rated 5 stars by Medicare for excellent performance.

You can enroll one time from December 8 all the way through November 30 of the following year. The enrollment effective date is the first of the month following the month in which we receive the enrollment request.”

If you are on traditional fee for service Medicare, the only option you appear to have in this SEP is to switch to a 5-star Medicare Advantage Plan, or to move to a 5-star drug plan, if you current plan is rated lower.

In a special publication by Medicare the agency explains the star rating system.

What the “Star” Ratings Means

Medicare health and prescription drug plans get an overall rating that summarizes all categories and measures into a single “star” rating. The star rating of the plan’s performance makes it easy for you to compare plans. If you’re interested in more detail, you can look at the health or drug plan summary scores, or you can “drilldown” to the star ratings category details (like Member Experience with Drug Plan)or to individual measures within the categories (like Members’ Ability to Get Prescriptions Filled Easily When Using the Plan).

A plan’s star rating is reviewed eachyear and results are available each fall. A plan can get ratings between one and five stars:
   ●
★★★★★ “Excellent”
   ●
★★★★ “Above Average”
   ●
★★★ “Average”
   ●
★★ “Below Average”
   ●
“Poor”

How You Can Use This Information

Use the star ratings, in addition to cost and coverage information, to compare plans and find a plan that’s good for you.
   ● Find out if the plan performed better this year than last year.
   ● See how plans in your area compare to Original Medicare (for some measures).
   ● Use the high and low performer symbols to quickly identify plans with an overall5-star rating or plans that consistently get low ratings.
Note: After December 8, 2011, you can switch to a plan that has an overall 5-star rating at any time during the year. You can only make a switch to a 5-star plan one time each year. •If the plan you’re interested in consistently gets low ratings, review the star ratings details of the plan to make sure it’s a good choice for you.

For More Information and to Get Plan Ratings:

   ● Visit www.medicare.gov/find-a-plan. Enter the appropriate information for a general or personalized search. Once you see the list of plans, you can view the starratings by selecting the plan name. Or, you can select up to three plans to compare.

   ● Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. CMS

>> Learn more at Medicare about Medicare Advantage Plans

>> Learn more about the Special Enrollment Period and the Medicare Star Quality Ratings from Kaiser Permanente by visiting kp.org/medicare, kp.org/medicarestars

 

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