medicare star ratings guide — understanding these ratings could save you from enrolling in a plan that underdelivers on care. Every year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage and Part D prescription drug plans on a scale of 1 to 5 stars. These scores reflect real performance data across dozens of quality measures. For the 2026 plan year, just over 40% of Medicare Advantage contracts earned 4 or more stars.
However, the average overall score dropped to 3.65 stars, down from 3.92 the prior year. That shift means choosing carefully matters more than ever. Before you commit during the Annual Enrollment Period, knowing how to read and compare these ratings can help you find a plan that truly fits your health needs.
What Medicare Star Ratings Measure and Why They Matter
CMS evaluates Medicare Advantage plans with prescription drug coverage (MA-PD) across 9 domains using up to 45 individual measures. Stand-alone Part D drug plans are rated on 4 domains with up to 12 measures. These domains cover areas like staying healthy through preventive screenings, managing chronic conditions, customer service responsiveness, member complaints, and drug safety. In most cases, a plan scoring 4 or more stars signals strong performance across multiple categories.
Star ratings directly affect what benefits a plan can offer. Plans with 4 or more stars receive a 5% quality bonus payment from CMS, which often translates into richer benefits for enrollees. As a result, higher-rated plans may include extras like dental coverage, vision benefits, or lower copays. For 2025 alone, total quality bonus payments to Medicare Advantage plans exceeded $12.
7 billion. Meanwhile, plans rated below 3.5 stars keep a smaller share of their benchmark savings — just 50%, compared to 70% for top-rated plans. A medicare star ratings guide built on these facts helps you see why scores aren’t just abstract numbers.
Your Medicare Star Ratings Guide to Reading the Scores
CMS releases updated star ratings every October, ahead of the Annual Enrollment Period that runs from October 15 through December 7. You can look up any plan’s rating on the Medicare Plan Finder at Medicare.gov. Alternatively, call 1-800-MEDICARE or contact your local State Health Insurance Assistance Program (SHIP) for free, personalized counseling.
When comparing plans, don’t stop at the overall star rating. Dig into the individual domain scores. For example, a plan might earn 4 stars overall but score poorly on member complaints or drug pricing accuracy. The domain-level breakdown reveals strengths and weaknesses that a single number hides. Typically, the categories that matter most depend on your personal situation. Someone managing diabetes should pay close attention to chronic condition management scores. A beneficiary taking multiple prescriptions should focus on drug safety and pricing accuracy ratings.
For 2026, CMS also added a new measure evaluating kidney health screenings for patients with diabetes. Additionally, the weight given to patient experience and complaint measures was reduced. These methodology changes mean year-over-year comparisons require caution. A plan that lost a star may not have gotten worse — the scoring rules themselves shifted. Using a medicare star ratings guide that accounts for these annual adjustments gives you a more accurate picture.
How to Use Star Ratings When Choosing a Plan
Start by narrowing your options to plans rated 4 stars or higher. Roughly 63.5% of Medicare Advantage enrollees are already in plans at that level. Five-star plans offer a unique advantage: they allow enrollment through a Special Enrollment Period at any time of year, not just during open enrollment. For 2026, 18 contracts received the top 5-star rating, up from just 7 the previous year. Major insurers like UnitedHealthcare, Humana, Aetna, and Blue Cross Blue Shield all operate plans in the 4- to 5-star range, though ratings vary by region and specific contract.
Next, compare the star ratings alongside other factors. A 5-star plan with a narrow provider network may not work if your doctors aren’t included. Similarly, a 4-star plan with strong drug coverage scores might serve you better than a 5-star plan that doesn’t cover your medications. Always cross-reference ratings with the plan’s formulary, provider directory, and out-of-pocket cost estimates on Medicare.gov. This medicare star ratings guide approach — combining quality scores with practical fit — leads to smarter enrollment decisions.
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Finally, revisit ratings every year. Plans can gain or lose stars based on updated performance data. A plan that earned 4.5 stars last year might drop to 3.5 this year. CMS recalculates cut points annually using clustering methods, so the bar for each star level can shift. Checking ratings each fall before the enrollment window opens ensures you aren’t staying in a plan that has declined in quality. Your local SHIP counselor can walk you through changes at no cost.
Frequently Asked Questions
What is the highest Medicare star rating a plan can receive?
The highest rating is 5 stars, which CMS considers excellent. For the 2026 plan year, only 18 Medicare Advantage contracts earned this top score. Plans with 5 stars allow beneficiaries to enroll outside the standard enrollment period through a Special Enrollment Period.
Where can I look up star ratings for Medicare plans in my area?
You can compare plan ratings on the Medicare Plan Finder at Medicare.gov. You can also call 1-800-MEDICARE for assistance. In addition, free counseling is available through your state’s SHIP program, which provides unbiased guidance from trained volunteers. A medicare star ratings guide like the Plan Finder lets you filter by location and plan type.
Do star ratings change every year?
Yes, CMS updates star ratings annually each October. The methodology itself can also change — for instance, CMS adjusted measure weights for the 2026 ratings cycle. As a result, a medicare star ratings guide from last year may not reflect current scores. Beneficiaries should check updated ratings before each Annual Enrollment Period, which runs October 15 through December 7.
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Official Sources & Resources
For verified information on Medicare regulations and consumer protection:
- Medicare.gov (Official Site): medicare.gov
- CMS (Centers for Medicare & Medicaid Services): cms.gov
- NAIC (National Association of Insurance Commissioners): naic.org
- KFF Medicare Research: kff.org/medicare
- Social Security Administration: ssa.gov
Content last reviewed May 2026. If you notice any outdated information, please contact us.