SelectHealth Medicare Advantage Star Ratings
Our members are important to us. That's why every year we work hard to earn high ratings from The Centers for Medicare & Medicaid Services (CMS).
In 2018, our Medicare Star Ratings were:
Overall – 4 Stars*
Health Plan Services – 4 Stars*
Drug Plan Services 4.5 Stars*
*All Star Ratings are based on a scale from one to five.
These documents break down and explain our current Star Ratings for our 2018 Medicare Advantage plans.
What’s a Star Rating for Medicare?
Each year the Centers for Medicare and Medicaid Services (CMS) measures the quality and value of certified health plans. Medicare certified health plans, both Part C (Medicare Advantage) and Part D (Prescription Drug), are rated on a star scale. The scale ranges from one to five stars, with five stars representing the highest quality. Scores are based on more than 50 care and service quality measures across several categories. Some examples of the categories include:
- Staying healthy: How well the plan covers and helps its members receive recommended health screenings, vaccinations, and other check-ups, including programs that encourage wellness and help members stay healthy.
- Managing chronic (long-term) conditions: How often members with different chronic conditions receive certain tests and treatments that help them manage their condition.
- Member experience: How members rate their satisfaction with plan benefits (e.g., coverage, copays, and customer service).
- Member complaints and plan performance: How often Medicare found problems with the plan and how often members had problems with the plan, including how well the plan handles member appeals and new enrollment request.
Why Do Star Ratings Matter?
What information does Medicare use to determine Star Ratings?
- Member satisfaction, plan, and provider surveys.
- Reviews of claims and other info submitted by health plans.
- Monitoring and auditing performed by Medicare.
Medicare rewards plans that achieve four- and five-Star Ratings with extra money that must be reinvested back into the health plan's programs and benefits. This means, the better we do to serve you, the better our benefits for you can be in the future.
Star Ratings Can Help You Make an Informed Choice
As a Medicare beneficiary, you have the opportunity to evaluate your current plan each year from October 15 to December 7 (the annual enrollment period). This is the time to make sure your plan will meet your healthcare needs for the coming year and make any necessary adjustments. The CMS Star ratings can help you compare the quality and performance of different plans.