Georgia Medicare Star Ratings: How to Choose a Plan

Medicare Star Ratings score every Medicare Advantage and Part D plan in Georgia from one star (poor) to five stars (excellent). It is the federal government's yearly report card on plan quality, published each fall next to every plan on the Medicare Plan Finder so you can weigh quality against price and benefits before you enroll. More than half of Georgia's Medicare beneficiaries, 1,132,430 of 2,019,345 as of March 2026, are enrolled in a Medicare Advantage or other health plan rather than Original Medicare, so for most Georgians the Star Rating is the fastest quality signal on the page. If you have both Medicare and Georgia Medicaid, ratings still matter, but your plan choices route through Dual Eligible Special Needs Plans and a separate set of monthly enrollment windows built for dual-eligible beneficiaries.1,2

How do Medicare Star Ratings work in Georgia?

Each year the Centers for Medicare and Medicaid Services (CMS) rates every Medicare Advantage (Part C) and Medicare Part D contract on a one-to-five scale, where one star means poor performance and five stars means excellent. CMS builds each contract's overall rating from a set of quality and performance measures, using statistical thresholds called cut points, and it lets you compare that rating next to a plan's benefits and costs on the Medicare Plan Finder at medicare.gov/plan-compare.1

Ratings are set fresh every fall and apply to the coming plan year, so a plan that earns four stars one year can rise or fall the next. That is why a rating you checked two years ago is not a safe guide today, and why CMS also flags a consistently weak plan with a low-performer icon on the Plan Finder. Five stars remains uncommon: for the 2026 ratings released October 9, 2025, only 18 contracts across the country, about 3.5 percent of all contracts, reached a five-star overall rating.1

Why do Georgia Medicare Star Ratings matter?

Most Georgians on Medicare are in a Medicare Advantage plan rather than Original Medicare. As of March 2026, CMS counted 2,019,345 people with Medicare in Georgia. Of those, 1,132,430 were enrolled in Medicare Advantage and other health plans and 886,915 stayed in Original Medicare, so more than half the state's beneficiaries are in a plan that carries a Star Rating. Every Medicare-eligible Georgian has access to at least one zero-premium Medicare Advantage plan for 2026, and CMS counts 180 Medicare Advantage plans available statewide for 2026, up from 178 in 2025. A KFF analysis of the CMS landscape files, which counts only plans open to general enrollment, puts the average Georgia beneficiary's actual choice at 47 plans offered by an average of 8 insurers. Either way the list is long, so the Star Rating is often the clearest way to tell strong plans from weak ones.2

The rating also signals what a plan can afford to offer. Under the Affordable Care Act, contracts rated four or five stars receive quality bonus payments, which plans can use to hold down premiums or add benefits Original Medicare does not cover. That is part of why a higher-rated Georgia plan often carries a richer dental, vision, hearing, or over-the-counter benefit than a lower-rated one at the same price. Every Medicare Advantage plan also caps your in-network out-of-pocket spending, federally limited to $9,250 for Part A and Part B services in 2026, while Original Medicare has no such cap.1,4

What do Star Ratings mean if you have both Medicare and Medicaid?

Georgians who have both Medicare and full Georgia Medicaid, known as dual eligibles, can enroll in a Dual Eligible Special Needs Plan (D-SNP), a type of Medicare Advantage plan built to coordinate the two programs. D-SNPs operating in Georgia for 2026 include plans from UnitedHealthcare Community Plan and CareSource. A D-SNP is scored on the same one-to-five Star Rating scale as any other Medicare Advantage plan, so the rating on the Plan Finder applies to the D-SNP you are considering too.5

Special Needs Plans come in three forms: Chronic Condition SNPs (C-SNPs) for people with qualifying conditions such as diabetes or chronic heart failure, D-SNPs for people with both Medicare and Medicaid, and Institutional SNPs (I-SNPs) for people who live in or need an institutional level of care. All are Medicare Advantage plans, so they must cover everything Original Medicare covers and add condition-specific benefits.5

For a full-benefit dual eligible, the cost math is different from a typical shopper's. Because Medicare providers are not allowed to bill enrollees in the QMB program for services and items Medicare covers, and Extra Help zeroes out Part D drug cost-sharing, a QMB-enrolled dual in a D-SNP faces $0 Medicare deductibles, coinsurance, and copays. Most integrated D-SNPs are also offered with a zero-dollar monthly premium, though that is a plan-design feature rather than a legal guarantee.6

Georgia's dual-eligible integration is more limited than in states that run a single fully integrated Medicare-Medicaid plan. Most long-term services and supports for older adults are delivered through Georgia's home- and community-based waivers, the Community Care Services Program (CCSP) and SOURCE, rather than through one integrated plan. The Georgia Department of Community Health also placed a moratorium on contracting with new D-SNPs effective August 1, 2025, while keeping existing D-SNP contracts in place, so the roster of available D-SNPs is narrower than the open Medicare Advantage market.5

Which enrollment window can you actually use to act on a rating?

