Aarp Medicare Advantage Choice
by UnitedHealthcare
The Aarp Medicare Advantage Choice by UnitedHealthcare offers Medicare Advantage Plans with additional benefits that Original Medicare does not cover. There are 181 different plans by Aarp Medicare Advantage Choice available. Not all plans are available in all locations and prices may vary by location. The plan with the lowest monthly premium is $0 and the highest monthly premium is $87. The plan with the lowest out-of-pocket expense is $2900 and the highest out-of-pocket is $7550. You can review the table below to see coverage and prices for Aarp Medicare Advantage Choice.
(Click the Plan ID for additional coverage details)
(Click the state to compare every plan in that state)
(⇅ Click the header to sort)
Plan ID ⇅ | Premium | Plan Type | MOOP | Members Enrolled |
States Where Plan is Available |
---|---|---|---|---|---|
H6528 033 0 |
$0 | Local PPO | $5,900 | 7877 | Alabama Part-C |
H1278 005 0 |
$0 | Local PPO | $6,400 | 8506 | Texas Part-C |
H2406 018 0 |
$0 | Local PPO | $3,400 | 32562 | Florida Part-C |
H2228 023 0 |
$0 | Local PPO | $3,900 | 26066 | New Mexico Part-C |
H3442 003 0 |
$0 | Local PPO | $6,700 | 14587 | Massachusetts Part-C |
H1821 001 0 |
$0 | Local PPO | $6,200 | 1594 | Washington Part-C |
H8768 003 0 |
$47.00 | Local PPO | $3,400 | 1310 | Illinois Part-C |
H2406 011 0 |
$0 | Local PPO | $4,900 | 34205 | Florida Part-C |
H3418 006 0 |
$0 | Local PPO | $7,550 | New York Part-C | |
H8768 027 0 |
$0 | Local PPO | $3,700 | 19252 | Missouri Part-C |
H0294 023 0 |
$0 | Local PPO | $6,700 | 1021 | Wisconsin Part-C |
H4829 008 0 |
$43.00 | Local PPO | $5,900 | 259 | California Part-C |
H2577 028 0 |
$0 | Local PPO | $6,700 | 1336 | Pennsylvania Part-C |
H1278 016 0 |
$0 | Local PPO | $6,700 | 1925 | Texas Part-C |
H2406 010 0 |
$0 | Local PPO | $4,900 | 17594 | Florida Part-C |
H2577 004 0 |
$0 | Local PPO | $6,700 | 9338 | North Carolina Part-C |
H3442 004 0 |
$0 | Local PPO | $6,700 | 31544 | Massachusetts Part-C |
H2228 030 0 |
$29.00 | Local PPO | $4,400 | 12874 | Illinois Part-C |
H7404 021 0 |
$0 | Local PPO | $5,900 | 2446 | Utah Part-C |
H2406 019 0 |
$0 | Local PPO | $4,900 | 3704 | Florida Part-C |
H8768 022 0 |
$0 | Local PPO | $7,550 | 62300 | New Jersey Part-C |
H3418 008 0 |
$0 | Local PPO | $7,200 | New York Part-C | |
H2577 014 0 |
$0 | Local PPO | $7,550 | 8110 | Virginia Part-C |
H2228 029 0 |
$32.00 | Local PPO | $4,500 | 22003 | Oregon Part-C |
H1278 003 0 |
$0 | Local PPO | $6,700 | 19397 | Texas Part-C |
H2406 008 0 |
$0 | Local PPO | $4,900 | 10023 | Florida Part-C |
H2577 016 0 |
$0 | Local PPO | $6,700 | 3075 | North Carolina Part-C |
