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Medicare gave its highest rating to CarePlus for 2020 and 2021 plan years – an overall 5 out of 5 stars. Medicare bases ratings on plan quality and performance. Medicare star ratings help you know how good a job our plan is doing.
The Centers for Medicare & Medicaid Services (CMS) created its Five-Star Quality Rating System to help consumers, their families, and caregivers compare Medicare health and prescription drug plans. The below information is the overall star rating CarePlus received by CMS. Information about all rated Medicare health and prescription drug plans is available from CMS at www.medicare.gov (link opens in new window) .
2021 CMS CarePlus Star Ratings Information
Frequently Asked Questions about Medicare Plans and the Star Ratings
What does the star rating mean for a healthcare plan?
Every year, Medicare rates all Medicare health and prescription drug plans on a scale of 1 to 5 stars to measure how well plans provide quality services to their members. The star ratings are published on the Medicare Plan Finder tool to help Medicare beneficiaries make informed decisions while selecting Medicare plans. In addition, the star ratings are a simple way for CMS to recognize how Medicare health plans are managing their members. Plans with 4 stars or above are typically considered above average in performance, according to CMS.
How does a health plan earn its star rating?
Every year, Medicare rates plans on their performance across a variety of categories made up of measures that Medicare feels are most important to Medicare beneficiaries. The overall star rating includes ratings for the following categories:
| Staying Healthy: Screening Tests and Vaccines | How many of the health plan’s members engaged and participated in preventative care to stay healthy. |
| Member Experience Rating | How satisfied members were with their overall health care experience (including customer service, benefits, and the plan’s physician network). |
| Customer Service Rating | How accessible customer service representatives were, and if they were able to answer member questions. |
| Chronic Condition Rating | How often members with certain conditions received regular check-ups, exams, and treatment for their condition(s). |
| Complaint Resolution Rating and Health Plan Performance | How often members had problems with the plan, and how much the plan’s performance improved (if at all) over time. |
As a Medicare Advantage plan, CarePlus provides prescription drug coverage, known as Medicare Part D coverage. Medicare also rates us on categories for prescription drug coverage and includes these results in our overall Star Rating. The Part D categories include:
| Drug Plan Customer Service Rating | How well the plan handled member calls and questions. |
| Drug Plan Complaint Resolution Rating and Health Plan Performance | How often members had problems with the plan, and how much the plan’s performance improved (if at all) over time. |
| Drug Plan Member Experience Rating | How satisfied members were with their overall experience with the drug plan. |
| Drug Safety/Pricing Accuracy Rating | How accurate the plan’s pricing information is, and how often members with certain medical conditions are prescribed drugs in a way that is safer and clinically recommended for their condition(s). |
After reviewing all of the above categories, Medicare rated CarePlus a 5-star health plan.
Because CarePlus is a 5-star health plan, eligible Medicare recipients generally can enroll in our health plan at any time during the year, and not just during the Annual Enrollment Period.
Click here to learn more about the 5-star Special Enrollment Period (SEP).
Every year, Medicare evaluates plans based on a 5-star rating system.
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