A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource
  • Menu
  • Home
  • Contact
  • MAPD
  • PDP
  • 2024
  • 2025
  • FAQs
  • Articles
  • Search
  • Contact
  • 2024
  • 2025
  • FAQs
  • Articles
  • Latest Medicare News
  • Search

Comparing 2013 and 2014 Medicare Plan Star Ratings

Category: Star Ratings & Plan Quality
Published: Oct, 17 2013 06:10:34


Medicare Advantage plans and Prescription Drug plans can earn a star rating from one to five stars. A 2-star rating means below average performance and a 5-star rating is considered excellent.  Currently, no Medicare plans have a star rating of less than a 2-stars.  Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to Medicare 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.

For plans covering health services, the overall score for quality of those services covers 36 different topics in five categories. For plans covering prescription drug services, the overall score for quality of those services covers 17 different topics in four categories. For plans covering both health and prescription drug services, the overall quality score quality for those services covers all 53 topics in nine categories.

An overall plan rating is then calculated and gives the beneficiary a single summary score that makes it easier to compare plans based on quality and performance. The overall CMS plan rating is included in the optional plan features on our PDP-Finder and MA-Finder tools.  Example: California Medicare Prescription Drug Plans. Example: Miami-Dade County, Florida Medicare Advantage Plans..


2013 Medicare Plans:

The 2013 Medicare plans, shown in the chart below carried an average star rating of 3.41 for stand-alone Prescription Drug plans (PDPs) and an average star rating of 3.46 for Medicare Advantage plans. The two 2013 5-Star stand-alone Prescription Drug plans were reduced to 4.00 stars for 2014.

2013 Stand-Alone Prescription Drug Plans - Medicare Star Rating
 Star Rating 2 2.5 3 3.5 4 4.5 5 Total Plans*
PDPs with rating 1 8 15 13 14 2 2 55
% PDPs with rating 2% 15% 27% 24% 25% 4% 4%  
PDPs with rating lower than 3.0 9 16% Average rating for all rated PDP plans 3.41
 Star Rating 2 2.5 3 3.5 4 4.5 5 Total Plans*
Med. Adv. Plans** with rating 0 59 134 133 63 55 14 458
% MAs** with rating 0% 13% 29% 29% 14% 12% 3%  
Med. Adv. Plans** with rating lower than 3.0 59 13% Average rating for all rated
Medicare Advantage Plans**
3.46
*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 S1234).
**Medicare Advantage plans include all types (Cost, PFFS, HMO, PPO, regional and local). If the same contract was offered with and without prescription drug coverage, it was only counted once.


2014 Medicare Plans:

In comparison, the 2014 Medicare plans have an average star rating of 3.40 for stand-alone Prescription Drug plans (PDPs) and an average star rating of 3.66 for Medicare Advantage plans. There is only one 5-Star stand-alone Prescription Drug plan available in 2014 and it is only available to residents of New York. There are 10 Medicare Advantage plans available for 2014 that have earned a 5-Star rating and they are available in 133 counties across the country -- these counties are in CA, CO, DC, FL, HI, IA, MD, NY, OR, TX, VA, WA, WI (To see if 5-star rated Medicare Advantage plans are available in your area, go to MA-Finder.com, enter your ZIP Code and click the 5-star rated plans box. Ex: Bay County, FL).

2014 Stand-Alone Prescription Drug Plans - Medicare Star Rating
Star Rating 2 2.5 3 3.5 4 4.5 5 Total Plans*
PDPs with rating 0 9 14 16 12 3 1 55
% PDPs with rating 0% 16% 25% 29% 22% 5% 2%  
PDPs with rating lower than 3.0 9 16% Average rating for all rated PDP plans 3.40
Star Rating 2 2.5 3 3.5 4 4.5 5 Total Plans*
Med. Adv. plans** with rating 1 15 102 147 80 65 10 420
% MAs** with rating 0.2% 4% 24% 35% 19% 15% 2%  
Med. Adv. plans** with rating lower than 3.0 16 3.8% Average rating for all rated
Medicare Advantage plans**
3.66
*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 S1234).
**Medicare Advantage plans include all types (Cost, PFFS, HMO, PPO, regional and local). If the same contract was offered with and without prescription drug coverage, it was only counted once.

As in 2013, 16% of all rated 2014 stand-alone prescription drug plans have a star rating less than 3.00.

Compare 2013 and 2014 Medicare Part D plan ratings

2014 Medicare Advantage plans saw a decrease in the number of plans falling under the 3.00 star rating benchmark.  2013 had 13% of all Medicare Advantage plans under the 3.00 star rating and 2014 shows only 3.8% of all MA plans under 3.00.

Comparison of 2013 and 2014 Medicare star ratings

The star ratings are increasingly important as Medicare entices plans to increase plan quailty by having the special enrollment period for 5-star plans introduced in the 2012 plan year and the special enrollment period for consistently low performing plans that was intruduced in the 2013 plan year.

The following chart shows the change trend for the plan star ratings from 2013 to 2014.  For example, there were a total of  14 plans in 2013 with a 3-star rating.  Of those plans, three plans' star rating remained unchanged from 2013 to 2014 (21%) and eight plans had an increase in their star rating (57%) and three plans dropped in plan rating (31%).

You can see from the chart below, that a large percentage of plans from the lower star-rating categories saw an improvement in their quality ratings from 2013 to 2014.

Change in 2013 Stand-Alone Prescription Drug Plan Ratings for 2014
  Plans with a Star Rating Decrease Plans whose Star Rating Stayed the same Plans with a Star Rating Increase Total Nbr Plans (Contract IDs)
   Stars Plans % Plans % Plans %
 2013 PDP Plan Rating 2 0 0% 0 0% 1 100% 1
2.5 0 0% 4 67% 2 33% 6
3 3 21% 3 21% 8 57% 14
3.5 8 53% 3 20% 4 27% 15
4 5 45% 3 27% 3 27% 11
4.5 1 50% 1 50% 0 0% 2
5 2 100% 0 0% - - 2

Medicare Advantage plans showed a similar tendancy in star rating changes from 2013 to 2014 -- the lower rated 2013 plans had a tendency toward increasing their star rating as compared to the moderately rated plan.  As noted above, this could be due, in part, to the new special enrollment period for consistently low rated plans.  See chart below.

Change in 2013 Medicare Advantage Plan Ratings for 2014
  Plans with a Star Rating Decrease Plans whose Star Rating Stayed the Same Plans with a Star Rating Increase Total Nbr Plans (Contract IDs)
2013
Med. Adv.
Plan
Rating
Stars Plans % Plans % Plans %
2 0 - 0 - 0 - 0
2.5 3 6% 9 17% 40 77% 52
3 9 8% 55 47% 52 45% 116
3.5 12 10% 66 54% 44 36% 122
4 20 33% 26 43% 15 25% 61
4.5 13 24% 38 70% 3 6% 54
5 5 45% 6 55% - - 11








Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.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.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • 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.