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What exactly is rated for each Medicare health plan?

The ratings system analyzes Medicare health plan performance across more than 50 distinct areas. Each area is assessed individually and assigned a star quality rating to reflect that assessment. The highest rating is 5 stars (5 stars) for excellent performance. The lowest rating is 1 star (single star) for poor performance.

The Centers for Medicare & Medicaid Services measures how well health and prescription drug plans perform on more than 50 items, which are grouped into different categories:

Medicare health plans are rated on how well they perform in five different categories:

1. Staying Healthy: Screenings, Tests, and Vaccines
2. Managing Chronic (Long-Term) Conditions
3. Member experience with the health plan
4. Member Complaints, Problems Getting Services, and improvement in the health plan’s performance
5. Health Plan Customer Service

Medicare drug plans are rated on how well they perform in four different categories:

1. Drug Plan Customer Service
2. Member Complaints, Problems Getting Services, and improvement in the drug plan’s performance
3. Member Experience with Drug Plan
4. Patient Safety and accuracy of Drug Pricing

You can also learn more about the ratings at medicare.gov.†

*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. Centers for Medicare & Medicaid Services Health Plan Management System, Plan Ratings 2014. Kaiser Permanente contract #H0524, H0630, H1170, H1230, H2150, H9003.

†Kaiser Permanente is not responsible for the content or policies of external Internet sites.

You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll.

Kaiser Permanente is an HMO plan with a Medicare contract. Kaiser Permanente is a Cost plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.

At sales meetings, a sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-220-3956 (toll free) or TTY 711. Calling this number will direct you to a licensed sales specialist.

 

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This page was last updated: December 31, 2013 at 12 a.m. PT