H1278 007 0 |
$0 | Local PPO | $3,900 | 7838 | Iowa Part-C |
H2228 023 0 |
$0 | Local PPO | $3,900 | 26066 | Texas Part-C |
H2406 013 0 |
$0 | Local PPO | $4,900 | 21576 | Florida Part-C |
H8768 015 0 |
$0 | Local PPO | $5,100 | 5261 | Ohio Part-C |
H3442 001 0 |
$0 | Local PPO | $6,700 | 25751 | Connecticut Part-C |
H3418 004 0 |
$0 | Local PPO | $7,550 | New York Part-C | |
H8768 026 0 |
$0 | Local PPO | $3,900 | 16158 | Missouri Part-C |
H8768 015 0 |
$0 | Local PPO | $5,100 | 5261 | Kentucky Part-C |
H2228 120 0 |
$28.00 | Local PPO | $5,700 | Hawaii Part-C | |
H1278 015 0 |
$0 | Local PPO | $6,700 | 4606 | Texas Part-C |
H1821 003 0 |
$19.00 | Local PPO | $6,500 | 14893 | Washington Part-C |
H6528 031 0 |
$0 | Local PPO | $5,700 | 23298 | Arkansas Part-C |
H1278 013 0 |
$0 | Local PPO | $6,700 | 23591 | Texas Part-C |
H2406 015 0 |
$0 | Local PPO | $3,900 | 3501 | Florida Part-C |
H2577 017 0 |
$0 | Local PPO | $6,700 | 6055 | North Carolina Part-C |
H8768 013 0 |
$0 | Local PPO | $5,500 | 3225 | Kentucky Part-C |
H1278 009 0 |
$25.00 | Local PPO | $5,900 | 1141 | South Dakota Part-C |
H2406 014 0 |
$0 | Local PPO | $4,900 | 4740 | Florida Part-C |
H2577 011 0 |
$0 | Local PPO | $6,700 | 2176 | Virginia Part-C |
H1278 010 0 |
$0 | Local PPO | $5,900 | 2801 | Texas Part-C |
H2406 009 0 |
$0 | Local PPO | $4,900 | 33229 | Florida Part-C |
H7404 018 0 |
$0 | Local PPO | $5,900 | 2995 | Nevada Part-C |
H2406 016 0 |
$0 | Local PPO | $4,900 | 11156 | Florida Part-C |
H8768 009 0 |
$0 | Local PPO | $4,900 | 31619 | Oklahoma Part-C |
H2228 065 0 |
$22.00 | Local PPO | $3,900 | 2578 | Indiana Part-C |
H1278 007 0 |
$0 | Local PPO | $3,900 | 7838 | South Dakota Part-C |
H3418 005 0 |
$0 | Local PPO | $7,550 | New York Part-C | |
H2228 030 0 |
$29.00 | Local PPO | $4,400 | 12874 | Missouri Part-C |
H2577 013 0 |
$0 | Local PPO | $6,700 | 1361 | Virginia Part-C |
H1278 014 0 |
$0 | Local PPO | $6,700 | 10715 | Texas Part-C |
H2406 012 0 |
$0 | Local PPO | $4,900 | 5749 | Florida Part-C |
H1278 007 0 |
$0 | Local PPO | $3,900 | 7838 | Nebraska Part-C |
H8768 005 0 |
$36.00 | Local PPO | $3,900 | 18603 | Illinois Part-C |
H1278 007 0 |
$0 | Local PPO | $3,900 | 7838 | Minnesota Part-C |
H2406 017 0 |
$0 | Local PPO | $4,400 | 9355 | Florida Part-C |
H8768 014 0 |
$0 | Local PPO | $5,100 | 6305 | Ohio Part-C |
H3418 007 0 |
$0 | Local PPO | $7,550 | New York Part-C | |
H2228 082 0 |
$0 | Local PPO | $4,900 | 2475 | Missouri Part-C |
H2577 027 0 |
$0 | Local PPO | $6,700 | 1252 | Virginia Part-C |
H2228 068 0 |
$28.00 | Local PPO | $5,700 | 1773 | Hawaii Part-C |
R7444 001 0 |
