When presenting a Medicare Advantage plan with a 5-star rating for customer service and care coordination and an overall plan performance rating of 4 stars, which statement best describes how to respond to a beneficiary?

• A. The plan has an overall rating of 5 stars.
• B. The Medicare Advantage plan received a 5-star rating in customer service and care coordination with an overall performance rating of 4-stars.
• C. The plan has 4 stars in customer service.
• D. The plan has 5 stars in cost sharing.

Answer: (B)

Medicare Advantage plan star ratings come from different categories, and each category is reported separately. In this scenario, the plan has a 5-star rating for customer service and care coordination, while the overall plan performance rating is 4 stars. That means you should describe both pieces of information together, accurately reflecting each rating without mixing them.

That’s why the best statement is that the plan received a 5-star rating in customer service and care coordination with an overall performance rating of 4 stars. It conveys the high performance in one area while noting the slightly lower overall performance, giving the beneficiary a precise picture.

It wouldn’t be correct to say the plan has an overall rating of 5 stars, or that it has 4 stars in customer service, or that it has 5 stars in cost sharing, because those statements would misrepresent the documented ratings. Also, there’s no provided information about cost sharing, so that aspect isn’t part of the accurate description.