If you plan to sign up for a Medicare Advantage plan in retirement, the state you retire in could make a big difference in the quality of services you receive.
The Centers for Medicare and Medicaid Services rates Medicare Advantage plans on a scale of 1 to 5 stars, with 5 being the highest rating. Medicare Advantage plans received an average of 3.32 stars in 2010. The average state-wide quality rating for Medicare Advantage plans ranges from 4 or more stars in Massachusetts and Minnesota to 2.5 stars in Alaska, Delaware, and Vermont, according to a new Kaiser Family Foundation analysis.
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The majority of Medicare Advantage recipients are not currently enrolled in a highly-rated plan. Nearly half (46 percent) of Medicare Advantage beneficiaries are in a plan with 3 or fewer stars, KFF found. Only a quarter (24 percent) of Medicare Advantage enrollees are currently signed up for a plan with 4 or more stars.
The share of the population enrolled in quality Medicare Advantage plans also varies considerably by state. In only four states – Washington, Oregon, Minnesota, and Massachusetts – and Washington, D.C. are more than half of beneficiaries enrolled in a plan with 4 or more starts. Five states have no residents enrolled in plans with at least 4 stars. Another 10 states have less than 10 percent of participating seniors enrolled in highly rated plans.
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Some Medicare Advantage participants are not enrolled in a quality plan because one is simply not offered in their area. Slightly more than one-third of beneficiaries (37 percent) do not currently have access to a Medicare Advantage plan that received 4 or more stars. But in other places individual participants don’t select a highly rated plan. In Nevada, Delaware, and Florida, for example, less than 10 percent of Medicare Advantage recipients are in plans with 4 or more stars, but more than 80 percent of Medicare beneficiaries have access to a highly rated plan. In only 5 states – Alaska, Mississippi, Montana, Nebraska, and Vermont – do no beneficiaries have the option to sign up for a highly rated plan.
“Some beneficiaries are not enrolled in plans with high quality ratings because they select their plan based on factors unrelated to the plan rating, such as the plan’s premium, the additional benefits offered by the plan, and whether their physician is included in the plan’s network,” according to the Kaiser Family Foundation report. “Also, it is not clear how many beneficiaries use Medicare.gov to select their Medicare Advantage plan, and thus many may not know how their plan rated relative to others in the area.”
In 2012, Medicare will begin to use this rating system to provide bonuses to highly performing Medicare Advantage plans.