What factors does Medicare use for their star rating system? I need to find a new Medicare plan during the open enrollment period and want to ensure I am comparing plans accurately.
If you are shopping for Medicare Advantage plans (the alternative to original Medicare) or Part D prescription drug plans during the open enrollment (October 15 to December 7), you will likely find an overwhelming amount of options. The Medicare star rating system is a terrific tool to help you narrow down your choices. Here is what you should know.
Understanding Medicare’s Star Ratings
The Medicare star ratings, which you will find in the Medicare’s online Plan Finder tool at Medicare.gov/plan-compare, offers a shorthand look at how Medicare Advantage and Part D plans measure up for quality and member experience.
In this annual rating system, five stars indicates excellent, four means above average, three signifies average, two represents below average and one means poor. Medicare Advantage plans (but not Part D plans) with at least a four-star rating get bonus payments from Medicare, which they can use to provide extra benefits.
It is important to know that plans with fewer than three stars for three consecutive years, can be terminated by Medicare. This policy encourages plans to maintain high quality standards. Low-performing plans will appear on Plan Finder with an upside-down red triangle that has an exclamation point inside.
Individuals in these low-performing plans can switch to better-rated plans at any time. In addition, if a five-star plan is available in your area, you can enroll during a Special Enrollment Period between December 8 and November 30 of the following year.
How Ratings Are Comprised
Medicare Advantage star ratings comprise of 30 quality and performance measures. Medicare Advantage Part D plans are rated on 40 factors while stand-alone Part D plan ratings comprise of 12 factors. Ratings for all types of plans are based partly on member experience, customer service and plan performance.
Part D ratings evaluate factors such as prescription drug safety and pricing, while Medicare Advantage ratings consider whether members are staying healthy and if members with chronic conditions get the tests and treatments typically recommended to them.
Be aware that five-star plans are few and far between. The Centers for Medicare & Medicaid Services (CMS) has revised the Medicare star rating methodology in recent years, making it extremely hard for a plan to earn five stars.
In 2025, just 2% of enrollees with Medicare Advantage are in a five-star plan while only 5% of enrollees have Part D plans with four or five stars. Four-star plans are much easier to find, as more than 70% of people with Medicare Advantage are enrolled in them.
Shopping Tips
Here are some tips to consider when evaluating Medicare Advantage and Part D star ratings during open enrollment:
- Do not choose or reject a Medicare Advantage or Part D plan only because of its star rating. Costs and access to services or health providers should be your top priority when choosing a plan. But a star rating could be your deciding factor when choosing between two plans with similar out-of-pocket costs and coverage.
- Do not panic if a plan’s 2026 star rating is slightly lower than its 2025 rating. The downgrade could be due to a drop in the way the ratings are computed from year to year. It is best to look at a plan’s star-rating history over several years.
- If you are comfortable with the cost and coverage of a plan but concerned about its star rating, click through the Medicare Plan Finder for the star ratings subcategories. You will be able to see how the plan performed across specific measures of quality and member satisfaction. This can help you focus on the areas that matter most to you.
If you have questions or need help choosing a plan, contact your State Health Insurance Assistance Program (877-839-2675, ShipHelp.org), which offers free unbiased Medicare counseling in person or over the phone.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of “The Savvy Senior” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