$53.00 | Regional PPO | $7,550 | 16578 | Connecticut Part-C |
R5329 001 0 |
$50.00 | Regional PPO | $7,550 | 1375 | Maine Part-C |
R7444 001 0 |
$53.00 | Regional PPO | $7,550 | 16578 | Massachusetts Part-C |
R5329 001 0 |
$50.00 | Regional PPO | $7,550 | 1375 | New Hampshire Part-C |
R7444 001 0 |
$53.00 | Regional PPO | $7,550 | 16578 | Rhode Island Part-C |
R7444 001 0 |
$53.00 | Regional PPO | $7,550 | 16578 | Vermont Part-C |
H3442 011 0 |
$0 | Local PPO | $6,700 | Connecticut Part-C | |
H8768 007 0 |
$30.00 | Local PPO | $4,500 | 1755 | Ohio Part-C |
H8211 006 0 |
$0 | Local PPO | $6,700 | 2608 | West Virginia Part-C |
H2228 018 0 |
$36.00 | Local PPO | $3,900 | 10803 | North Carolina Part-C |
H2228 127 0 |
$0 | Local PPO | $4,900 | North Carolina Part-C | |
H8768 017 2 |
$0 | Local PPO | $3,900 | 18845 | Iowa Part-C |
H2228 037 0 |
$43.00 | Local PPO | $6,700 | 2953 | Pennsylvania Part-C |
H4829 003 0 |
$73.00 | Local PPO | $4,500 | 2696 | California Part-C |
H2228 021 0 |
$22.00 | Local PPO | $3,900 | 27752 | Indiana Part-C |
H2001 001 0 |
$0 | Local PPO | $5,900 | 15369 | Maine Part-C |
H2577 009 0 |
$0 | Local PPO | $6,700 | 5467 | Virginia Part-C |
H1278 001 0 |
$19.00 | Local PPO | $3,900 | 17557 | Nebraska Part-C |
H8768 017 1 |
$0 | Local PPO | $3,900 | 18845 | Iowa Part-C |
H2577 006 0 |
$0 | Local PPO | $5,900 | 32296 | South Carolina Part-C |
H2228 024 0 |
$0 | Local PPO | $6,700 | 13956 | Hawaii Part-C |
H2228 064 0 |
$24.00 | Local PPO | $3,900 | 2755 | Indiana Part-C |
H2577 001 2 |
$0 | Local PPO | $5,500 | 12943 | Colorado Part-C |
H2228 118 0 |
$0 | Local PPO | $4,300 | 1540 | New Mexico Part-C |
H1821 002 0 |
$0 | Local PPO | $6,500 | 31963 | Washington Part-C |
H4829 004 0 |
$45.00 | Local PPO | $5,900 | 1122 | California Part-C |
H3442 007 0 |
$29.00 | Local PPO | $6,700 | 10078 | New Hampshire Part-C |
H2228 019 0 |
$18.00 | Local PPO | $3,700 | 32830 | Indiana Part-C |
H3442 006 0 |
$0 | Local PPO | $5,900 | 4006 | Rhode Island Part-C |
H8211 001 0 |
$19.00 | Local PPO | $5,900 | 5797 | West Virginia Part-C |
H4829 011 0 |
$48.00 | Local PPO | $2,900 | California Part-C | |
H3442 010 0 |
$0 | Local PPO | $6,900 | 3870 | Vermont Part-C |
H2228 022 0 |
$18.00 | Local PPO | $3,900 | 5684 | Indiana Part-C |
H8211 009 0 |
$0 | Local PPO | $4,900 | 329 | Montana Part-C |
H4829 005 0 |
$87.00 | Local PPO | $6,700 | 721 | California Part-C |
H8768 008 0 |
$29.00 | Local PPO | $4,400 | 19011 | Oklahoma Part-C |
H2228 071 0 |
$0 | Local PPO | $6,400 | 1675 | Missouri Part-C |
H2228 101 0 |
$0 | Local PPO | $7,550 | 4066 | Maryland Part-C |
H2228 035 0 |
$21.00 | Local PPO | $5,900 | 4827 | Pennsylvania Part-C |
