Medicare Advantage Star Ratings: How to Read Them

Medicare Advantage star ratings are a yearly report card from the federal government. The Centers for Medicare & Medicaid Services (CMS) scores Medicare Advantage and Part D plans from 1 to 5 stars, and 5 is the best. CMS rates each contract on up to 43 measures if it offers both medical and drug coverage, up to 33 if it offers medical coverage only, and up to 12 for a standalone Part D plan. The stars are a useful first filter. They are not a promise about your own care, and a 5-star plan can still be the wrong plan for you.

This guide explains what goes into the score, what the latest results look like, and where the system falls short. It also covers the one-time 5-star enrollment option and a practical way to use all of it during this fall’s open enrollment.

Almond Insurance

Look Beyond the Star Rating

Almond Insurance helps you compare Medicare plans against your individual needs, with personalized advice and clear explanations.

Explore Medicare guidance

TL;DR

Stars run from 1 (poor) to 5 (excellent) and are published by CMS each year. They cover Medicare Advantage (Part C) and Part D drug plans.
Ratings belong to a contract, not to the exact plan you are looking at. One contract can hold several plans with different networks and benefits.
A 5-star plan in your area lets you switch once, between December 8 and November 30 of the following year. Switching from a plan with drug coverage to one without can cost you your drug coverage.
Use stars to narrow the list. Then check your doctors, your prescriptions and your out-of-pocket costs.

What the star ratings measure
What the stars mean at a glance
What the latest ratings show
Why insurers care so much about stars
The limits of the system
The 5-star enrollment option
How to use star ratings this fall
Questions to ask beyond the stars
Get help comparing plans
FAQ
Sources

What the star ratings measure

The rating answers one question: how well does this insurance company’s contract perform for its members? The score blends several kinds of information:

Health outcomes and screenings, such as whether members get preventive care and how well chronic conditions are managed.
Member experience, drawn from surveys of people enrolled in the plan.
Customer service, including how quickly the plan handles calls, appeals and complaints.
Drug plan performance, such as pharmacy services and whether members take their medications as prescribed.

The number of measures depends on the contract type. As noted above, the CMS 2026 fact sheet lists up to 43 for plans that bundle medical and drug coverage, up to 33 for medical-only contracts and up to 12 for standalone drug plans.

The rating you see on Medicare.gov is an overall number, usually in half-star steps, so a plan can be a 3.5 or a 4.5. The overall number hides the detail. A plan can score well on member satisfaction and poorly on, say, getting appeals resolved on time. If a measure matters to you, look at the individual scores.

What the stars mean at a glance

Stars	Plain-English meaning
5	Excellent performance
4 to 4.5	Above average to very good
3 to 3.5	Average
1 to 2.5	Below average to poor

The scale is relative to how other plans do that year, so the same underlying care can score differently from one year to the next.

What the latest ratings show

Five-star plans are rare, and the number swings from year to year. According to a summary of the 2026 results, CMS released the ratings on October 9, 2025. Eighteen of the 516 rated Medicare Advantage contracts earned 5 stars, compared with seven the year before and 38 in the 2024 ratings. The same summary put the average score at 3.65, down from 3.92.

Two lessons follow. First, a rating is a snapshot, and plans move up and down. Second, the list of 5-star plans in a given county may be empty. In many parts of the country, no Medicare Advantage plan reaches 5 stars at all.

CMS publishes new ratings every fall, just ahead of open enrollment. Check the current year’s number on Medicare.gov’s Plan Finder rather than relying on an article’s snapshot, including this one.

Why insurers care so much about stars

Stars are tied to money. Under the Quality Bonus Program, plans rated 4 stars or higher receive a bonus that raises their payment benchmark. KFF projects federal spending on these bonuses at no less than $13.4 billion in 2026, and says 64% of Medicare Advantage enrollees are in plans receiving them.

Plans can use that extra payment to offer benefits such as vision, hearing and dental, or to lower Part B premiums. That is a real advantage for members. It also means plans work hard to earn and market their stars, and an advertisement that says “4-star plan” is telling you about a payment tier as well as quality.

The limits of the system

Stars help, but you should know where they mislead.

Ratings belong to contracts, not plans

This is the one that trips people up. Star ratings are reported at the contract level, and one contract often includes several plans with different networks, benefits and service areas. The 4.5 you see for a plan may reflect members in a different county, using a different set of hospitals, than the ones you would use.

The Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress, has made the same point. It has said that contract-level reporting can hide large differences between plans within one contract. It has also raised concerns that the measures do not fully account for social risk factors and that there are too many of them.

Some plan types fit poorly

MedPAC has also noted that the ratings are a poor fit for institutional special needs plans. They serve people who often cannot take part in the surveys that feed the score. If you or a loved one is considering a special needs plan, read its stars with extra caution.

The formula keeps changing

CMS adjusts the methodology regularly. In its contract year 2027 final rule, the agency is removing 11 administrative process measures that people found hard to use when telling plans apart. It is shifting the focus toward clinical care and patient experience. That should make the ratings easier to interpret over time, but it also means a plan’s rating may not be directly comparable with its rating from a few years ago.

