If you’re on Medicare or are a caregiver for someone who is, the U.S. News Best Medicare Plans site can help you navigate the options and get the right medical coverage. These guides can help you decide whether original Medicare is the best option or whether to look at Medicare Advantage plans, which are offered by insurance companies to provide Medicare coverage, or to consider adding a drug plan or a Medigap plan instead. It’s important to look at the monthly premiums of a Medicare Advantage plan versus Medigap and whether your doctors and hospitals are in-network, among other factors. Plus, we provide guidance on choosing a good drug plan, either added onto original Medicare or bundled with a Medicare Advantage plan.
We’ve also evaluated all insurance companies and the plans they offer in your state. Best Medicare Advantage Plans and Best Medicare Part D Plans highlight these top-performing companies. This year, U.S. News increased the cutoff criteria for the Best Part D Honor Roll. To make the list, insurance companies had to receive an average of 4.5 or 5 stars across all plans in a given state.
Methodology for the 2015 Best Medicare Advantage Plans
U.S. News used data from the Centers for Medicare & Medicaid Services, including its rating of each Medicare Advantage plan. CMS scores each Medicare plan from 1 to 5 stars, in half-star intervals. For an insurer to make the U.S. News list, its Medicare Advantage plans available in a given state had to earn an average rating of at least 4.5 out of 5 stars, and all its plans in the state had to earn at least 3 stars. This assures that companies on our “Best” list maintain a consistent quality across all their plans. We found that even with a large state like California, where 27 companies offer plans, very few companies tend to offer top-rated plans consistently. (Just two companies, Kaiser Permanente and CareMore Health Plan, made the list in California, for example.) In 13 states, no company met our criteria. Some companies met our criteria in multiple states.
Methodology for the 2015 Best Medicare Part D Plans
We used the CMS five-star system for all Part D (prescription drug) plans. We grouped the 2015 star ratings by company and within each state, then averaged each company’s ratings in that state. For an insurer to make this U.S. News list, its Part D plans available in a given state had to earn an average rating of at least 4.5 out of 5 stars, and all had to earn at least 3 stars. One insurer in 20 states made our 2015 Part D Honor Roll.
“Wellness Care” and “Customer Service” ratings:
New for 2015, U.S. News has calculated a 1 to 5 star rating for each Medicare plan, based on CMS data, along dimensions that we call “Wellness Care” and “Customer Service.” CMS rates these plans across dozens of factors, which can be grouped by two themes: factors that track how existing members of those plans do health-wise, like whether plan members who have diabetes got a cholesterol screening in the past year, and customer service aspects, like how responsive a plan is to customer phone calls.
For our “Wellness Care” score, we weighted groupings of factors that deal with that theme much higher than other factors, and vice versa for “Customer Service.” If a plan’s factors or “measures” do not contain data – for example, the plan is too new to be measured or there isn’t enough data available – and those groupings are important in our weightings, we do not rate the plan along “Wellness Care” or “Customer Service” accordingly.
More About Best Medicare Plans
In addition to rating insurers, U.S. News has republished the CMS star ratings for each Medicare Advantage plan and Part D plan in the country. Plans are searchable by ZIP code from the U.S. News Medicare homepage or the search box at the top of every page on Medicare. By default, Medicare Advantage plans with drug coverage are displayed, but you can click to see Part D plans only, or Medicare Advantage plans without drug coverage. Use the search refine drop-downs and check boxes on the left side to narrow down plans according to your criteria. Note, for example, there are Medicare Advantage plans with a $0 premium, though that is zero dollars on top of what a person on original Medicare already pays – that amount is automatically deducted from the person’s Social Security check.
If you would like to buy the plan or find out more information from a licensed sales agent, we partner with eHealth.com, an Internet-based broker licensed in all states to sell Medicare plans. You can also go to the official government site, medicare.gov, and look up the plan there. Another important factor to consider is the drug coverage you may need. Drug plans will pay different amounts on drugs, or even change their pricing year-to-year. You may want to take a list of your existing medications and input them into medicare.gov’s site or ehealth.com, and either site will show you plans that support your drugs, as well as the most cost-effective plans.
Date: October 15, 2014