Medicare Star Quality Ratings Q&A
Q: What does the new 5-star Special Enrollment Period (SEP) mean for me?
A: It means you may not have to wait until the next open enrollment period to start getting 5-star quality, service, and performance. You can make a one-time change to a 2012 5-star Medicare health plan any time of the year for any reason, as long as you meet all Medicare Advantage enrollment requirements.
Call 1-855-817-5831 (toll free) or 711 (TTY for the hearing/speech impaired), 8 a.m. to 8 p.m., 7 days a week, to find out more about this new Special Enrollment Period for 5-star plans.
Or enroll now online in one of our 5-star Medicare health plans in California, Colorado, Hawaii, Oregon, or Washington.*
Q: I’d like to know the rating for my current health plan. Where can I find that information?
A: You can use Medicare’s Plan Finder to search by plan name or ID. The results page will show you the Medicare Star Quality Rating for that plan.
You can search by either plan name or plan ID, but your results will be better if you enter both fields. Your plan ID should be listed on your member identification card.
You can also get plan ratings by calling the Medicare Program at 1-800-MEDICARE (1-800-633-4227) (toll free) or 711 (TTY for the hearing/speech impaired), 24 hours a day, 7 days a week.
Q: I have Original Medicare. Is there a way to compare it to a Medicare Advantage or Medicare Cost plan?
A: Yes. Across 8 areas, you can compare the performance of health plans to the performance of Original Medicare in your area. To request that information, call the Medicare program at 1-800-MEDICARE (1-800-633-4227) (toll free) or 711 (TTY for the hearing/speech impaired), 24 hours a day, 7 days a week.
Q: What if my Medicare health plan isn’t rated?
A: The Medicare Program rates every Medicare health plan in the United States. However, due to data limitations or new plan offerings, some plans may not be measured in all categories or topics. If you have a specific question about your plan’s rating, you should call 1-800-MEDICARE (1-800-633-4227) (toll free) or 711 (TTY for the hearing/speech impaired), 24 hours a day, 7 days a week.
Q: Where can I go to find a list of all 50-plus areas that are individually rated for each plan?
A: You can learn more about the 50-plus areas at medicare.gov. In addition, Kaiser Permanente has developed a Guide to the Medicare Star Quality Ratings that includes details on the 50-plus topics that are rated. The guide is free with no obligation.
Call for your free† Guide to the Medicare Star Quality Rating System, at 1-855-817-5831 (toll free) or 711 (TTY for the hearing/speech impaired), 8 a.m. to 8 p.m., 7 days a week.
You can also learn more about the ratings for Kaiser Permanente Senior Advantage (HMO), Kaiser Permanente Senior Advantage (HMO-POS), Kaiser Permanente Medicare Plus (Cost) and other Medicare health plans at medicare.gov.
*Plan performance summary Star Ratings are assessed each year and may change from one year to the next. Centers for Medicare & Medicaid Services Health Plan Management System, Plan Rating 2012. Kaiser Permanente contract #H0524, H0630, H1170, H1230, H2150, H6360, H9003.
†Free with no obligation.
Anyone who has Medicare Parts A and B (or Part B only for Mid-Atlantic and Ohio regions), including some people under the age of 65 with disabilities, may apply. Individuals must have both Part A and Part B (or Part B only for Mid-Atlantic and Ohio regions) to enroll. You must reside in the Kaiser Permanente Senior Advantage (HMO) or Medicare Plus (Cost) service area in which you enroll. Eligible Medicare beneficiaries may enroll in a Medicare Health Plan with Medicare Prescription Drug Coverage only during specific times of the year. Eligible beneficiaries with access to a Medicare Cost Plan may enroll at any time but may only elect the Part D optional supplemental benefit during specific times of year. For more information, please contact Kaiser Permanente. If you join a Kaiser Permanente Senior Advantage plan, then you must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Kaiser Permanente will be responsible for the costs. If you live in the Mid-Atlantic or Ohio regions, please see the Summary of Benefits or Evidence of Coverage for more information about benefits cost-sharing for our plan and any optional supplemental benefit package. Premiums, cost-sharing, and optional supplemental benefits may change each year. For the Kaiser Permanente Senior Advantage plan with a point-of-service option: With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers.
Kaiser Permanente is a health plan with a Medicare contract.
This page was last updated: July 31, 2012 at 12 a.m. PT