Stars say nothing about your doctors or your drugs

A 5-star plan that leaves your cardiologist out of network is a bad plan for you. A 3.5-star plan with your specialists, your pharmacy and a low drug bill may be the better pick. Stars measure the contract’s average performance, not how well it fits one person.

The 5-star enrollment option

Medicare gives you a special way to move into a top-rated plan. If a 5-star Medicare Advantage plan, drug plan or cost plan is available where you live, you can use the 5-star Special Enrollment Period to join it. The window runs from December 8 to November 30 of the following year, and you get one change in that time.

Three things to know before using it:

It is one switch, not a rolling permission. You cannot hop to each new 5-star plan as ratings change. Choose carefully.
Watch your drug coverage. Medicare cautions that if you leave a Medicare Advantage plan with drug coverage for a 5-star plan without it, you may lose your drug coverage and face late enrollment penalties later.
Confirm the details before you move. Check that your doctors, hospitals and prescriptions are covered by the specific plan, not just the contract’s rating.

If you are comparing this option with your regular choices, our plain-language guide to Medicare enrollment periods shows how the windows fit together.

How to use star ratings this fall

The Medicare annual enrollment period runs from October 15 to December 7, so it is open now. Here is a sequence that works.

List what you cannot give up. Write down your doctors, your hospital, your pharmacy and every prescription with its dose.
Pull up plans in your county. Use Plan Finder with your ZIP code, and note the overall star rating of each Medicare Advantage and Part D option.
Use stars to trim, not to decide. Drop plans rated under 3 stars unless something specific makes them worth a look. Keep the 4-plus-star plans and the average plans that cover your doctors.
Check the individual measures. If you take many medications, look at the drug plan scores. If you worry about care access, look at the member experience and complaint measures.
Compare total cost, not premiums. A $0 premium can sit beside high copays and a large out-of-pocket maximum. Our piece on the Medicare Advantage out-of-pocket cap explains what the cap does and does not include.
Compare against Medigap. Original Medicare with a Supplement plan works differently from Advantage, and stars do not apply to Medigap policies at all. See Medicare Advantage vs. Medicare Supplement for the trade-offs.
Ask about changes for next year. Plans can change networks, benefits and drug lists every January. Read the Annual Notice of Change that your current plan mails to you.

Questions to ask beyond the stars

Stars rarely answer the questions that cause regret later. Before you enroll, ask:

Is each of my doctors and my preferred hospital in network, and is the plan an HMO or a PPO?
Does the plan require referrals or prior authorization for the services I use most?
What is the maximum I could pay out of pocket in a bad year?
Are all my prescriptions on the drug list, and at what tier?
If I travel or spend winters elsewhere, what coverage do I have away from home?

If you are unsure whether a stay will be billed as inpatient or observation, or what skilled nursing care might cost, our explainer on observation versus inpatient status is worth a read before you pick a plan.

Get help comparing plans

We are a Medicare insurance agency in Rockford, Illinois. We help people in Northern Illinois and Southern Wisconsin compare Medicare Advantage, Medicare Supplement and Part D plans, and we explain each option in plain language. We can check your doctors and prescriptions against the plans in your county, and show you where the stars help and where they don’t. You do not pay us directly for this guidance. Carriers compensate us when a client enrolls in a plan through us.

You can start with our Medicare Advantage and Medicare Supplement comparison service, or read about Medicare Advantage guidance first. If your main worry is prescription costs, our Part D prescription review is the place to begin.

Free, non-commercial counseling is also available in Illinois through the Senior Health Insurance Program (SHIP), whose volunteer counselors do not sell insurance. It is a good second opinion.

FAQ

Is a 5-star Medicare Advantage plan always the best choice?

No. The rating describes how a contract performs on average, not whether it covers your doctors, your drugs and your budget. A 5-star plan with the wrong network can cost you more and frustrate you more than a 4-star plan that fits. Use stars to narrow your list, then test the finalists against your own needs.

How often are star ratings updated?

CMS publishes new ratings every year, in the fall before open enrollment begins. The most recent set I could confirm, for 2026, was released on October 9, 2025. Look up the current numbers on Medicare.gov because a plan’s score can rise or fall by a half star or more from one year to the next.

Can I switch to a 5-star plan any time of year?

Yes, but only once. If a 5-star plan is available in your area, the special enrollment period lets you make one change between December 8 and November 30 of the next year. Be careful if your current plan includes drug coverage, because moving to a plan without it could leave you without drug coverage and open to late penalties.

Do star ratings apply to Medicare Supplement plans?

No. Stars apply to Medicare Advantage and Part D plans. Medigap policies are standardized by letter, so the benefits are the same from one company to the next. What differs is price and the insurer’s service. Our guide to Medicare Supplement and Medigap explains how to compare them.

Where do I find my plan’s star rating?

Use Plan Finder on Medicare.gov, enter your ZIP code and your drugs, and the rating appears beside each plan. You can also call 1-800-MEDICARE. If you would rather have someone go through the results with you, we can do that at no direct cost to you.

Medicare Advantage Star Ratings: How to Read Them