You found a Medicare plan in your area with a perfect 5-star rating, and you'd like to switch to it, except Open Enrollment ended months ago. There's a window built for exactly this. It's called the 5-star Special Enrollment Period, and it lets you move to a top-rated plan once a year, outside the usual sign-up seasons. There's one thing to check before you jump, though, and it can cost you real money if you skip it.

In This Guide

What a 5-Star Rating Actually Means

Every contract year, Medicare assigns each Medicare Advantage and Medicare drug plan an overall performance rating, and a 5-star overall rating is the highest one a plan can earn. Think of it as Medicare's own report card on a plan: how members rate it, how well it manages care, how it handles complaints and customer service.

A couple of things are worth knowing about that number. A plan's rating is set for a specific contract year, so a plan that's 5 stars this year might not be next year, and the SEP is tied to the year the plan earned the top rating. And the rating that matters here is the overall star rating, not a rating on one slice of the plan. If you want the full breakdown of how Medicare's star ratings are scored and where to look one up, we've got a separate guide for that.

The short version: a 5-star plan is Medicare telling you this is one of its best-performing options in your area. The 5-star SEP is the reward that comes with it, a chance to move to that plan without waiting for the next enrollment season.

The Medicare 5-Star Special Enrollment Period Window: December 8 to November 30

Here's how the timing works. The 5-star SEP opens on December 8 and stays open through November 30 of the following year, and you can use it only once during that stretch. So it's a long window, almost a full year, but it's a one-shot benefit: use it to make one switch, and you're done until the next window.

That's genuinely different from the enrollment periods most people know. During the Annual Enrollment Period each fall, you can change plans as many times as you like, and only your last choice sticks. The 5-star SEP isn't like that. You get one move, so make it count.

What can you switch into? A Medicare Advantage plan, a stand-alone Medicare drug plan, or a Medicare Cost Plan, as long as it carries a 5-star overall rating and is available where you live. If there's no 5-star plan offered in your area, there's nothing to switch into, so whether this window helps you at all depends on your county.

The Drug-Coverage Risk Before You Switch

This is the part to slow down on, because it's where a good-news benefit can quietly cost you.

Say you're on a Medicare Advantage plan that includes prescription drug coverage, as many do. You spot a 5-star Medicare Advantage plan and switch to it, but that particular 5-star plan doesn't include drug coverage. Moving to it can leave you without prescription coverage, and you'd have to wait until your next enrollment opportunity to get it back. Worse, a gap in Part D drug coverage can trigger a Part D late enrollment penalty.

That penalty isn't a flat fee. The Part D late enrollment penalty is figured from Medicare's national base beneficiary premium, $38.99 in 2026, so the amount depends on how long you went without coverage. The point is simple: check whether a 5-star plan includes drug coverage before you switch, especially if you rely on prescriptions.

There's a second version of this trap. If you move from a Medicare Advantage plan that has drug coverage to a stand-alone 5-star Medicare drug plan, you get disenrolled from your Medicare Advantage plan completely, including its health benefit. You're returned to Original Medicare for your health services. That may be exactly what you want, but it's a much bigger change than "I'm just switching my drug plan," so go in knowing it.

How to Use the Medicare 5-Star Special Enrollment Period

None of this is a reason to skip a genuinely better plan. It's a reason to look before you leap. Three quick checks cover it:

1
Step 1

Confirm the plan is 5 stars for the current contract year

Ratings change year to year, and the SEP is tied to the plan holding a 5-star overall rating right now.

2
Step 2

Check the drug coverage

If you take prescriptions, make sure the 5-star plan you're eyeing actually includes Part D drug coverage. Switching to one that doesn't is what triggers a penalty later.

3
Step 3

Understand what you're leaving

Moving to a stand-alone drug plan drops you out of Medicare Advantage entirely and back to Original Medicare, so know whether you're changing your drug plan or your whole health setup.

If any of that gets murky, a call to Medicare or your State Health Insurance Assistance Program (SHIP), which offers free one-on-one counseling, can walk you through whether a specific 5-star plan is the right move for your situation.

Frequently Asked Questions

When can I use the 5-star Special Enrollment Period?

Any time from December 8 through November 30 of the following year. It's a long window, but you can use it only once during that stretch to make a single switch into a 5-star plan.

How often can I use it?

Once per contract year. Unlike the fall Annual Enrollment Period, where you can change your mind repeatedly and only your final pick counts, the 5-star SEP gives you exactly one move.

Which plans can I switch into?

A Medicare Advantage plan, a stand-alone Medicare drug plan, or a Medicare Cost Plan, as long as it holds a 5-star overall rating and is offered in your area. If no 5-star plan is available where you live, the window doesn't give you anything to switch into.

Can switching to a 5-star plan cost me a penalty?

It can, if you're not careful about drug coverage. Moving from a plan that includes prescription coverage to a 5-star plan without it can leave you owing a Part D late enrollment penalty and waiting until your next enrollment chance to get drug coverage back. Check the plan's drug coverage first.

What happens to my Medicare Advantage plan if I switch to a stand-alone 5-star drug plan?

You're disenrolled from your Medicare Advantage plan entirely, including its health benefit, and returned to Original Medicare for your health services. It's a bigger change than swapping just a drug plan, so make sure that's what you intend.

Learn More

MedicareMedicare Enrollment Periods: When You Can Sign Up and SwitchWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs. MedicareMedicare Star Ratings: How Plans Are ScoredMedicare Star Ratings score health and drug plans 1-5 stars. Learn what the ratings measure, how to use them on Plan Finder, and the 5-star enrollment right. MedicareMedicare Special Enrollment Periods: When You Can Change Outside the Usual WindowsThe life events that let you enroll in or switch Medicare outside the usual windows: retiring past 65, losing Medicaid, moving, a plan exit, and the COBRA trap.

Find personalized help deciding whether to switch to a 5-star Medicare plan 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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.