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How Medicare Star Ratings can help you choose—and help you save

What are Medicare Advantage Star ratings?

Each year, Medicare reviews Medicare Advantage (Medicare Part C) and stand-alone Medicare prescription drug plans (Medicare Part D) and rates each one. The highest-performing plans earn 5 Stars; the lowest get 1 Star. Plans with a higher Star rating often offer added benefits and programs that lower-rated plans don’t—all at no additional cost to the member.1

In 2022, we’re proud to say that 97% of Humana members are in plans rated 4 Stars or higher.2

How Star ratings are determined

Medicare uses information from member satisfaction surveys, health plans and healthcare providers to determine Star ratings. The rating system uses more than 40 different quality measures across multiple categories including:

  • Customer service
  • Member experience
  • Staying healthy (screenings, tests and vaccines)
  • Managing chronic conditions
  • Drug safety and accuracy of drug pricing
  • Getting appointments and care quickly
  • Member complaints
  • Members choosing to leave their plan

What does a Medicare 5-Star rating mean for you?

It’s important to understand that Star ratings are not tied to plan premiums. A 3-Star plan may require a monthly premium and a 5-Star plan may have a $0 premium.

Here’s how it works: The federal Medicare program provides financial rewards to insurers for highly rated plans. Insurers may use those rewards to reduce member premiums, copays, deductibles or to beef up a plan’s added benefits. So a 4- or 5-Star plan may include extra like dental, vision and hearing coverage. And that additional coverage may help lower your out-of-pocket healthcare costs.

Shop by coverage and cost first—then consider Star ratings

Begin with what matters most to you.

  • Is your doctor in our network?
  • Are the drugs you’re taking included in our list of covered drugs?
  • Are there preferred cost-sharing pharmacies in your area?
  • Is the plan affordable?

Once you’ve answered the big questions and narrowed down your plan choices, look at the Star rating Medicare has assigned to each plan. Here’s why: In 2022, the typical shopper has 39 Medicare Advantage plans available to them.3 That’s a lot to sort through! Coverage and costs are key factors, but if you’ve found more than one plan that meets your needs, you can use Star ratings to help you choose.

To find each Humana plan’s Star rating, select your plan and then select, “See plan summary.”

What Star ratings measure

Medicare Star ratings offer a clear and simple overview of a plan’s quality and performance. Once you’ve found a plan (or 3 or 10) that meets your needs, that’s when you want to consider that plan’s Star rating. Here are just a few things Star ratings can show you.

How current members rated the plan

Did Humana make it easy for them to get the care they needed, when they needed it? Was our Customer Care team helpful and courteous on the phone?

How a plan performed based on industry standards

Were our members able to take advantage of the preventive care our plans provide, like flu shots or blood pressure screenings? Did we provide tools to help them manage chronic health issues like diabetes or rheumatoid arthritis?

How the plans you’re interested in compare to each other

Star ratings are not related to plan cost in any way. A $0 premium plan may earn a 5-Star rating. So if you’ve narrowed down your plan choices, the Star ratings may help you make your final choice.

How Star ratings help insurers offer better plans

While shoppers can use Star ratings to compare their plan choices, Medicare Advantage plan providers, like Humana, use Star ratings, too. They help us learn more about what Medicare shoppers want and need from their plans so we can create better ones.

Sources

  1. Jeannie Fuglesten Biniek et al., “Medicare Advantage in 2021: Star Ratings and Bonuses,” Kaiser Family Foundation, last accessed May 5, 2022, https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2021-star-ratings-and-bonuses/.
  2. “97% of Humana’s Medicare Advantage Members Are in Contracts Rated 4-Star or Higher for 2022, Reflecting Strong Commitment to Quality of Care, Patient-Centered Clinical Outcomes and Customer Service,” Humana Inc., last accessed November 2, 2021, https://press.humana.com/news/news-details/2021/97-of-Humanas-Medicare-Advantage-Members-Are-in-Contracts-Rated-4-Star-or-Higher-for-2022-Reflecting-Strong-Commitment-to-Quality-of-Care-Patient-Centered-Clinical-Outcomes-and-Customer-Service/default.aspx#gsc.tab=0.
  3. Meredith Freed et al., “Medicare Advantage 2022 Spotlight: First Look,” Kaiser Family Foundation, last accessed May 5, 2022, https://www.kff.org/medicare/issue-brief/medicare-advantage-2022-spotlight-first-look/.