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Consumer News

Understanding Medicare

by Patricia Smith
Posted: 12/18/2013

People on Medicare can change plans or enroll in one for the first time by December 7—or they’ll have to wait until next year
People on Medicare can change plans or enroll in one for the first time by December 7—or they’ll have to wait until next year.

(NAPSI)—During Medicare’s annual open enrollment period, which ends December 7, millions of Medicare beneficiaries must decide on their Medicare Advantage (MA) health plan for the coming year. While many factors go into deciding about a plan—cost, choice of doctors, benefits—there’s one important question Medicare beneficiaries should ask: What is the quality rating of the plans I’m considering?

A high rating means better health care and the best value for your money. Medicare uses a system called Star Ratings. Plans receive a rating of up to five stars. These ratings are based on things like how well the plan does at keeping people healthy by making sure they get the treatments, tests and vaccines they need to prevent illness, how quickly you can get an appointment and see specialists, and how the plan responds to your complaints and concerns.

For 2014, over a third of MA plans will receive four or more stars, which is an increase from 28 percent in 2013. Seven of the 11 MA plans earning five stars this year are members of the Alliance of Community Health Plans, an organization representing the nation’s leading health plans.

You can learn more about MA plans—and their quality ratings—using the Medicare Plan Finder at www.Medicare.gov. MA plans are called “Medicare Health Plans” in the Plan Finder.

The National Committee for Quality Assurance also evaluates quality in MA plans; those rankings can be found at www.ncqa.org.

• Ms. Smith is president and CEO of the Alliance of Community Health Plans, www.achp.org.

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