Even though it’s already August, did you know that you can still take advantage of the opportunity to enroll in a 5-star Medicare Advantage Prescription Drug (MAPD) plan? Many individuals may think that they have missed the enrollment window. However, it’s important to highlight that the 5-star Special Enrollment Period (SEP) allows eligible individuals to join a 5-star plan throughout the year. These top-rated plans offer exceptional quality and satisfaction. They provide comprehensive coverage, excellent customer service, and an extensive network of healthcare providers.
What is a 5-Star Plan?
A Medicare Advantage 5-star rating means it has the highest possible rating for quality from Medicare.gov. Medicare calculates these ratings using a wide range of criteria. This includes customer satisfaction, access to health care and the rate of receiving preventive care. A 1-5 star rating is then assigned to plans, with 5 being excellent. It isn’t easy to achieve a 5-star rating. For example, in 2023 only 11% of contracts received this excellent rating!
If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating is available in your area, there is a 5-star Special Enrollment Period you can use to switch from your current Medicare plan to a Medicare plan with a “5-star” quality rating. This means that you don’t have to wait until the annual enrollment period (AEP) to change your coverage. However, you can only switch once between December 8 and November 30 the following year.
On average, in 2023, a 5-star Medicare Advantage plan with prescription drug coverage costs and $49 per month. However, 5-star plans have no monthly costs are available almost everywhere that these high-rated plans are offered. What this means is that you can possibly get a high-quality plan for very little cost!
Your Old Plan
Once you choose a new stand-alone Medicare Prescription Drug Plan, you will be disenrolled from your Medicare Advantage Plan, which includes the health benefit. You will go back to Original Medicare for coverage of your health services.
If you move from a Medicare Advantage Plan that has drug coverage to a 5‑star Medicare Advantage Plan that doesn’t, you may lose your prescription drug coverage. You’ll have to wait until your next enrollment opportunity to get drug coverage, and you may have to pay a Part D late enrollment penalty. This means you need to ensure that you are reading all the details and are sure that your new plan will meet your needs.
If you’re considering enrolling in a MAPD plan and seeking the best possible coverage, don’t forget that the 5-star SEP can still be accessed to ensure you have access to a high-quality plan that meets your healthcare needs. If you’re spending too much on your Medicare health plan, consider enrolling in a 5-star plan and save money. All the choices can be a lot to consider, but that’s what I am here for, reach out any time if you need help!
Brenda Gilliam, Your Insurance Agent, Medicare Insurance Agent & Extra Help Coordinator
* Not affiliated with any government agency.
*We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.