H1278 001 0 |
$19.00 | Local PPO | $3,900 | 17557 | Iowa Part-C |
H8768 017 2 |
$0 | Local PPO | $3,900 | 18845 | Illinois Part-C |
H8768 030 0 |
$25.00 | Local PPO | $5,900 | 4014 | Mississippi Part-C |
H4829 010 0 |
$48.00 | Local PPO | $2,900 | California Part-C | |
H2228 071 0 |
$0 | Local PPO | $6,400 | 1675 | Kansas Part-C |
H4829 012 0 |
$48.00 | Local PPO | $2,900 | California Part-C | |
H2228 116 0 |
$0 | Local PPO | $4,300 | 2035 | New Mexico Part-C |
H2228 031 0 |
$19.00 | Local PPO | $4,700 | 19097 | Idaho Part-C |
H2228 076 0 |
$34.00 | Local PPO | $5,100 | 4362 | Arizona Part-C |
H2577 030 0 |
$0 | Local PPO | $4,900 | North Carolina Part-C | |
H2577 001 1 |
$0 | Local PPO | $5,900 | 12943 | Colorado Part-C |
H2228 117 0 |
$0 | Local PPO | $4,300 | 633 | New Mexico Part-C |
H2228 099 0 |
$0 | Local PPO | $6,900 | 687 | Washington D.C. Part-C |
H8768 024 0 |
$0 | Local PPO | $3,700 | 11518 | Kansas Part-C |
H2001 017 0 |
$29.00 | Local PPO | $4,900 | 5592 | Utah Part-C |
H2228 093 0 |
$0 | Local PPO | $5,900 | 7075 | Delaware Part-C |
H6528 036 0 |
$0 | Local PPO | $6,500 | Wyoming Part-C | |
H2577 021 0 |
$35.00 | Local PPO | $5,500 | 3004 | Pennsylvania Part-C |
H2577 018 0 |
$26.00 | Local PPO | $5,900 | 7885 | North Carolina Part-C |
H1278 020 0 |
$0 | Local PPO | $4,500 | 3565 | Nebraska Part-C |
H8768 023 0 |
$0 | Local PPO | $3,700 | 55502 | Kansas Part-C |
H2577 026 0 |
$29.00 | Local PPO | $6,900 | 2809 | South Carolina Part-C |
H2228 067 0 |
$55.00 | Local PPO | $5,100 | 1581 | Hawaii Part-C |
H2228 110 0 |
$0 | Local PPO | $4,800 | 655 | Indiana Part-C |
H2577 023 0 |
$24.00 | Local PPO | $5,200 | 1805 | Colorado Part-C |
H2228 115 0 |
$19.00 | Local PPO | $3,800 | 1354 | New Mexico Part-C |
H1821 005 0 |
$34.00 | Local PPO | $6,000 | 3938 | Washington Part-C |
H4829 016 0 |
$0 | Local PPO | $6,700 | California Part-C | |
H2228 080 0 |
$0 | Local PPO | $4,500 | 11658 | Indiana Part-C |
H8768 023 0 |
$0 | Local PPO | $3,700 | 55502 | Missouri Part-C |
H8211 002 0 |
$32.00 | Local PPO | $5,400 | 3274 | West Virginia Part-C |
H4829 014 0 |
$0 | Local PPO | $4,500 | California Part-C | |
H8211 007 0 |
$33.00 | Local PPO | $3,900 | 704 | Montana Part-C |
H8768 016 0 |
$0 | Local PPO | $5,900 | 7635 | Oklahoma Part-C |
H2228 036 0 |
$44.00 | Local PPO | $5,500 | 3094 | Pennsylvania Part-C |
H2228 102 0 |
$26.00 | Local PPO | $7,550 | 4429 | Maryland Part-C |
H1278 020 0 |
$0 | Local PPO | $4,500 | 3565 | Iowa Part-C |
H8768 032 0 |
$0 | Local PPO | $3,900 | 4314 | Illinois Part-C |
H8768 034 0 |
$0 | Local PPO | $6,400 | Mississippi Part-C | |
H4829 013 0 |
$0 | Local PPO | $4,500 | California Part-C | |
