Tarrant County Medicare Insurance Specialists

Tarrant County Medicare Insurance Specialists know the medicare plans and what medicare evaluates to rate the quality

Medicare uses information from many sources to do the ratings. This includes required data reporting from the health plan as well as surveys filled out by members of a health plan. Medicare also uses information obtained from healthcare providers.

Both health plans and prescription drug plans are evaluated on the:

• How a plan helps its members stay healthy: screenings, tests, and vaccines
• The experiences members have had with a plan
• What complaints members have had: trouble getting services, and choosing to leave the plan, along with whether the plan has improved in the past two years
• The plan’s overall customer service

Along with the above, prescription drug plans are also evaluated on how well they handle their patient safety, including whether they give accurate information on drug prices.

In general, Medicare rates plans based on its member’s health, complaints, receipt of recommended care, and satisfaction. Some of the factors used to rate plans may be important to you and your health and satisfaction with the plan, and others not so much. Note, these ratings do not take into account whether the plans include high-quality hospitals and doctors in its network.

If Medicare gives a plan fewer than three stars for three years in a row, Plan Finder will flag the plan as low-performing. The symbol Plan Finder uses to show that a plan is low-performing is an upside-down red triangle with an exclamation point inside of it (similar to a caution sign). Medicare will notify you if the plan you are enrolled in is flagged as low-performing. You will not be removed from the plan, but you may want to check the plan’s costs and coverage to make sure it is still a good plan for you.