Lumaktaw sa pangunahing content

Comparing Health Care Providers



How do I compare the quality fo Health Care Providers?
Medicare collects information about the quality and safety of medical care and services given by most health care providers (and facilities).

Check Medicare.gov/quality-care-finder and get a snapshot of the quality of care they give their patients. Some feature a star rating system to help you compare quality measures that are important to you.

Find out more by:

  • Talking to your health care provider. Each health care provider should have someone you can talk to about quality.
  • Asking your doctor or other health care provider what he or she thinks about the quality of care other providers give. You can also ask your doctor or other health care provider about the quality of care information you find on Medicare.gov.
Having access to quality and cost information upfront helps you get a complete picture of your health care options. You'll be able to compare quality ratings, cost information, and other details to help you get the best value for your health care.


How do I compare the quality of Medicare health and drug plans?
The Medicare Plan Finder at Medicare.gov/plan-compare features a star rating system for Medicare health and drug plans. The Overall Star Rating gives an overall rating of the plan's quality and performance for the types of services each plan offer.



For plans covering health services, this is an overall rating for the quality of many medical/health care services that fall into 5 categories and includes:


1. Staying healthy - screening tests and vaccines: Whether members got various screening tests, vaccines, and other check-ups to help them stay healthy.

2. Managing chronic (long-term) conditions: How often members with certain conditions got recommended tests and treatments to help manage their condition.

3. Member experience with the health plan: Member ratings of the plan.

4. Member complaints and changes int the health plan's performance: How often members had problems with the plan. Includes how much the plan's performance improved (if at all) over time.

5. Health plan customer service: How well the plan handles member calls questions.








For plans that cover the prescription drug, this is an overall rating for the quality of prescription-related services that fall into 4 categories and includes:

1. Drug plan customer service: How well the plan handles member calls and questions.

2. Member complaints and changes in the drug plan's performance: How often members had problems with the plan. Includes how much the plan's performance improved over time. 

3. Member experience with drug plan: Member ratings of the plan.

4. Drug safety and accuracy of drug pricing: How accurate the plan's pricing information is and how often members with certain medical conditions are prescribed drugs in a way that's safer and clinically recommended for their condition.


For plans that cover both health services and prescription drugs, the overall rating for quality and performance covers all the topics above. 

You can compare the quality of health care providers and Medicare plan services nationwide by visiting Medicare.gov or by calling your State Health Insurance Assistance Program (SHIP). 






Mga etiketa:

Mga Komento

Mag-post ng isang Komento

Mga sikat na post sa blog na ito

Durable Medical Equipment and Medicare

Medicare   Part B  covers the D urable Medical Equipment (DME).   These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home.  There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered. Eligible equipment Medicare’s DME benefit does not cover all medical equipment.  Medicare only covers DME if your  provider  says it is  medically necessary for use in the home . You also must order your DME from suppliers who contract with  Original Medicare  or your  Medicare Advantage  Plan . However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. DME coverage Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment...
Mag-post ng isang Komento
Magbasa nang higit pa

Everything you need to know: Medicare Dental Coverage

ADA, The American Dental Association said that individuals 60 and over face some rather unique dental concerns. Approximately one in four seniors have gone five years or more since their last dental visit and 16 percent in this age range consider their oral health as poor. Also, for instance, there are more than 500 medications that cause dry mouth, some of which were prescribed for high blood pressure, high cholesterol, Parkinsons's and Alzheimer's disease. This is now the common cause of cavities in older adults. Unfortunately, Medicare doesn't always help with this issue. In fact, according to Medicare.gov , this federal health insurance program typically does not cover dental care, procedures, or supplies. They don't provide benefits toward regular cleanings or services designed to treat and/or correct problematic oral issues, such as fillings or tooth extractions and they don't generally offer benefits for dental devices, including dentures and dent...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare Advantage Star Ratings

The Medicare Advantage and Part D star ratings for 2020 shows that more plans have 4 stars or higher star ratings this 2020 as compared to 2019. Also, there are more plans being offered to start on October 15.  According to the Centers for Medicare and Medicaid Services, there are about 1,200 more Medicare Advantage plans operating in 2020 than in 2018. Approximately 52 percent of contracts for Medicare Advantage plans offering Part D coverage earned 4 stars or higher, compared to about 45% in 2019. In the 401 contracts for 2020, 210 are at 4 stars or higher, compared to 172 in 2019 when there were only 376 contracts. Twenty contracts for MA and Part D earned 5 stars, 72 earned 4.5 stars and 118 earned 4 stars. This compares to 14 that earned 5 stars in 2019, 64 that earned 4.5 stars, and 94 that earned 4 stars last year. The comparison between 2020 and 2019 shows 55 contracts rated 3 stars for 2020 as opposed to 66 in 2019. The average star rating for 20...
Mag-post ng isang Komento
Magbasa nang higit pa