H2228 111 0 |
$0 | Local PPO | $4,500 | 367 | Indiana Part-C |
H4829 015 0 |
$0 | Local PPO | $4,500 | California Part-C | |
H2228 047 0 |
$19.00 | Local PPO | $3,800 | 3493 | New Mexico Part-C |
H2228 032 0 |
$74.00 | Local PPO | $3,900 | 2890 | Idaho Part-C |
H2228 094 0 |
$0 | Local PPO | $5,600 | 14193 | Arizona Part-C |
H2577 031 0 |
$29.00 | Local PPO | $4,500 | North Carolina Part-C | |
H2577 022 0 |
$24.00 | Local PPO | $5,200 | 1938 | Colorado Part-C |
H2228 049 0 |
$19.00 | Local PPO | $3,800 | 1786 | New Mexico Part-C |
H2228 100 0 |
$29.00 | Local PPO | $6,500 | 1239 | Washington D.C. Part-C |
H2001 023 0 |
$0 | Local PPO | $5,500 | Utah Part-C | |
H2228 129 0 |
$29.00 | Local PPO | $5,700 | Delaware Part-C | |
H6528 035 0 |
$35.00 | Local PPO | $5,500 | 2532 | Wyoming Part-C |
H2577 029 0 |
$0 | Local PPO | $6,900 | 937 | Pennsylvania Part-C |
H8768 032 0 |
$0 | Local PPO | $3,900 | 4314 | Iowa Part-C |
H2228 085 0 |
$0 | Local PPO | $6,700 | 5462 | Pennsylvania Part-C |
H4829 018 0 |
$19.00 | Local PPO | $6,700 | California Part-C | |
H2228 081 0 |
$0 | Local PPO | $4,800 | 4077 | Indiana Part-C |
H4829 017 0 |
$0 | Local PPO | $6,700 | California Part-C | |
H2001 010 0 |
$57.00 | Local PPO | $5,500 | 1605 | Maine Part-C |
R0759 001 0 |
$0 | Regional PPO | $6,700 | 43159 | Florida Part-C |
H2228 086 0 |
$0 | Local PPO | $6,700 | 5166 | Pennsylvania Part-C |
H2228 079 0 |
$0 | Local PPO | $5,500 | 1839 | Idaho Part-C |
H2228 131 0 |
$0 | Local PPO | $6,900 | Pennsylvania Part-C | |
H2001 019 0 |
$0 | Local PPO | $6,700 | 2361 | Maine Part-C |
H8768 033 0 |
$0 | Local PPO | $5,900 | 1105 | Ohio Part-C |
H8768 035 0 |
$35.00 | Local PPO | $7,550 | New Jersey Part-C | |
H2577 003 2 |
$0 | Local PPO | $6,700 | 1011 | Colorado Part-C |
H7404 024 0 |
$0 | Local PPO | $6,700 | Utah Part-C | |
H2228 130 0 |
$0 | Local PPO | $7,550 | Pennsylvania Part-C | |
H2228 124 0 |
$0 | Local PPO | $7,500 | Idaho Part-C | |
H2228 125 0 |
$0 | Local PPO | $5,700 | New Mexico Part-C | |
H2577 003 1 |
$0 | Local PPO | $5,900 | 1011 | Colorado Part-C |
H2228 126 0 |
$0 | Local PPO | $5,700 | New Mexico Part-C | |
H6528 041 0 |
$0 | Local PPO | $7,550 | Georgia Part-C | |
H2577 005 0 |
$0 | Local PPO | $6,700 | 3515 | South Carolina Part-C |
Contact Info UnitedHealthcare
Website: UHC.com/Medicare
Toll Free: 888-834-3721
Member Phone: 800-711-0646
Reviews for Aarp Medicare Advantage Choice
Aarp Medicare Advantage Choice H2228 received a 4 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on quality and performance measures. You can use the CMS star rating to review performance among several different plans.
