Why Medicare choice matters to you



How do you choose the right Medicare health plan? It’s a choice with big impact.

Consider a study published last year in Stroke, the Journal of the American Heart Association. It showed how one health care system was able to cut the death rate from stroke nearly in half.

Utilizing advanced information technology, Kaiser Permanente discovered that prescribing cholesterol-lowering medications for stroke patients while still in the hospital reduced the overall mortality rate from 11 percent to 6 percent, compared with waiting until the patients got home. It’s an example of how the highest quality health care systems proactively work to improve the lives of their members.

“People should look for a Medicare plan that focuses on prevention,” said Jeff Weisz, M.D., executive medical director of Kaiser Permanente Northwest. “That means you’ll get the health screenings you need that will catch cancer and other problems early, when we have a much better chance of saving lives.”

This fall, 49 million Americans — more than ever — will look for a Medicare or Medicare Advantage plan that is right for them. Since most of us don’t read scientific journals to find a health provider, here are four tips to help you find the best Medicare plan.

1) Know your health plan’s star quality rating. The Centers for Medicare & Medicaid Services assign an overall star rating to each Medicare plan for how well it performs. The Medicare ratings range from 1 star (lowest rating) to 5 stars (highest rating). The system rates plans on preventive care, managing chronic conditions, member satisfaction, customer

service and pharmacy care. Only 11 Medicare Advantage plans with prescription drug benefits out of 563 plans nationwide earned the top 5-star rating for 2013.

2) Use the Medicare ratings to find a quality plan. The highest-rated plans feature well-coordinated, patient-centered care. When seniors suffer from chronic illness or require hospitalization, high-quality plans initiate best practices and treatment to deliver excellent follow-up care. To find a plan’s star rating, visit www.medicare.gov/find-a-plan.

3) Look for customer service and responsiveness to your needs. The very best providers give patients tools to take charge of their health that include making online appointments, getting lab results electronically and providing secure email to their doctors.

4) You can choose 5-star excellence almost any time of year. Medicare’s Special Enrollment Period allows enrollment in a 5-star plan outside of the one-time annual enrollment period for most plans. Seniors who become eligible for Medicare as they turn 65 should enroll during the three-month period prior to and after their 65th birthday. After this initial enrollment period, they may be subject to higher premiums or late penalties if there has been a gap in their coverage. Learn more at www.medicare.gov. Plan performance summary star ratings are assessed by the Centers for Medicare & Medicaid Services each year and may change from one year to the next.

David Northfield is media relations manager for Kaiser Permanente in Portland.