Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to Medicare Advantage plans. These ratings are an incentive for Medicare plans to improve plan quality by making it easier for beneficiaries to compare and choose plans based on quality and performance. (You can read more about
what the star ratings measure here.)
In review of the 2018 Medicare Advantage quality star ratings, only 3% of all Medicare Advantage plans (14 plans) fell at or
below a 3.0 star rating with the majority of plans clustering between
3.5 and 4.0 stars.
In addition, 31% of all Medicare Advantage plans (176 out of 559 plans) did not receive a
rating this year.
Of the 281 rated
local HMO plans, 4% or 13 plans, have a rating that
falls below the 3.0 star rating benchmark and only 12 plans (4%)
have a 5-star (excellent) rating. These 12 plans qualify for the
5-star special enrollment period.
There are 70 rated
local PPO plans, only one of the rated plans has a rating below the 3.0 star minimum acceptable rating and only one local PPO plan has a
5-star rating. The majority of the local PPO plans fall within the 3.5
to 4.0 star range.
There are only 22 rated
regional PPO plans. No rated plans have a rating
below the 3.0 star benchmark and 21 plans have a star rating of 3.5 stars.
Rated
PFFS plans are in the 3 to 3.5 stars rating level, with no plans below 3 stars.
The five (5) rated Medicare
Cost plan
are all earning between 4.0 and 5.0 stars.
The chart below is a breakdown by health plan type for all 2018 Medicare Advantage plans. In contrast to the paragraphs above that discussed percentages of
rated plans, the percentages in the chart are of
total plans, which includes both rated and unrated plans.
Health
Plan Type |
2018 Medicare Advantage Plan
Star Ratings* |
Total Plans*** |
n/a |
2 |
2.5 |
3** |
3.5 |
4 |
4.5 |
5 |
Cost |
6 |
0 |
0 |
0 |
0 |
1 |
2 |
2 |
11 |
55% |
- |
- |
- |
- |
9% |
18% |
18% |
Local HMO |
88 |
2 |
11 |
50 |
89 |
73 |
44 |
12 |
369 |
24% |
1% |
3% |
14% |
24% |
20% |
12% |
3% |
Local PPO |
26 |
0 |
1 |
9
|
25 |
23 |
11 |
1 |
96 |
19% |
- |
1% |
9% |
26% |
24% |
11% |
1% |
Regional PPO |
2 |
0 |
0 |
0 |
21 |
1 |
0 |
0 |
24 |
- |
- |
- |
- |
88% |
4% |
- |
- |
PFFS |
1 |
0 |
0 |
1 |
4 |
- |
0 |
0 |
6 |
17% |
- |
- |
17% |
67% |
- |
- |
- |
MMP |
50 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
50 |
100% |
- |
- |
- |
- |
- |
- |
- |
MSA |
3 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
3 |
100% |
- |
- |
- |
- |
- |
- |
- |
Total MA & MAPD Plans |
176 |
2 |
12 |
60 |
139 |
98 |
57 |
15 |
559 |
31% |
0.5% |
2% |
11% |
25% |
18% |
10% |
3% |
Chart Notes:
n/a means that these plans have not received a quality star rating. Either the plan is too new, or there is insufficient data to calculate a star rating.
*Medicare Advantage plans both with and without prescription drug coverage are included in the numbers above (but if the same contract has both with and without prescription drug coverage, the plan is only counted once).
**A star rating of 3
means average performance. Star rating definitions.
***Medicare uses the term plan(s) to mean the contract identifier associated with the plan. In the chart above the total plans is the total number of unique contract id (ex: H1234 or R1234). The total number of plans includes plans that either did not have enough data to calculate a summary score or were too new to be measured.
Learn more about the 2018 Medicare Star Ratings here.
You can see the summary and detailed star rating for any Medicare plan using our PDP-Finder or MA-Finder tools. Click on the plan name for the summary ratings and links to detailed ratings. As an example, here is a link to the Florida Aetna Medicare Rx Select (PDP), scroll down the details chart to see the summary ratings and click on the rating to see the details of the ratings and how the ratings compare to the previous year.