Overall Rating
Measure | Rating | Stars |
---|---|---|
Overall Rating | 4 out of 5 | |
Part C Summary Rating | 4 out of 5 | |
Part-D Summary Rating | 3.5 out of 5 | |
Staying Healthy: Screenings, Tests, Vaccines | 4 out of 5 | |
Managing Chronic (Long Term) Conditions | 4 out of 5 | |
Member Experience with Health Plan | 3 out of 5 | |
Complaints and Changes in Plans Performance | 4 out of 5 | |
Health Plan Customer Service | 5 out of 5 | |
Drug Plan Customer Service | 5 out of 5 | |
Complaints and Changes in the Drug Plan | 3 out of 5 | |
Member Experience with the Drug Plan | 3 out of 5 | |
Drug Safety and Accuracy of Drug Pricing | 4 out of 5 |
Staying Healthy, Screening, Testing, and Vaccines
Managing Chronic And Long Term Care for Older Adults
Measure | Rating | Stars |
---|---|---|
Total Rating | 4 out of 5 | |
SNP Care Management [5] | 4 out of 5 | |
Medication Review [6] | 5 out of 5 | |
Pain Assessment [7] | 5 out of 5 | |
Osteoporosis Management [8] | 2 out of 5 | |
Diabetes Care - Eye Exam [9] | 5 out of 5 | |
Diabetes Care - Kidney Disease [10] | 5 out of 5 | |
Diabetes Care - Blood Sugar [11] | 5 out of 5 | |
Controlling Blood Pressure [12] | 3 out of 5 | |
Reducing Risk of Falling [13] | 3 out of 5 | |
Improving Bladder Control [14] | 3 out of 5 | |
Medication Reconciliation [15] | 3 out of 5 | |
Statin Therapy [16] | 3 out of 5 |
Member Experience with Health Plan
Member Complaints and Changes in Plans Performance
Health Plan Customer Service Rating
Drug Plan Customer Service
Measure | Rating | Stars |
---|---|---|
Total Rating | 5 out of 5 | |
Call Center, TTY, Foreign Language [29] | 5 out of 5 |
Ratings For Member Complaints and Changes in the Drug Plans Performance
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing
Measure | Rating | Stars |
---|---|---|
Total Rating | 4 out of 5 | |
MPF Price Accuracy [35] | 5 out of 5 | |
Drug Adherence for Diabetes Medications [36] | 3 out of 5 | |
Drug Adherence for Hypertension (RAS antagonists) [37] | 4 out of 5 | |
Drug Adherence for Cholesterol (Statins) [38] | 3 out of 5 | |
MTM Program Completion Rate for CMR [39] | 4 out of 5 | |
Statin with Diabetes [40] | 3 out of 5 |
Breast Cancer Screening-Percent of female plan members aged 52-74 who had a mammogram during the past two years.
Colorectal Cancer Screening-Percent of plan members aged 50-75 who had appropriate screening for colon cancer.
Annual Flu Vaccine-Percent of plan members who got a vaccine (flu shot).
Monitoring Physical Activity-Percent of senior plan members who discussed exercise with their doctor and were advised to start, increase, or maintain their physical activity during the year.
SNP Care Management-This measure is defined as the percentage of eligible Special Needs Plan (SNP) enrollees who received a health risk assessment (HRA) during the measurement year.
Medication Review-Percent of plan members whose doctor or clinical pharmacist reviewed a list of everything they take (prescription and non-prescription drugs, vitamins, herbal remedies, other supplements) at least once a year.
Pain Assessment-Percent of plan members who had a pain screening at least once during the year.
Osteoporosis Management-Percent of female plan members who broke a bone and got screening or treatment for osteoporosis within 6 months.
Diabetes Care - Eye Exam-Percent of plan members with diabetes who had an eye exam to check for damage from diabetes during the year.
Diabetes Care - Kidney Disease-Percent of plan members with diabetes who had a kidney function test during the year.
Diabetes Care - Blood Sugar-Percent of plan members with diabetes who had an A1C lab test during the year that showed their average blood sugar is under control.
Controlling Blood Pressure-Percent of plan members with high blood pressure who got treatment and were able to maintain a healthy pressure.
Reducing Risk of Falling-Percent of plan members with a problem falling, walking, or balancing who discussed it with their doctor and received a recommendation for how to prevent falls during the year.
Improving Bladder Control-Percent of plan members with a urine leakage problem in the past 6 months who discussed treatment options with a provider.
Medication Reconciliation-This shows the percent of plan members whose medication records were updated within 30 days after leaving the hospital.
