How to Use Medicare's Plan Ratings System During Open Enrollment

Medicare's fall open enrollment has been underway since Oct. 15. At this point, you only have a short amount of time to make changes to your Medicare coverage for 2025, since open enrollment wraps up on Dec. 7.

There are several good reasons to consider a new Medicare Advantage or Part D drug plan. First of all, you should've received a notice of change for your current plan by now. If things are changing for the worse, such as your premiums are rising, that's reason enough to consider a switch.

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You may also want to consider getting a new Medicare plan if your needs have changed. Maybe you're taking a new medication that will cost more under your current Part D plan. Maybe you've been diagnosed with a new condition, and the right Medicare Advantage plan could make it easier to manage based on that plan's supplemental benefits.

At this point, you may have to make a decision on a new Medicare plan quickly. The good news is that Medicare makes it fairly easy to find the right coverage with its plan finder tool. You simply enter your zip code and some personal information, and you'll get a list of options that are available in your area.

One thing you'll want to pay attention to, though, are star ratings for Medicare plans. And if you're new to open enrollment and aren't familiar with the star ratings system, here's some good information to have.

A pretty easy system to follow

Medicare's star ratings systems gives plans anywhere from one to five stars, with five being the best. For Medicare Advantage plans, ratings are based on these factors:

• Member experience
• Customer service
• Plan performance
• Support of chronic conditions
• Resources to help promote good health (including screenings and preventive care)

For Medicare Part D drug plans, ratings are based on these factors:

• Member experience
• Customer service
• Plan performance
• Drug safety
• Drug pricing

Medicare's star ratings system also accounts for enrollee turnaround. A plan that loses a lot of members in a given year will likely have that reflected in its overall rating, as high levels of turnover are an indication that members aren't so satisfied.

This isn't to say that a four-star plan isn't worth pursuing when there's a five-star plan in your area. But a one- or two-star plan should give you pause.

What you should really do is use the system to weed out plans with notably low ratings. From there, if you're left with a few choices with good ratings, you'll want to compare your costs and benefits to see which plan to move forward with.

Get moving right away

The best way to navigate Medicare open enrollment is to give yourself plenty of time to put the right coverage in place. But at this point, you're pretty much down to the wire. So don't delay. Start reviewing your plan choices and use Medicare's star ratings system to whittle down your options so you're not automatically stuck with your current plan in the new year.

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