A 5-star Special Enrollment Period allows you to upgrade your Medicare Advantage Plan, Medicare Drug Plan (Medicare Part D), or Medicare Cost Plan. Check out all the requirements here.
What is a 5-star Medicare Plan?
The Centers for Medicare Services (CMS) created a Five Star Quality Rating System that evaluates plans using data from member satisfaction surveys, plan details, and input from healthcare providers to give them overall star ratings. Imagine Medicare plans as restaurants. Some are 5-star fine dining, while others are more like casual diners. Medicare gives each plan a star rating to help you choose the right one. A 5-star plan is like dining at a Michelin-starred restaurant – you know you’re getting top-notch quality. (Source: Medicare.gov)
The purpose of these ratings is to help you compare the quality and performance of different plans. These ratings are updated every year, so you can always find the newest and best options. It’s a good idea to check these ratings regularly to make sure you’re getting the best possible coverage for your needs. Thinking about switching Medicare plans? Check out our article: ‘Medicare Insurance Switching: Ultimate Guide‘.
Learn More about Medicare Advantage Get a MA Quote
What is a 5-star Special Enrollment Period?
The 5-star Special Enrollment Period is a unique opportunity to switch to a Medicare plan with a top-tier quality rating. If a Medicare Advantage Plan, Medicare Drug Plan, or Medicare Cost Plan in your area has received a 5-star rating, you can use this enrollment period to make the switch.
This enrollment period is available once per year, starting on December 8 and ending on November 30 the following year. That means you have plenty of time to decide if a 5-star plan is the right fit for you.
Need help figuring out if you qualify for this Special Enrollment Period or if it’s right for you? Give Senior65.com a call at 800-930-7956.
Why use the 5-Star SEP?
Here at Senior65.com, we have learned that most of our clients who used the 5-star rule wanted to switch plans because they were prescribed a drug that wasn’t covered under their current plan. Using this rule is one of the few ways to switch Part D drug plans outside the AEP open enrollment dates of Oct 15 to Dec 7th. That being said, others have told us they were unable to find a 5-Star plan in their area.
Important Things to Consider Before Switching
Before jumping into a 5-star plan, there are a few things to keep in mind:
If You’re Switching to a Medicare Drug Plan:
Moving from a Medicare Advantage Plan (with drug coverage) to a stand-alone Medicare Drug Plan will automatically disenroll you from your Medicare Advantage Plan. In this case, your health coverage will revert to Original Medicare.
If Your New Medicare Advantage Plan Doesn’t Cover Drugs:
Switching from a Medicare Advantage Plan with drug coverage to a 5-star Medicare Advantage Plan without drug coverage could leave you without prescription drug benefits. To regain drug coverage, you’ll have to wait for your next enrollment opportunity—and you may face a Part D late enrollment penalty.
How to Switch to a 5-star Medicare Plan
If you’re considering a switch to a 5-star plan, start by checking if one is available in your area. Keep in mind that Medicare is quite strict with its ratings. Even finding a 4-Star plan can be tough. But don’t worry, we can help you find one in your area. You can compare plans and ratings on the CMS website.
Remember, you can only use the 5-star Special Enrollment Period once per year, so make sure to evaluate your options carefully. Whether you’re looking for better coverage or simply a higher-rated plan, this enrollment period offers a great chance to make a change.