The Med Diva

An insider's guide to Medicare Part D and more

Archive for the category “Five-Star Special Enrollment Period”

Don’t Settle for Lousy Customer Service in Your Medicare Plan.

Don't settle for a bad Medicare plan

Don’t get stuck in a jam if you don’t like your Medicare plan.

I recently came across a slew of complaints about the SilverScript Medicare Part D plan on the Complaints List website. (SilverScript is sponsored by the SilverScript Insurance Company, which is an affiliate of CVS Caremark.) The majority of complaints were about the drug plan’s customer service – or alleged lack thereof.

For example, Rita posted this complaint:

I’ve been treated rudely, after waiting on hold for an hour plus, sent to someone else after another 45 minutes, then that person said to hold and hung up on me. There should be a law about these customer service people treating the disabled elderly with more respect. Their day will come too. I feel as if they don’t care if we live or die and if we die without our meds they would be happy.

Now, I need to point out that last month the Centers for Medicare and Medicaid Services took action against SilverScript for issues related to claims processing (for example, some claims for new members were being rejected at pharmacies). Many of the complaints on the Complaints List website may be tied to this claims processing issue; however, it appears that the SilverScript customer service reps have not been properly trained on how to help people and treat them with respect.

No one should have to deal with horrible customer service. That’s why Medicare has established a 5-star special enrollment period.

Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. As I’ve mentioned before, low star ratings typically mean lower quality and poor customer service.

Last year SilverScript earned only 3 stars from Medicare. This was the lowest star rating among the top 10 Medicare Part D plans in 2012. Based on all the complaints I’ve read, it won’t surprise me if the plan’s ratings drop even lower for 2013.

Here’s the good news for Rita and everyone else who has complaints about his or her Medicare plan: You may not have to settle for a plan with bad customer service all year long. That’s because you can switch to a 5-star Medicare Prescription Drug Plan or Medicare Advantage Plan if you are not happy with your current plan. The Special Enrollment Period for joining a 5-star plan runs from December 8 through November 30 every year.

Although very few plans have earned a 5-star rating from CMS this year, if you’re fortunate enough to find one that serves your area, you can disenroll from your current plan if you’re not satisfied and join a plan that has earned 5 stars.

Use the following resources to get plan ratings:
• The overall plan star ratings are available at the Medicare Plan Finder.
• You can call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• You can download the Medicare fact sheet, which has additional information about star ratings.


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