How can you find out about the quality of a Medicare health care plan before you buy it? That’s where Medicare Star Ratings come in. Whether you're enrolling in Medicare for the first time or looking to switch plans, these ratings provide a clear, simple way to understand how different plans measure up.
Read on to learn about the Medicare Star Ratings, including how they work, what they measure, and how to use them to evaluate Medicare Advantage and Medicare Part D plans for the 2027 coverage year.
What are the Medicare Star Ratings?
The Star Ratings system was developed by the Centers for Medicare & Medicaid Services (CMS). It rates Medicare Advantage (Part C) and prescription drug (Part D) plans on a 5-star scale with 1 being the lowest score and 5 being the highest score.
| Medicare Star Ratings Scale | |
| ⭐⭐⭐⭐⭐ | Excellent |
| ⭐⭐⭐⭐ | Above average |
| ⭐⭐⭐ | Average |
| ⭐⭐ | Below Average |
| ⭐ | Poor |
Ratings focus on health plan quality based on measurements of customer satisfaction and the quality of care a plan delivers.
The goal of Star Ratings is to improve the quality of care and general health status for people with Medicare. This rating system also supports the efforts of CMS to improve the level of accountability for the care provided by physicians, hospitals, and other providers.
While Star Ratings can be a valuable comparison tool, they should be reviewed alongside premiums, deductibles, provider networks, prescription drug coverage, and out-of-pocket costs.
"Medicare Star Ratings give you a quick snapshot of how a plan performs based on factors like quality of care, how satisfied members are, and customer service,” explained Ryan Ramsey, a Medicare expert and NCOA Associate Director of Health Coverage and Benefits. “While a high star rating shouldn't be the only thing you look at when choosing a plan, it's a good tool for comparing plans and narrowing down your options."
How do I find a Medicare Star Rating?
You can find the Star Ratings for current Medicare Advantage or Part D plans by using the Medicare Plan Finder tool. Five-star plans will have a special star icon beside them. CMS reviews and updates Star Ratings annually. New Star Ratings are published each fall and appear in the Medicare Plan Finder before the annual Open Enrollment Period, helping beneficiaries compare plan quality alongside coverage and costs.
If plans are new to the marketplace, they will not have ratings.
What do Medicare Star Ratings measure?
For Medicare Advantage, plans are given an overall star rating based on five unique categories:
- Member experience with the health plan: This is measured by members' personal reviews of a plan.
- Customer service: This is based on how well the plan responds to and handles member complaints and appeals.
- Plan performance: This focuses on member complaints and changes in the plan’s performance. It includes how often Medicare found problems with the plan, how often members had problems with the plan, and how much the plan's performance has improved over time, if at all.
- Chronic conditions: This is based on how often members with certain long-term conditions were recommended tests and treatments to help manage their condition.
- Staying healthy: This category measures whether members received various screening tests, vaccines, and preventive check-ups to help them stay healthy.
CMS updates the methodology periodically to improve measurement of plan quality. It has also finalized future updates that place greater emphasis on clinical outcomes, patient experience, and meaningful measures of care quality while reducing reliance on certain administrative measures.
For Medicare Part D (prescription drug coverage), plans are given an overall star rating based on four categories:
- Member experience with the drug plan: This is based on members' personal reviews of the Part D plan.
- Customer service: This measurement is based on how well the plan manages member complaints and claim appeals.
- Plan performance: This focuses on member complaints and changes in the plan’s performance. It includes how often Medicare found problems with the plan, how often people had problems with the plan, and how much the plan's performance has improved (if at all) over time.
- Drug safety and pricing: This category measures how accurate the plan’s pricing information is, and how often people with certain medical conditions are prescribed drugs in a way that is safer and clinically recommended for their condition.
How do Medicare Star Ratings help me compare plans?
Medicare Star Ratings provide additional points of comparison, along with costs and coverage, when you’re shopping around for a Medicare plan. A 5-star rating is considered excellent. Medicare plans with fewer than 3 stars are generally considered below-average performers. You should closely review alternatives and compare quality, provider networks, prescription coverage, and costs.