A high or low Star Rating is only useful if you have a window to act on it. Georgians have several, and dual-eligible beneficiaries have two extra monthly windows that most shoppers do not. The Annual Election Period is the main yearly window; the 5-star Special Enrollment Period is the one tied directly to ratings.

The 5-star SEP is powerful but narrow: it only lets you move into a plan that currently holds a five-star overall rating, and it can be used just once in the December 8 to November 30 window.1 Since the 2025 contract-year rule (CMS-4205-F, effective January 1, 2025), full-benefit dual eligibles and Extra Help recipients no longer wait for a quarterly window. They can elect a standalone Part D plan once a month, and if they are enrolled in the affiliated Medicaid managed care plan, they can join an aligned integrated D-SNP once a month, each effective the first of the following month.3,7 The standard windows, the Annual Election Period and the Medicare Advantage Open Enrollment Period, still apply to everyone.8

How Medicare Savings Programs and Extra Help protect dual-eligible Georgians

For a dual eligible, a plan's Star Rating matters less for out-of-pocket cost than it does for a typical shopper, because Georgia's Medicare Savings Programs already absorb most Medicare cost-sharing. The Qualified Medicare Beneficiary (QMB) program pays the Part B premium, which is $202.90 a month in 2026, along with the $283 annual Part B deductible and Medicare coinsurance, so a QMB enrollee's Medicare cost-sharing is effectively zero.9,10

Georgia applies the federal Medicare Savings Program standard through the Division of Family and Children Services, with an asset test. For 2026 the resource limit for all three programs is $9,950 for an individual and $14,910 for a couple. That is the federal standard rather than an absolute cutoff, because states can disregard income and resources on top of it, so apply rather than rule yourself out. Enrollees in QMB, the Specified Low-Income Medicare Beneficiary (SLMB) program, or the Qualifying Individual (QI) program are automatically eligible for the Part D Extra Help (Low-Income Subsidy), which carries its own higher resource limits of $16,590 for an individual and $33,100 for a couple.9,10 Because this cost protection travels with you across plans, a dual eligible can weight a plan's Star Rating and its care coordination more heavily than its price when comparing D-SNPs.

Low-performing plans, and what changes for D-SNPs in 2027

CMS does not only reward strong plans; it flags weak ones. When a contract earns fewer than three stars for three years in a row, the Medicare Plan Finder marks it with a low-performer icon, a clear signal to look elsewhere before you enroll.1

Two changes taking effect for contract year 2027 reshape how integrated D-SNPs work in Georgia. First, certain integrated D-SNPs must issue a single member ID card that serves as the card for both the Medicare and Medicaid plans, and must run one integrated health risk assessment instead of two, finalized in the 2024 Medicare Advantage and Part D final rule (CMS-4201-F). Second, exclusively aligned enrollment provisions at 42 CFR 422.514(h), adopted in the CY2025 final rule (CMS-4205-F), limit enrollment in certain D-SNPs to people also enrolled in an affiliated Medicaid managed care organization, and cap how many such plans an insurer can offer in the same area.11 For dual-eligible Georgians, that means the D-SNP you can pick will increasingly be tied to the Medicaid plan you are already in, so checking both the Star Rating and the alignment matters.

How to check a Georgia plan's Star Rating and switch

Start at the Medicare Plan Finder at medicare.gov/plan-compare. Enter your ZIP code, and every Medicare Advantage and Part D plan available to you appears with its overall Star Rating shown up front; you can sort or filter by rating, premium, or drug coverage, and each plan's detail page shows its category scores.1 If you find a stronger plan, use the right window: the Annual Election Period runs October 15 through December 7 for a January 1 start, and people already in a Medicare Advantage plan get one more change during the Medicare Advantage Open Enrollment Period, January 1 through March 31. Dual eligibles can also use their monthly windows described above.8

For free, unbiased help, contact GeorgiaCares, Georgia's State Health Insurance Assistance Program, at 1-866-552-4464. GeorgiaCares counselors do not sell insurance and can walk you through Star Ratings, plan comparisons, Extra Help, Medicare Savings Programs, and enrollment strategy.12

How this plays out in Georgia

The following are illustrative examples, not real cases, meant to show how the windows fit together.

Example #1: a dual eligible in metro Atlanta. A full-benefit dual eligible is enrolled in an integrated D-SNP through her Medicaid managed care plan. Checking the Plan Finder in April, she sees her D-SNP now carries a low-performer icon. Rather than wait for fall, she uses the monthly Integrated Care Special Enrollment Period to move to a higher-rated aligned D-SNP, effective the first of the next month, keeping her $0 Medicare cost-sharing throughout.3

Example #2: a non-dual beneficiary in Savannah. A Medicare Advantage enrollee who does not have Medicaid finds that a five-star plan is now offered in his county. He uses the 5-star Special Enrollment Period, available once between December 8 and November 30, to switch into it without waiting for the Annual Election Period. He cannot use that window again until the next ratings release.1

Learn More

Find personalized help comparing Georgia Medicare plans by Star Rating at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.