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Limitations on using the 2015 "5-Star" Medicare plan Special Enrollment Period due to plan availability.

Category: Star Ratings & plan quality
Published: Jul, 03 2015 02:07:57
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What is the 5-Star Special Enrollment Period?
Special Enrollment Periods allow you to change Medicare plans outside of the annual Open Enrollment Period (October 15th through December 7th) and are granted only for exceptional reasons. You can click here to read more about Special Enrollment Periods.  One type of relatively new Special Enrollment Period that is available in a few areas of the country is the 5-star Special Enrollment Period.  As discussed below, the 5-Star Special Enrollment Period allows you to change enrollment once a year to a Medicare plan with a 5-star quality rating. You can click here to read about the 5-star Special Enrollment Period.

However, "5 Star" rated Medicare Part D and Medicare Advantage plans are available only in a few areas across the country.

Currently, there are approximately 4,090,000 people who could take advantage of the 2015 5-Star Special Enrollment Period (discussed below).  These people are enrolled in a Medicare plan that has a star rating of less than 5 stars and there is a 5-Star rated plan available in their area.  About 1,153,185 of these members are enrolled in Medicare Part D prescription drug plans (PDPs) and an additional 2,937,418 people are enrolled in Medicare Advantage plans.

As many people have found, there are only five "5-Star" rated stand-alone Medicare Part D prescription drug plans (PDPs) offered in 2015.  These plans include the:

In addition, a 5-star stand-alone Medicare Part D prescription drug plan (PDP) is available statewide in:

  • Iowa - currently 226,740 people enrolled in Iowa PDP plans with less than 5 stars,
  • Minnesota - currently 240,817 members enrolled in Minnesota PDP plans with less than 5 stars,
  • Montana - 70,606 people enrolled in Montana PDP plans with less than 5 stars,
  • Nebraska - currently 138,445 people enrolled in Nebraska PDP plans with less than 5 stars,
  • North Dakota - 52,169 people enrolled in North Dakota PDP plans with less than 5 stars,
  • South Dakota - currently 70,148 members enrolled in South Dakota PDP plans with less than 5 stars,
  • Wisconsin - 310,874 people enrolled in Wisconsin PDP plans with less than 5 stars,
  • Wyoming - currently 43,386 members enrolled in Wyoming PDP plans with less than 5 stars.

Again, there are approximately 1,153,185 beneficiaries enrolled in Medicare Part D prescription drug plans that have less than a 5-star rating.  These plan members are all eligible for the 5-star Special Enrollment Period.

The only available 5-Star 2015 Medicare Advantage plans include: So a 5-star Medicare Advantage plan may be available to you if you live in a specific county located in: California (30 counties), Colorado (17 counties), the District of Columbia, Florida (19 counties), Hawaii (3 counties), Iowa (5 counties), Maryland (11 counties), Maine (16 counties), New Hampshire (2 counties), Ohio (7 counties), Oregon (15 counties), Virginia (9 counties), Washington (16 counties), or Wisconsin (11 counties).

Below is a list of counties where 5-star rated Medicare Advantage plans are available.  Also listed is the number of members currently enrolled in Medicare Advantage plans that have a star rating lower than 5 stars.  These members, approximately 2,937,418 people would be eligible to take advantage of the 5-Star Special Enrollment Period:

California 5-Star Medicare Advantage Plans: Colorado 5-Star Medicare Advantage Plans: District of Columbia 5-Star Medicare Advantage Plans: Florida 5-Star Medicare Advantage Plans: Hawaii 5-Star Medicare Advantage Plans: Iowa 5-Star Medicare Advantage Plans: Maryland 5-Star Medicare Advantage Plans: Maine 5-Star Medicare Advantage Plans: New Hampshire 5-Star Medicare Advantage Plans: Ohio 5-Star Medicare Advantage Plans: Oregon 5-Star Medicare Advantage Plans: Virginia 5-Star Medicare Advantage Plans: Washington State 5-Star Medicare Advantage Plans: Wisconsin 5-Star Medicare Advantage Plans:

To learn more about taking advantage of the 5-Star Special Enrollment Period, you can telephone a Medicare representative at 1-800-633-4227.




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