Star Ratings not only help consumers compare plans; they also encourage health plans to improve quality and member experience through CMS's quality incentive programs.
What is the 5-star Special Enrollment Period?
If there’s a 5-star Medicare Advantage plan or Part D drug plan available in your area, you can use what’s called the 5-Star Special Enrollment Period to switch from your current Medicare plan to a Medicare plan with an excellent Medicare Star Rating. You can take advantage of this opportunity only once between Dec. 8 (after the Open Enrollment Period) and Nov. 30 of the following year.
Other periods in which you can enroll in a Star-Rated Medicare Advantage or Part D plan include:
- Initial Enrollment Period: This period is for people who are new to Medicare. It takes place during the three months before, the month of, and the three months after your 65th birthday.
- Open Enrollment Period: This takes place Oct. 15–Dec. 7 annually, for those already enrolled in Medicare and who want to switch plans.
- Special Enrollment Period: These are opportunities older adults have outside of the Initial and Open Enrollment Periods to change Medicare Advantage plans, if they meet certain conditions.
When is my Special Enrollment Period?
What is the Special Enrollment Period for Disenrollment?
Medicare sends a notice to beneficiaries enrolled in plans that have received overall ratings below 3 stars for three consecutive years. This notice encourages members to review and compare other available plans.
If you're enrolled in a lesser-rated Medicare Advantage or Part D plan, are you stuck with it? Luckily, the answer is no. Beneficiaries enrolled in plans that receive fewer than 3 stars for three consecutive years may qualify for a Special Enrollment Period for Disenrollment that allows them to switch to a higher-rated plan. You can also switch to a newer Medicare plan that has not yet been rated.
Keep in mind: For both of these Special Enrollment Periods, you may lose your Part D coverage if you move from a Medicare Advantage plan that has drug coverage to a 5-star Medicare Advantage Plan that does not have this coverage. You may have to wait until the next Open Enrollment Period to get drug coverage, and you may end up with a late enrollment penalty. The Part D late enrollment penalty is a monthly add-on premium calculated as 1% of the current national base beneficiary premium multiplied by the number of uncovered months, rounded to the nearest 10 cents. Learn more about Medicare Advantage Special Enrollment Periods and Medicare Part D Special Enrollment Periods.
Who can help me choose the right Medicare plan?
If you’re wondering, “How do I get unbiased Medicare advice?”, a great place to start is contacting your local State Health Insurance Assistance Program (SHIP). Find your local SHIP here.
SHIPs offer unbiased Medicare counseling provided by trained staff members and volunteers. Your SHIP counselor can walk you through your options for Medicare coverage and help you identify the plan(s) that best fits your needs. They can also help you apply for benefits that can save you money on your Medicare costs, such as Medicare Part D Extra Help or the Medicare Savings Programs (MSPs).
Frequently asked questions
How do Medicare Star Ratings work?
The Centers for Medicare & Medicaid Services (CMS) assigns Star Ratings to Medicare Advantage and Part D plans each year based on factors such as quality of care, customer service, member satisfaction, and how well the plan helps its members stay healthy. Plans receive an overall rating from 1 to 5 stars, with 5 stars representing the highest quality.
What is a good Medicare Star Rating?
In general, a plan with 4 or more stars is considered above average, while a 5-star plan is Medicare's highest rating. While a higher rating is a good sign, it shouldn't be the only factor you consider when you’re shopping around. You should still compare the plan's costs, provider network, prescription drug coverage, and benefits to make sure it aligns with your health needs and finances.
How often are Medicare Star Ratings updated?
Medicare Star Ratings are updated once a year. CMS evaluates Medicare Advantage and Part D plans annually and releases new ratings before the Medicare Open Enrollment period (Oct. 15 – Dec. 7). Since a plan's rating can change from year to year, it's a good idea to review the latest Star Rating each time you're comparing plans.
