Medicare Star Ratings score every Medicare Advantage and Part D drug plan from 1 to 5 stars each year, giving you a quality benchmark before you pick a plan. The ratings cover 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 quality bonuses mean for your benefits, and the 5-star Special Enrollment Period that lets you switch to a top-rated plan at any point in the year.
What Star Ratings measure
CMS calculates Star Ratings from dozens of performance measures grouped into two categories: Health Plan quality (for Medicare Advantage) and Drug Plan quality (for Part D). Within those categories, CMS weighs three broad dimensions.
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 CAHPS Health Plan 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 an 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 whether members are screened 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 plans must meet a minimum enrollment threshold before a reliable rating can be calculated. New plans that lack sufficient enrollment history may receive a "plan too new to be rated" designation and will not have a star rating displayed on Plan Finder.
How ratings translate into benefits
Plans with 4 or more stars receive quality bonus payments from CMS. Under the current quality bonus payment system, these plans get a percentage increase applied to their base payment rate. The additional revenue allows 4-and-5-star plans to offer lower premiums, reduced cost-sharing, or additional supplemental benefits, including dental, vision, hearing, and fitness programs, that plans without the bonus payments cannot afford to offer at the same price point.
For 2026, the Centers for Medicare and Medicaid Services reported that the average Medicare Advantage monthly plan premium is approximately $14.00, down from $16.40 in 2025. Higher-rated plans tend to cluster at the lower end of that premium range because the bonus payments reduce the per-member cost. You still owe the Part B premium regardless of your plan's star rating.
CMS can take corrective action against consistently low-rated plans, and persistent low performance can put a plan at risk of being removed from the program. This creates an ongoing incentive for plans to invest in care management and member services rather than coast on existing enrollment.
The 5-Star Special Enrollment Period
This is the enrollment right most beneficiaries do not know exists. Under federal rules, a person enrolled in Original Medicare or a Medicare Advantage plan that is not rated 5 stars may switch to a 5-star Medicare Advantage or Part D plan once per calendar year, at any time. The switch does not have to happen during the fall Annual Election Period (October 15 through December 7) or the Medicare Advantage Open Enrollment Period (January 1 through March 31).
To use the 5-Star SEP:
- You must be currently enrolled in Original Medicare or a non-5-star Medicare Advantage or Part D plan.
- You can make one change under this SEP per calendar year.
- Coverage in the new plan starts the first day of the month after the plan receives your enrollment request.
- The 5-star plan must be available in your service area.
The practical value is significant. If a 5-star plan enters your area mid-year, or if you become dissatisfied with your current plan between enrollment periods, the 5-Star SEP gives you an exit that the standard calendar does not. The limitation is supply: not every county has a 5-star plan available, and in 2026 only 11 contracts nationally reached that threshold.
One clarification: the 5-Star SEP applies to the plan's rating for the plan year you're switching into, not the prior year's rating. 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
Medicare Plan Finder at medicare.gov/plan-compare is where CMS publishes plan ratings alongside premium, cost-sharing, and formulary data. To pull star ratings for plans in your area:
- Go to medicare.gov/plan-compare and enter your ZIP code.
- Select the plan type you want to compare (Medicare Advantage, Part D drug plan, or both).
- Plans display with their star rating shown as a row of stars. Filter by "4 stars and above" to narrow the list to higher-quality options.
- Click any plan to see its full rating breakdown by category, not just the overall score.
The category-level breakdown matters. A plan might score 4.5 stars overall but only 3 stars on member experience, which could 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.
Plan Finder also shows the prior year's rating for context, so you can see whether a plan's quality is trending up or down.
| Rating | What it means | CMS financial treatment |
|---|---|---|
| 5 stars | Excellent quality | Quality bonus payment; eligible for 5-Star SEP enrollments year-round |
| 4–4.5 stars | Above average | Quality bonus payment |
| 3–3.5 stars | Average | No bonus; no sanction |
| 1–2.5 stars | Below average | Corrective action risk; possible plan removal |
| "Plan too new to be rated" | Insufficient enrollment data | No rating; no bonus |
Enrollment periods that interact with Star Ratings
Star Ratings intersect with three enrollment windows. Knowing which window applies keeps you from missing a switch opportunity.
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. Plan Finder publishes updated Star Ratings for the upcoming plan year before October 15, so you can compare current ratings before making a change that takes effect January 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. Star Ratings for the current plan year are in effect. Coverage changes take effect the first day of the month after enrollment.
5-Star Special Enrollment Period (year-round, once per calendar year). Described above. This is the only window that lets you switch based on quality, outside the standard calendar, as long as a 5-star plan is available in your area.
For more detail on the enrollment calendar, see the Medicare enrollment periods guide.
Frequently asked questions
CMS publishes new ratings each fall, and they apply to the following plan year. A plan rated 4.5 stars for 2026 may rate differently for 2027. Check Plan Finder each fall during the Annual Election Period to see whether your current plan's rating has changed before deciding whether to stay or switch.
No. The 5-Star Special Enrollment Period allows one plan change per calendar year. If you used it in March to switch to a 5-star Medicare Advantage plan, you cannot use it again until January 1 of the following year. You may still be eligible for other SEPs based on life events such as moving out of your plan's service area.
Not automatically. Star Ratings measure quality, not price. A 5-star plan may or may not have lower premiums or cost-sharing than a 4-star plan in your area. Quality bonus payments do give higher-rated plans more flexibility to reduce costs, but the actual premiums and cost-sharing are set by each plan. Always compare both the star rating and the full cost structure on Plan Finder before enrolling.
The 5-Star SEP is only usable if a 5-star plan is available and accepts enrollment in your service area. In 2026, only 11 contracts nationally reached 5 stars, and coverage is not uniform across counties. If no 5-star plan operates in your area, the SEP is not available to you that year. Your options are the Annual Election Period in the fall and, if you're already in an MA plan, the MA Open Enrollment Period from January through March.
Learn More
- Medicare overview: Parts A, B, C, and D explained
- Original Medicare vs. Medicare Advantage: how to choose
- Medicare enrollment periods: when you can sign up and switch
Find personalized help comparing Medicare Advantage plan quality and Star Ratings 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.