Medicare Star Ratings: What They Mean (2027)

Every fall, Medicare grades the quality of every Medicare Advantage and Part D drug plan on a 1-to-5 scale. These Medicare Star Ratings are one of the few plain signals a family has for judging a plan before enrolling, and they measure preventive care, chronic-condition management, member experience, and drug safety. This guide explains what each rating category measures, how to pull ratings from Medicare Plan Finder, what the quality bonus means for your benefits, and how the 5-Star Special Enrollment Period lets you switch to a top-rated plan outside the usual fall window.

What do Medicare Star Ratings measure?

CMS calculates Star Ratings from many performance measures grouped into two categories: Health Plan quality (for Medicare Advantage) and Drug Plan quality (for Part D). It scores each contract against thresholds called "cut points" and rolls the measures up into an overall rating. Within those categories, the measures fall into three broad dimensions.1

Health plan measures cover how well a plan keeps members healthy and manages ongoing conditions. Specific measures include breast cancer screening rates, colorectal cancer screening, flu vaccine uptake, controlling blood pressure in members with hypertension, managing blood sugar in members with diabetes, and statin use in people with cardiovascular conditions. Plans that score well on these measures get credit for delivering care that actually reduces hospitalizations and complications, not just for processing claims.

Member experience measures capture what enrollees report about their plan. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey asks members whether it was easy to get needed care, how quickly they got appointments, how well doctors communicated, and how they rate the plan overall. These survey scores make up a meaningful slice of the total rating, because a plan can hit clinical benchmarks on paper while still leaving members unable to get timely appointments.

Drug plan measures (for Part D, whether standalone or built into a Medicare Advantage prescription drug (MA-PD) plan) track medication safety and adherence. Measures include medication adherence for diabetes, hypertension, and cholesterol medications; safe prescribing practices; completion of medication reviews; and screening for high-risk drugs. A plan that scores well here is actively working to keep members on their medications and flag dangerous drug combinations, not just dispensing at a cost.

CMS weights some measures more heavily than others, and a plan must meet a minimum enrollment threshold before a reliable rating can be calculated. A new or low-enrollment plan may carry a "plan too new to be rated" designation and show no star rating on Plan Finder. That is not a zero-star verdict; it simply means CMS does not yet have enough data. At the other end, Plan Finder flags contracts with consistently low-quality ratings using a "low performing" icon. Four Medicare Advantage drug plan contracts carry it for 2027. Separately, being enrolled in a plan that has been rated under 3 stars for the last 3 years is its own Special Enrollment Period trigger, so a persistently weak rating is also a way out mid-year.1

How do Star Ratings affect your benefits and costs?

Plans rated 4 stars or higher receive quality bonus payments from CMS, a rule the Affordable Care Act put in place. Contracts rated 4, 4.5, or 5 stars get a 5% increase applied to their county payment rate, and that percentage doubles to 10 points in a qualifying county that meets the criteria set in federal law. Contracts below 4 stars get no increase, with two narrow exceptions: a plan from a company that has had no other MA contract in the past three years, and a plan too small (fewer than 500 enrollees) to report the required quality data, still bid against a benchmark carrying a 3.5-percentage-point add-on. These percentages are CMS's 2027 payment rules. The 2027 Star Ratings feed into 2028 bonus payments, which follow CMS's 2028 rules.1 That bonus changes what CMS pays the plan, not what the plan has to charge you, so read the plan's own premium, cost-sharing, and extra benefits off its plan documents rather than inferring them from the star count. Most Medicare Advantage plans do offer extras Original Medicare doesn't, such as routine dental, vision, hearing, and fitness coverage.2

For 2026, the Centers for Medicare & Medicaid Services estimates the average Medicare Advantage monthly plan premium at about $14.00, down from $16.40 in 2025. You normally still owe your Part B premium on top of any plan premium, regardless of your plan's star rating, though CMS notes that some plans "may have a $0 premium and may help pay all or part of your Part B premium." A star rating tells you nothing about whether a plan does that, so check the premium and any giveback separately from the stars.2

A higher rating is not a guarantee of lower cost, though. Star Ratings measure quality, not price, so treat the star number as a tiebreaker rather than the decision. Confirm first that a plan covers your doctors, your prescriptions, and gives you an out-of-pocket maximum you can live with, then break ties on the rating. A 5-star plan that does not cover your medications is still the wrong plan.

