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2020 Medicare Plan Star Rating Details

Plan Quality and Performance Ratings

Information on quality can help you compare Medicare plans. Higher quality means better care and value. Looking at this plan’s star rating tells you how well the plan performs overall and in different categories. Medicare measures how well health and prescription drug plans perform.
Guide to Medicare Star Ratings
5 Stars: Excellent
4 Stars: Above Average
3 Stars: Average
2 Stars: Below Average
1 Star: Poor
NtED:Not enough data available
NEW:Plan too new to be measured
N/A:Not applicable
NtR:Plan not required to report measure
SML:Plan too small to be measured
NoD:No data availalble
NtO:Benefit not offered by plan

2020 Medical Associates Health Plan, Inc. (H1651) Star Rating Details
Kearney Community Senior Plan (Cost) (H1651-018-0)
Benefits & Contact Info        
The Kearney Community Senior Plan (Cost) (H1651-018-0)
in Dawson, NE: CMS MA Region 19 which includes: NE
Plan Monthly Premium: $145.00
Star Rating Category & Measures20202019
Overall Star Rating [?]55
Summary Rating of Health Plan Quality [?]55
Staying Healthy: Screenings, Tests and Vaccines [?]44
  • Breast Cancer Screening [?]
  • Colorectal Cancer Screening [?]
  • Annual Flu Vaccine [?]
  • Improving or Maintaining Physical Health [?]
  • Improving or Maintaining Mental Health [?]
up from last year4
  • Monitoring Physical Activity [?]
  • Checking to See if Members Are at a Healthy Weight [?]
down from last year5
Managing Chronic (Long Term) Conditions [?]44
  • Special Needs Plan (SNP) Care Management [?]
  • Care for Older Adults — Medication Review [?]
  • Care for Older Adults — Functional Status Assessment [?]
  • Care for Older Adults — Pain Assessment [?]
  • Osteoporosis Management in Women who had a Fracture [?]
  • Diabetes Care — Eye Exam [?]
  • Diabetes Care — Kidney Disease Monitoring [?]
up from last year4
  • Diabetes Care — Blood Sugar Controlled [?]
  • Rheumatoid Arthritis Management [?]
  • Reducing the Risk of Falling [?]
down from last year3
  • Improving Bladder Control [?]
  • Medication Reconciliation Post-Discharge [?]
  • Plan All-Cause Readmissions [?]
  • Statin Therapy for Patients with Cardiovascular Disease [?]
Member Experience with Health Plan [?]55
  • Ease of Getting Needed Care and Seeing Specialists [?]
  • Getting Appointments and Care Quickly [?]
  • Health Plan Provides Information or Help When Members Need It [?]
  • Member’s Rating of Health Care Quality [?]
  • Member’s Rating of Health Plan [?]
  • Coordination of Members’s Health Care Services [?]
Member Complaints and Changes in the Health Plan’s Performance [?]4 down from last year5
  • Complaints about the Health Plan (higher score is better - means fewer complaints) [?]
  • Members Choosing to Leave the Plan (higher score is better - means fewer members leaving) [?]
  • Improvement (if any) in the Health Plan’s Performance[?]
down from last year4
Health Plan Customer Service [?]NtEDNtED
  • Health Plan Makes Timely Decisions about Appeals [?]
  • Fairness of Drug Plan’s Appeal Decisions [?]
  • Availability of TTY Services and Foreign Language Interpretation When Prospective Members Call the Health Plan [?]

Tips & Disclaimers
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  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.