A new tool for seniors during Medicare open enrollment

It is open enrollment season for Medicare beneficiaries. The period starts and ends sooner this year, and seniors have until Dec. 7 to make changes to their federal health plans.

New this fall is a five-star rating system for Medicare Advantage, the hybrid public-private health insurance and prescription drug plans.

Plans are ranked based largely on consumer surveys, customer service and preventive services. High-performing plans get government bonuses that must be used for member benefits.

Philadelphia-area residents should not get their hopes up for a five-star plan, though.

“None of the plans in this area received that ranking yet,” said Roseanne Egan, acting regional administrator for the Centers for Medicare and Medicaid Services. “It doesn’t mean that they’re poor quality or poor access, it just hasn’t risen to what other plans have been able to achieve yet.”

Only 12 out of almost 450 plans nationwide have five stars, but CMS said it sees the star-ranking system as an incentive toward improvement.

In addition to the performance bonuses, five-star plans will be allowed to accept new enrollees year-round, rather than just during the enrollment period.

Karen Chenoweth, of the Center for Advocacy for the Rights and Interests of the Elderly CARIE, said she is required to remain unbiased when giving advice through the publicly funded program, so she cannot direct seniors to one plan over another.

With the star system, “we can have part of that conversation with them,” Chenoweth said. “This way we can remain nonbiased and explain that this ranking is based on Medicare’s data.”

No matter the plan, annual wellness visits and some preventive services that were free starting last year under traditional Medicare also will be offered without co-pays for Medicare Advantage plans starting this year.

Locally, 16,000 Independence Blue Cross members who were previously covered by a discontinued Medicare Advantage plan called Keystone 65 Advantage have been automatically moved to a new plan.

Marketing Director Roger van Baaren said beneficiaries should decide if they want to opt for a different plan before the December deadline.

“The premium at the one they’ll be enrolled is a little higher, some of the cost-sharing is a little lower, but we’re basically giving them a lot of information about the new product in case they want to have a product that is lower in cost than the one they had last year,” he said.

That “new product” is a plan with $15 premiums.