Skip to content

    Health Care Reform:

    Health Insurance & Affordable Care Act

    How to Use Medicare Plan Ratings

    What Medicare Evaluates to Rate Quality

    Medicare uses information from many sources to do the ratings. This includes surveys filled out by members of a health plan. Medicare also uses information from health care providers and from the plans.

    Both health plans and prescription drug plans are evaluated on:

    • How a plan helps you stay healthy
    • What experiences members have had with a plan
    • What complaints members have had, which includes problems getting care as well as whether the plan has improved in the past 2 years
    • The plan’s customer service

    Prescription drug plans are also evaluated on how well they handle patient safety, which includes whether they give accurate information on drug prices.

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

    WebMD Medical Reference

    Today on WebMD

    stethoscope on person's chest
    Your Marketplace choices,
    How not to waste money on health care.
    man in cafe looking at computer
    Finding low-cost health insurance.
    doctor showing girl a stethoscope
    Get the facts on health insurance.
    Loading …
    URAC: Accredited Health Web Site TRUSTe online privacy certification HONcode Seal AdChoices