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Customer Reviews for California Medicare Advantage Plans
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Forget Yelp, we have something much better when comparing Medicare Advantage plans in California.
The Star Rating!
We'll explain why this might be the most important tool for comparing all the different options out there.
It sure does cut through all the marketing hype that Medicare members get inundated with when they turn 65 or at the end of each year.
There's no hiding!
First, our credentials:
Let's walk through how to use the Star Rating to find the best Advantage plan with these steps:
- A quick intro to the Medicare Star Rating for Advantage plans
- How to use the Star Rating to compare plans
- What Advantage plans have the highest ratings in California
- The 5-Star Plan Move Rule
- How to change or switch Advantage plans
- Quoting and Enrolling in plans that show Star Ratings
Let's get started!
A quick intro to the Medicare Star Rating for Advantage plans
Built right into the Medicare system is a fantastic tool to compare Medicare Advantage and part D (medication) plans.
It's on a scale from 1 and 5 with 5 being the best (excellent really).
There's a total score and component scores across these five areas:
- Member experience with the health plan. This is measured by member ratings of
the plan.
- Customer service. This is based on how well the plan handles member appeals.
- Plan performance. This focuses on member complaints and changes in the plan's
performance. It includes how often Medicare found problems with the plan, how
often members had problems with the plan, and how much the plan's performance
has improved over time.
- Chronic conditions. This is based on how often members with certain conditions
got recommended tests and treatments to help manage their condition.
- Staying healthy. This measures whether members got various screening tests,
vaccines, and other check-ups to help them stay healthy.
The ratings are primarily given by the enrollees of the plan the prior year.
So for example, we have Star Ratings now that primarily reflect last year's performance.
Some important notes!
- Each carrier will have their own Star Rating and each plan they offer
may
also have its own rating.
- Different plan from carrier can have really different ratings
- Regional differences do not figure into the plan rating unless the carrier offers different plans (separate ID) by region
The average Star rating for Advantage plans in California is just above 4 stars.
Okay....so what's the big deal? Does the Star Rating actually matter when comparing Advantage plans?
How to use the Star Rating to compare plans
Throughout our reviews, we talk about our Triple Threat:
- Low or no cost
- Max out of pocket under $1000
- Star Rating of 4 or higher!
Check out How to Compare Advantage Plans or our Insider's Guide to Advantage Plans to learn more.
The monthly premium and out-of-pocket-max are super easy to compare when you run your quote here:
The Star Rating gets to something much more important.
Remember what we're giving up with an Advantage plan versus a supplement:
Provider networks are stricter and care is more managed
Learn all about how to compare Medicare Supplements and Advantage plans.
This is just a function of the HMO model (most Advantage plans) versus more of a PPO feel (Supplement).
The Star Rating basically reflects just how well the carrier is handling the "managed care" restraints on control.
If members are constantly running into roadbumps to see doctors or get things done, it's going to show in the Star Rating!
And it's working!
Just look at the progression towards higher ranked plans:
That's the whole point of the Star Ranking to begin with...to slowly nudge the market towards better care as reflected by the actual enrollees.
The Star Rating can and will change year to year so its important to make sure to quote the market during Annual Open Enrollment each year.
Our free system makes this easy since your information is already loaded in and you just need to update doctors and medications.
Let's look at the current setup!
What Advantage plans have the highest ratings in California
Again...it's super important to run a specific quote for your area since not every plan or carrier is available in every area:
Running across major markets (LA, Bay Area, Sac, and San Diego), some clear
"winners" jump out on the Star Rating field.
First, Kaiser has a strong rating and people generally know if they want to stay with Kaiser or use doctors/hospitals outside of the Kaiser network.
We focus on the carriers that contract directly with private doctors/hospitals so along those lines...
There are regional players which have strong Star Ratings:
- SHARP - San Diego area (5 being highest)
- SCAN - LA Care (4.5 being highest)
Of the major carriers, three really stand out depending on the area:
- United Healthcare(R)
- Humana
- Blue Shield
All have 4 star plans depending on the area.
United Healthcare(R)'s provider network is probably the biggest and they boast hospitals like Cedars and UCLA if in your area.
Alignment has 4 stars but we would prefer SCAN since it's bigger (which affects ability to contract with good providers) and has a higher star rating for a smaller carrier.
Complaint #1 and 2 with Advantage plans is not being able to see doctors and meds aren't covered.
The Star rating and the doctor networks are good indicators to how this will actually feel as a member!
Run your quote to see the Star rating by the major carriers:
Let's shine a light on a little known option.
The 5-Star Plan Move Rule
Most people don't realize that the Star Rating actually gives you an escape valve if you don't like your plan!
You're allowed to move to a 5 star plan (if available in your area) once per year after Open Enrollment!
This can occur once between Dec 8th and Nov 30th (essentially the opposite of annual open enrollment).
Most people don't realize this is an option outside of the Jan-March "re-do" period to change plans during the year.
It's basically a reward for a plan that's able to have 5 Stars...they can attract new enrollees anytime during the year.
Reach out to us if you have any questions on this option.
What about the other times of the year?
How to change or switch Advantage plans
There are a few key windows to remember which are not exhaustive.
- Annual Open Enrollment: Oct 15 - Dec 7th each year; change, add, or drop
coverage
- Open Enrollment: Jan 1st-March 31st; change or drop coverage
- 5 Star rule from above!
- 1st year on Advantage plan (check with us for general rules on this)
There are other special triggers (moves, loss of coverage, changes in medi-cal status, etc) so definitely check with us!
For most people, Annual Open Enrollment at the end of each year is when all the activity occurs.
The Star Ratings will also be updated prior to this window so people can make an educated decision based on how the enrollees viewed their plan!
So...how do we see these Star Ratings for our area?
Quoting and Enrolling in plans that show Star Ratings
You can see the quotes and plans here:
You'll see a Star rating by each plan and remember, the Star Rating is tied to a plan...not a carrier.
It's not uncommon to see two plans from the same carrier in one area have completely different Star Ratings!
Choose accordingly.
Luckily, our quoting system will rank the plans according to Star Rating to make this easier to compare.
You can also see Special Need Plans by clicking on that link at top (see Special Need Plan guide to learn more if you're eligible for medi-cal or have a chronic disease).
Either way, the Star Rating consumer reviews will show!
Reach out with any questions on the plans available but the enrollment side is just as easy.
For most carriers, you can add to the "Cart" and even enroll right online.
The best part about this is that at Annual Open Enrollment, you can update info including doctors and RX and most of the work is already done (info still in the system!).
This can save so much time and hassle with every open enrollment and there's no cost to use it or for our assistance!
Now, you know why the Star Rating is part of our Triple Threat selection system for Advantage plans and Part D!
