Skip to content

Medicare Star Ratings

What does it mean to be rated a Five (5) Star Plan?

A plan can get a rating from one to five stars. A 5-star rating is considered excellent.

What are the Medicare Star Ratings?

Medicare uses information from member satisfaction surveys, plans, and health care providers to give an over-all performance star rating to Medicare health and prescription drug plans. The overall plan rating gives you a single summary score that makes it easy for you to compare plans based on quality and performance. Our plan’s rating is measured on both the health and drug services that we cover.

The overall score for quality of health services covers 36 different topics in 5 categories:

Staying healthy
Includes frequency of screening tests, vaccines, and other check-ups that keep members healthy.

Managing chronic (long-term) conditions
Includes frequency of tests and treatments for members with chronic conditions.

Ratings of health plan responsiveness and care
Includes ratings of member satisfaction with the plan.

Health plan member complaints and appeals
Includes how often members filed a complaint against the plan.

Health plan telephone customer service
Includes how well the plan handles calls from members.

The overall score for quality of drug services covers 17 different topics in the following 4 categories:

Drug plan customer service
Includes how well the drug plan handles calls and makes decisions about member appeals.

Member experience with drug plan
Includes member satisfaction information.

Drug plan member complaints and Medicare audit findings
Includes frequency of member complaints about the drug plan and findings from Medicare’s audit of the plan.

Drug pricing and patient safety
Includes how well the drug plan prices prescriptions and provides updated information on the Medicare website.

Learn More about HealthSun's 5-star rating for 2021.

Learn More about HealthSun's 5-star rating for 2022.

What is the 5-star Special Enrollment Period?

The 5-star Special Enrollment Period provides an opportunity for you to switch to a 5-star Medicare Advantage plan without or with prescription drug coverage, or a 5-star Medicare stand-alone Prescription Drug Plan. You may use this 5-star Special Enrollment Period one time between December 8 and November 30 of the next year, provided you meet the plan’s enrollment requirements (e.g., living within the service area, meeting requirements regarding end-stage renal disease, etc). People enrolled in a plan with a 5-star overall rating may also switch to different plan with a 5-star overall rating.

Learn how you can enroll in HealthSun.

Learn More About Plan Ratings

Visit the Medicare Plan Finder Tool on www.medicare.gov to learn more about plans and see their ratings. You can find a plan’s overall rating on the Plan Results page or view a complete summary of all plan’s quality and performance ratings by clicking “Plan Ratings” on the Plan Results page.

Health Plan Accredited by AAAHC

HealthSun Health Plans is an HMO plan with a Medicare Contract and a Medicaid contract with the State of Florida Agency for Health Care Administration. Enrollment in HealthSun Health Plans depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. Star rating is for contract years 2018, 2019, 2020, 2021, and 2022. HealthSun complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-336-2069. (TTY: 1-877-206-0500). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-877-336-2069. (TTY: 1-877-206-0500).

Do you need to file a complaint? File your complaint online via CMS by submitting the Medicare Complaint Form. Should you need to file a complaint with Medicare you may do so by calling CMS at 1-800-Medicare.

Report suspected instances of FWA or any other non-compliance activity. For your convenience, you can call our Compliance Hotline at 1-844-420-0080 (USA and Canada only) available 24 hours a day and 7 days a week provided by LightHouse Services. Para español llama al 1-800-216-1288 (Si usted esta llamando desde México marque el 1-800-681-5340). You can also email issues to [email protected] or fax to 215-689-3885 (must include the company name on the email and fax).