Medicare rates every Medicare Advantage plan and Part D plan from 1 to 5 stars each year. The rating tells you how good the plan is on customer service, member experience, quality of care, and drug pricing. A 5-star plan is rare. If one is in your area, you have a special enrollment perk most members never use.
What is a Medicare star rating?
The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage and Part D plans every year. Plans are scored from 1 star (lowest) to 5 stars (highest), in half-star increments.
The rating reflects how well the plan performs on a long list of measures: how often members can get appointments, how well the plan manages chronic conditions, customer service hold times, drug pricing accuracy, complaint rates, and many more.
Star ratings come out every October. The ratings apply to the next calendar year, so 2026 star ratings affect plans available during the October 2025 Annual Enrollment Period through 2026.
What goes into the rating
Medicare Advantage plans (with drug coverage)
MA plans with drug coverage are scored on up to 40 measures across 5 categories:
- Staying healthy: Screenings, vaccines, preventive checkups
- Managing chronic conditions: Diabetes care, heart disease, mental health follow-up
- Member experience: Survey results from current members
- Member complaints and changes: Complaints filed and changes to the plan
- Customer service: Call wait times, accuracy of information, claims processing
Plus the Part D measures, since the plan includes drugs:
- Drug plan customer service
- Drug pricing and patient safety
- Drug accuracy
Stand-alone Part D plans
Stand-alone Part D plans are scored on about 12 measures, focused on:
- Customer service
- Drug pricing and patient safety
- Member experience
- Drug pricing accuracy
Why 5-star plans are rare
Out of hundreds of Medicare Advantage plans nationwide, typically fewer than 30 earn 5 stars in any given year. Many states have no 5-star plans at all.
The rating system is genuinely hard to top. A plan must do well on dozens of measures simultaneously. A weakness in one area can drop the overall rating by half a star.
Some carriers consistently produce 5-star plans: Kaiser Permanente, certain regional Blue plans, some UnitedHealthcare plans in specific markets, and a few others. Most national carriers have a mix of 3.5, 4, and 4.5 star plans, with very few 5-star products.
The 5-star Special Enrollment Period
This is the perk most Medicare members do not know about. If a 5-star Medicare Advantage or Part D plan is available in your zip code, you have a one-time Special Enrollment Period each year to switch into it.
The 5-star SEP runs from December 8 through November 30 of the following year. That is almost the entire year. You can use it once during that window.
You can use the SEP to:
- Switch from your current Medicare Advantage plan to a 5-star MA plan
- Switch from a Part D plan to a 5-star Part D plan
- Switch from Original Medicare to a 5-star Medicare Advantage plan
How to check if there is a 5-star plan in your area
Two ways:
- Go to Medicare.gov, enter your zip code, and look at the Plan Ratings filter
- Ask your independent Medicare agent. They will know what is rated 5-star locally
Most areas have at least a few 4 and 4.5 star plans. Truly 5-star plans are concentrated in a handful of regions. If you live in a major metro area, the odds are better than in rural areas.
Should you pick a plan based only on star rating?
No. Star ratings are one factor, not the only one. A 4-star plan that includes your doctors and covers your drugs is better than a 5-star plan that does not.
Use the star rating as a tiebreaker between two plans that meet your other needs. If Plan A and Plan B both cover your doctors, drugs, and have similar costs, the higher star rating breaks the tie.
For more on plan selection, see our article on the 10 questions to ask before picking a plan.
Star rating changes in 2026
CMS adjusts the rating methodology every few years. For 2026, several changes are in effect:
- More weight on member experience measures
- New focus on health equity for under-served populations
- Tighter scoring on prior authorization handling
- Continued emphasis on accurate drug pricing
These changes have caused some plans to lose stars in 2026 even if their service has not changed. The bar keeps moving up.
Why high-star plans usually cost less
Here is something most people miss. CMS pays carriers more for high-star plans. A 4 or 5 star plan gets a quality bonus that lets the carrier offer richer benefits or lower premiums.
So high-star plans often have:
- Lower monthly premiums
- More extras like dental and vision
- Lower copays
- More generous out-of-pocket maximums
This is a big reason to favor 4 and 5 star plans when available. The carrier can afford to be generous because of CMS bonuses.
Star ratings and Part D drug plans
For stand-alone Part D plans, star ratings matter slightly less because the differences in service are smaller. Most Part D plans are rated 3 to 3.5 stars. A 4-star or 5-star Part D plan is somewhat unusual.
For Part D specifically, what matters most is whether your drugs are covered at good copays, not the star rating. A 3-star plan that has all your drugs at preferred tier might cost you less than a 5-star plan that has them at high tier.
How to use the 5-star SEP
If a 5-star plan is in your area and you want to use the SEP:
- Find the 5-star plan on Medicare.gov or through your agent
- Confirm your doctors are in network and your drugs are covered
- Apply through the carrier or through your agent
- The new coverage starts the first of the month after you enroll
- Your old plan ends automatically the day before
You only get one switch using the 5-star SEP per year. If you change your mind later, you have to wait for the next Annual Enrollment Period.
The bottom line
Star ratings are one of the best tools Medicare gives members to compare plans. A 4 or 5 star plan usually delivers better service, more generous benefits, and fewer headaches than a lower-rated plan.
If a 5-star plan is available in your area, it is worth a serious look, plus the SEP perk that lets you switch any time of year. If you cannot find one near you, focus on 4 and 4.5 star plans. Avoid plans rated below 3 stars except in unusual situations.
