US health agency releases 2025 quality ratings for Medicare plans

[BumRushDaShow]

Source: Yahoo! Finance/Reuters

Updated Thu, October 10, 2024 at 7:11 PM EDT


NEW YORK (Reuters) -The U.S. government announced quality ratings for 2025 Medicare health and prescription drug plans on Thursday, the first indication of which large health insurers, including CVS Health, UnitedHealth Group and Humana, will get bonus payments in 2026.

Sixty-two percent of people currently enrolled in Medicare Advantage plans that cover prescription drugs are covered by plans rated four or more stars, the Medicare agency said in its release, down from 74% last year. About 40% of plans being offered are four stars or higher, down from 42% in 2024.

The agency scores health plans between one to five stars, with five being the highest performing. Low ratings can discourage older Americans from renewing their Medicare coverage with certain insurers and reduce plan enrollments, said Joanna Gajuk, a research analyst at Bank of America, in a note.

Research firm KFF said in September that the government was on track to pay out nearly $12 billion in star ratings-related bonuses to Medicare Advantage plans in 2024.

Read more: https://finance.yahoo.com/news/us-health-agency-releases-2025-210339199.html

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Link to CMS FACT SHEET - 2025 Medicare Advantage and Part D Star Ratings

[et tu]

1. ok i'm not a math person

[so glad our fingers and toes are ten each- it helps lol]
but why is the government paying advantage plans bonuses?
shouldn't medicare be as inclusive as private advantage plans?
perplexed i am~

[BumRushDaShow]

2. "shouldn't medicare be as inclusive as private advantage plans?"

Look at what it took to even get Congress to insert a provision to allow HHS/CMS to negotiate prices for Medicare-eligible drugs.

Good luck with getting much more than that as a change until the GOP stops thinking of "people" as "chits" that take money out of corporate pockets.

Medicare Part C (Medicare Advantage) was established through H.R.2015 - Balanced Budget Act of 1997

(snip)

Title IV: Medicare, Medicaid, and Children's Health Provisions - Subtitle A: Medicare+Choice Program - Chapter 1: Medicare+Choice Program - Amends title XVIII (Medicare) of the Social Security Act (SSA) to establish a Medicare+Choice program under which each Medicare+Choice eligible individual (one entitled to benefits under Medicare part A (Hospital Insurance) and enrolled under Medicare part B (Supplementary Medical Insurance)) is entitled to elect, in accordance with certain procedures, to receive Medicare benefits either through the original Medicare fee-for-service program or through a Medicare+Choice plan.

(snip)

[et tu]

5. thank you!

ok let's go brandon- universal health care!?!?

[PatrickforB]

10. Well, you know healthcare is my hot button and I have taken flack on here when I make my pronouncements

about Medicare for all Americans, but that is what we need. I remember 1997 and the do-nothing GOP Newster House.

These turkeys have been screwing us over for decades, DECADES, ever since the Social Security Act passed back nearly 100 years ago, Wall Street has been trying to get control over it so they can earn PROFITS by creating speculative bubbles (can anyone say 'age-based derivatives bundles?'). And in 1965 when Medicare passed, we all supposedly became commies.

And these Medicare Advantage programs are gradually covering less and charging more, cause profits are everything and we are merely cash cows for these billionaire Wall Street greed lizard parasites until we can't pay anymore, then they hope we won't die too painfully, though they don't really care. Once we've paid out our entire estate to this for-profit healthcare system (and I include nonprofits like Sisters of Catholic Charity and Kaiser in that, too, because they are all about maximizing retained earnings), then we are just dried up husks who had better die as soon as possible so we aren't a bother to CEOs and shareholders.

I'm with Bernie on this one, and like AOC, I believe that billionaires are parasites on our body politic who should be taxed out of existance. Which is why so many billionaires are for Trump.

No, our healthcare system SUCKS, even the ACA nowadays because these insurance companies are charging the absolute MAX they can get away with.

The PROFIT MOTIVE is in direct conflict with our best interests as patients. It is. This is a role for government if there ever was one.

[BumRushDaShow]

11. The mechanism to phase it in is already there

The thing is to be able to expand CMS with the staff needed to handle it.

[PatrickforB]

12. Now you're talkin! Let's hope the headline on November 6 is 'MANDATE' and that Kamala and the Dems

have the Senate, House AND the White House.

[ampm]

3. Every year I get flooded

Medicare Advantage programs are terrible. We need better choices for Medicare programs. I get flooded every year with phone calls and mailers trying to get me into one. Your choices are in-network doctors, and if you need a specialist, good luck. Also, your out-of-pocket expenses are high. We need more than a rating we need more upfront information on what's not covered

[travelingthrulife]

13. There should be no out of pocket expenses when you are paying a premium every month

Medicare is really screwed up with private insurers in the mix. Every year old people get to try to be their own HR department with complex choices and far too many choices, most of which are just a rip off anyway. How about one choice that covers everything. Human bodies get sick.
Medicare used to function well with 3% overhead

[hlthe2b]

4. Marked for later...

[LtTx]

6. Mine dropped from 5 star to 4.5

It has been 5 star for at least the last 10 years. Bought by Cigna last year (was KelseyAdvantage- specific to the Houston metro area)
Out of pocket is also going up from 3400 to 4450.

I am seriously considering going to Medicare with a Medigap plan (I will be able to do this as I am moving from the coverage area) so no underwriting. Medigaps are about 150-200 for the plan I would want. Advantage plans in the new area are even worse than the ones in Houston. The lowest out of pocket I could find was 5900!

[ampm]

7. I'm staying with my medigap

I have friends who are on medicare advantage and if they go out of network they have to pay now some of our doctors aren't taking Medicare Advantage so they're stuck. We need universal health.

[mahina]

8. Good to know. Which medical did you choose? How did you decide? I am at sea.

Thank you.

[PatrickforB]

9. Hey, I have an idea! How about automatic complete Medicare coverage, including dental, vision and

prescription drugs for ALL AMERICANS??????????????????

Gosh, then it wouldn't be like a graduate level chemistry exam to enroll in Medicare (why is it so HARD????).

Same with Social Security. It ought to happen automatically. We shouldn't even have to think about it, or apply, and coverage should be automatic.

Because from an end-user perspective, the enrollment process is very confusing. Thanks to years of Republicans weakening these programs a line at a time.

Cause don't you know, Wall Street just needs more PROFITS, and everyone knows that PROFITS are FAR more important than human life!