The 5-Star Special Enrollment Period

This is the enrollment right most beneficiaries do not know exists. Under federal rules, if a 5-star Medicare Advantage, Part D, or Medicare Cost plan is available in your area, you can use the 5-Star Special Enrollment Period (SEP) to switch to it from your current plan, outside the fall Annual Election Period (October 15 through December 7) and the Medicare Advantage Open Enrollment Period (January 1 through March 31).1

How the 5-Star SEP works:

• You can use it once between December 8 and November 30 of the following year.
• A 5-star plan must be available in your area.1
• Ask the new plan when your coverage will start before you submit the request.
• If you have questions before you switch, call 1-800-MEDICARE (1-800-633-4227).3

Medicare warns about two traps here. If you switch from a Medicare Advantage plan that includes drug coverage to a 5-star Medicare Advantage plan that does not, you may lose your drug coverage, have to wait until your next enrollment opportunity to get it back, and have to pay a Part D late enrollment penalty. And if you switch from a Medicare Advantage plan with drug coverage to a stand-alone Medicare drug plan, you are disenrolled from the Medicare Advantage plan, health benefits included, and returned to Original Medicare. Before you switch, confirm the 5-star plan covers both your care and the prescriptions you need.1

The practical value is real, but the limitation is supply. Not every county has a 5-star plan. For 2027, only 15 Medicare Advantage drug plan contracts nationally reached that threshold, down from 22 for 2026 in CMS's updated count, and no stand-alone drug plan did. If a 5-star plan enters your area mid-year, or you become dissatisfied with your current plan between enrollment periods, the 5-Star SEP gives you an exit the standard calendar does not.1

One clarification: the 5-Star SEP applies to the plan's rating for the plan year you are switching into, not the prior year's rating.4 A plan can gain or lose 5-star status from one year to the next, so verify the current rating on Plan Finder before submitting an enrollment request.

How to use Medicare Plan Finder to compare Star Ratings

The online Medicare Plan Finder tool at Medicare.gov is where you can view and compare Star Ratings alongside each plan's benefits and costs.1

The category-level breakdown matters. A plan might score 4.5 stars overall but only 3 stars on member experience, which can signal difficulty reaching customer service or getting specialist referrals. If access and responsiveness are priorities for you, the category breakdown tells you more than the summary number. Comparing a plan's rating with its rating the year before shows whether its quality is trending up or down.

Which enrollment window lets you switch plans?

Star Ratings intersect with three enrollment windows. Knowing which one applies keeps you from missing a switch opportunity.5

Annual Election Period (October 15 through December 7). This is when most people review and change their Medicare coverage for the coming year. Any Medicare beneficiary can switch plans during this window, and changes take effect January 1. CMS sets new Star Ratings each fall (the 2027 ratings went up on Plan Finder on October 8, 2026, in time for this year's window), so you can compare current ratings before you commit.1

Medicare Advantage Open Enrollment Period (January 1 through March 31). People already enrolled in a Medicare Advantage plan may make one change: switch to a different MA plan, or return to Original Medicare and add a Part D plan. The change takes effect the first of the month after the plan gets your request.6

5-Star Special Enrollment Period (once between December 8 and November 30). Described above. It lets you switch to a top-rated plan outside the standard calendar, as long as a 5-star plan is available in your area. It is one of two ways out tied to quality: the other opens if your plan has been rated below 3 stars for the last 3 years, and you can use that one at any time while you are in the plan.1

For more detail on the enrollment calendar, see the Medicare enrollment periods guide.

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