Statin Therapy-This rating is based on the percent of plan members with heart disease who get the right type of cholesterol-lowering drugs. Health plans can help make sure their members are prescribed medications that are more effective for them.
Getting Needed Care-Percent of the best possible score the plan earned on how quickly members get appointments and care.
Getting Appointments-Percent of the best possible score the plan earned on how easy it is for members to get information and help from the plan when needed.
Customer Service-Health Plan Provides Information or Help When Members Need It. Percent of the best possible score the plan earned on how easy it is for members to get information and help from the plan when needed.
Health Care Quality-Percent of the best possible score the plan earned from members who rated the quality of the health care they received.
Rating of Health Plan-Member's Rating of Health Plan Percent of the best possible score the plan earned from members who rated the health plan.
Care Coordination-Percent of the best possible score the plan earned on how well the plan coordinates members’ care. (This includes whether doctors had the records and information they needed about members’ care and how quickly members got their test results.)
Complaints about Health Plan-Patients’ Experience and Complaints Measure Complaints about the Health Plan (lower numbers are better because it means fewer complaints
Members Leaving the Plan-Percent of plan members who chose to leave the plan. Members Choosing to Leave the Plan (more stars are better because it means fewer members choose to leave the plan)
Health Plan Quality Improvement-Improvement (if any) in the Health Plan’s Performance. This shows how much the health plan’s performance improved or declined from one year to the next.
Timely Decisions About Appeals-Percent of appeals timely processed by the plan (numerator) out of all the plan‘s appeals decided by the Independent Review Entity (IRE) (includes upheld, overturned, partially overturned appeals and dismissed because the plan agreed to cover.)
Reviewing Appeals Decisions-This rating shows how often an independent reviewer found the health plan’s decision to deny coverage to be reasonable.
Call Center, TTY, Foreign Language-Percent of time that TTY services and foreign language interpretation were available when needed by people who called the health plan’s prospective enrollee customer service phone line.
Call Center, TTY, Foreign Language-Percent of time that TTY services and foreign language interpretation were available when needed by people who called the drug plan’s prospective enrollee customer service line.
Complaints about the Drug Plan-Complaints about the Drug Plan (number of complaints for every 1,000 members). Lower numbers are better because it means fewer complaints.
Members Choosing to Leave the Plan-Members Choosing to Leave the Plan lower percentages are better because that indicates fewer members choose to leave the plan.
Drug Plan Quality Improvement-This shows how much the drug plan’s performance has improved or declined from one year to the next year.
Rating of Drug Plan-Percent of the best possible score the plan earned from members who rated the prescription drug plan.
Getting Needed Prescription Drugs-Percent of the best possible score the plan earned on how easy it is for members to get the prescription drugs they need using the plan.
MPF Price Accuracy-A score comparing the drug’s total cost at the pharmacy to the drug prices the plan provided for the Medicare Plan Finder website.
Drug Adherence for Diabetes Medications-Percent of plan members with a prescription for diabetes medication who fill their prescription often enough to cover 80% or more of the time they are supposed to be taking the medication. One of the most important ways people with diabetes can manage their health is by taking their medication as directed. The plan, the doctor, and the member can work together to find ways to do this.
Drug Adherence for Hypertension (RAS antagonists)-Percent of plan members with a prescription for a blood pressure medication who fill their prescription often enough to cover 80% or more of the time they are supposed to be taking the medication.
Drug Adherence for Cholesterol (Statins)-Percent of plan members with a prescription for a cholesterol medication (a statin drug) who fill their prescription often enough to cover 80% or more of the time they are supposed to be taking the medication.
MTM Program Completion Rate for CMR-Some plan members are in a program (called a Medication Therapy Management program) to help them manage their drugs. The measure shows how many members in the program had an assessment of their medications from the plan. The assessment includes a discussion between the member and a pharmacist (or other health care professional) about all of the member’s medications.
Statin with Diabetes-This rating is based on the percent of plan members with diabetes who take the most effective cholesterol-lowering drugs. Plans can help make sure their members get these prescriptions filled.
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Source:CMS Plan and Prices Info
Source:CMS Star Ratings