Buffalo, NY (October 24, 2018) – Independent Health has once again been recognized as a 4.5 Star Rated Medicare Plan* by the Centers for Medicare and Medicaid Services (CMS). The annual Star Ratings are designed to help Medicare beneficiaries assess the quality, value and performance of every Medicare Advantage plan throughout the nation.
Using a 5-Star Quality Rating System, with 5 being the highest-rated plan, the 2019 Medicare Star Ratings for all Medicare Advantage health plans and Medicare Part D prescription drug plans were released earlier this month. Independent Health’s HMO and PPO plans both earned 4.5 Stars for 2019. This marks the ninth consecutive year that Independent Health’s HMO plan has received a 4.5 Star Rating and the fourth straight year that its PPO plan has achieved it.
“Independent Health takes great pride in the fact that our Medicare Advantage Plans have been consistently rated highly by CMS over the years,” said Cathy Aquino, director of government sales, Independent Health. “Our 4.5 Star Medicare Rating in 2019 is a testament to our long-standing efforts of providing the highest level of customer service and partnering with health care providers to make sure our members receive well-coordinated, high-quality care.”
The Medicare Star Ratings program was created 11 years ago; however, it wasn’t until 2011 that CMS began to assign overall ratings. The rating system measures Medicare beneficiaries' experience with their health plans and the health care system. The key components that plans are measured on each year include:
- Screenings, tests and vaccines
- Managing chronic (long-term) conditions
- Customer service
- Patient safety and accurate drug pricing
- Member experience
- Member complaints, access and improvement
“With this year’s open enrollment period currently upon us, the CMS Star Ratings serve as a helpful and unbiased way for Medicare beneficiaries to objectively compare their medical and prescription drug options for 2019 and choose the plan that is right for them,” said Aquino.
Do some homework before enrolling in a Medicare Advantage plan
In addition to looking at each health plan’s Medicare Star Ratings, Aquino suggests that Medicare beneficiaries consider the following when choosing a Medicare Advantage plan for 2019:
- What type of plan best meets your health care needs?
Many health insurers offer different types of Medicare Advantage plans, with the two most common being:
Health Maintenance Organization (HMO) plan – With this plan, you must use the doctors and hospitals that are in the HMO's network. Many HMOs require their members to choose a primary care doctor affiliated with their plan. HMO plans typically have lower costs for doctor office visits than other types of plans.
Preferred Provider Organization (PPO) plan – This plan gives you more flexibility when picking a doctor or hospital. Members of PPOs can seek medically necessary care either inside or outside of the network; however, their copayments, coinsurance and/or deductibles may be higher for services they receive outside the network.
Make sure you understand how the various plans work, especially if you travel frequently or are a “snowbird” with extended periods outside of the plan’s service area.
- Do your health care providers participate with the plan?
With some health insurers, provider participation varies by plan. You may have to pay much higher costs if your doctor or hospital are not part of the plan’s network. That’s why you should verify that your doctors and hospital are “in-network” by reviewing the plan’s provider directory, which lists all of the doctors and hospitals who participate in its network. This directory should be available on the plan’s website or by request.
- Are your medications included on the plan’s formulary?
Each plan has its own formulary, which is a list of all the prescription medications that it covers. Medications are typically grouped into tiers on a formulary. The tier that your medication is in determines your portion of the drug cost. Make sure you review the formulary to see if your medications are covered by the plan and how much you will have to pay.
- Will you have to pay more for certain benefits?
Some Medicare Advantage plans offer extra benefits like eye exams, dental care and hearing aids. Check if these benefits are included with your coverage. Also, find out if your dentist, optometrist/ophthalmologist and/or audiologist will accept this coverage.
- Will you get the support you need?
It’s important to find a plan that provides the one-on-one attention you deserve. See if your plan offers extended hours or convenient locations where you can go to get your Medicare-related questions answered? In addition, ask your family and friends what type of experience they’ve had with their plan. Were they satisfied with the level of customer service they received after they enrolled?
“While on the surface some plans may appear more affordable because of a lower monthly premium, they might end up costing more in the long-run because of network design, provider participation, or drug costs,” said Aquino.
This year’s Medicare open enrollment period began on October 15 and runs through December 7. As a way to provide assistance and support to all Medicare beneficiaries, Independent Health has several Medicare Information Centers and ancillary sites currently open throughout the region, including new locations in Niagara Falls and Jamestown/Lakewood, as well as year-round sites in Cheektowaga/Depew, Orchard Park and Williamsville. According to Aquino, more than 260,000 Western New Yorkers have received the help they need by visiting our Medicare Information Centers since they first opened in 2007. Independent Health members are encouraged to visit one of these sites to receive a personalized, one-one-one RedShirt® Benefit review before the open enrollment period ends.
“Understanding Medicare can sometimes be complicated, and there are often different factors one must consider before enrolling in a plan,” said Aquino. “That’s why Independent Health has a dedicated staff of RedShirts who are always here to provide their support and expertise to our members, not only during open enrollment but throughout the entire year. It’s just one of the many ways we deliver the RedShirt® Treatment and one of the many reasons why more people choose us than any other Medicare Advantage plan in Western New York**.”
For more information about Independent Health’s 2019 Medicare Advantage plan options and Medicare Information Centers, visit www.independenthealth.com/Medicare.
Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS and PPO plans. Enrollment in Independent Health depends on contract renewal.
*Every year, Medicare evaluates plans based on a 5-star rating system.
**Per CMS WNY enrollment data 10/2018.