Medicare Star Ratings: How They Can Help You Choose a Plan

Medicare star ratings (compiled by the government) help shoppers compare Medicare Advantage and Part D drug plans.
Alex Rosenberg
Kate Ashford, CSA®
By Kate Ashford, CSA® and  Alex Rosenberg 
Edited by Holly Carey

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You’re shopping for a Medicare Advantage plan or a Medicare Part D prescription drug plan. You’ve found one that has the coverage you need at a cost you can afford. So how can you tell whether it’s a good Medicare plan?

Medicare Advantage plans and Medicare Part D plans are sold by private insurance companies, but they're monitored and regulated by the government. Medicare star ratings from the Centers for Medicare & Medicaid Services, or CMS, can help you compare plans’ quality, performance and member satisfaction.

Here’s how to use Medicare star ratings to find the best plan for you.

What are Medicare star ratings?

Medicare star ratings rank plans on a 5-point scale

Centers for Medicare & Medicaid Services. Medicare 2023 Part C & D Star Ratings Technical Notes: 5-Star Scale. Accessed Jan 9, 2023.
:

  • 5 stars: Excellent.

  • 4 stars: Above average.

  • 3 stars: Average.

  • 2 stars: Below average.

  • 1 star: Poor.

CMS calculates each plan’s rating based on the plan’s quality of care and measurements of customer satisfaction. You can find a plan’s rating with the Medicare plan-finding tool. The 5-star plans have a special star icon in the results list.

CMS updates plans’ star ratings each year based on the most recent data. Ratings are released in October unless plans are new to the marketplace (in which case, they won’t have ratings until CMS is able to collect the relevant data).

Star ratings for Medicare Advantage plans

All Medicare Advantage, or Medicare Part C, plans receive ratings for health coverage in the following five categories

:

  • Member experience: How do members rate things like ease of seeing specialists and getting appointments quickly?

  • Plan performance: What is the complaint history of the plan, and has its performance gotten better or worse over time? Are members leaving the plan?

  • Customer service: How well does the plan respond to member requests and appeals?

  • Staying healthy: Do members have access to checkups, vaccinations and screening tests that help them stay in good health?

  • Chronic conditions: Do members with chronic conditions get the kinds of tests and treatments that would typically be recommended to them?

Medicare Advantage plans also get a summary rating for Medicare Part C — a weighted average of its performance on all health plan measures.

Medicare Advantage plans with prescription drug coverage are rated on the Medicare Part D measures described below. These plans receive a summary rating for health plan measures, another summary rating for drug plan measures, and an overall rating for the plan.

Star ratings for Medicare Part D prescription drug plans

Medicare Part D plan ratings are based on the following four categories

:

  • Member experience: How do members rate the plan?

  • Plan performance: What is the complaint history of the plan, and has its performance gotten better or worse over time? Are members leaving the plan?

  • Customer service: How well does the plan respond to member requests and appeals?

  • Drug safety and pricing: How accurate is the plan’s pricing information? Are members with specific medical conditions prescribed drugs appropriately and safely?

Each Medicare Part D plan gets a summary rating, which is a weighted average of all the Medicare Part D measures.

How to compare plans using Medicare star ratings

To compare Medicare plans’ performance as a whole, look at their overall or summary ratings. The best plans have 5 stars.

As a baseline for comparison, here are CMS’ figures for plans’ average star ratings and how many people are in plans rated 4 stars or better

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet (PDF). Accessed Jan 9, 2023.
:

  • Medicare Advantage plans with prescription drug coverage have an average overall star rating of 4.15 for 2023. Approximately 72% of beneficiaries enrolled in a Medicare Advantage plan with prescription drug coverage are in one with at least 4 stars in 2023.

  • Stand-alone Medicare Part D plans have an average summary rating of 3.25 stars for 2023. Approximately 9% of beneficiaries enrolled in a stand-alone Part D plan are in one with at least 4 stars in 2023.

If you have more specific needs for your care, it can be worth comparing plans’ scores on individual categories or measures. For example, if you have diabetes, it could be important to find a plan that performs well on the diabetes measures in the chronic conditions category.

You can see plans’ ratings for individual measures under “Plan Details” when using the Medicare plan-finding tool.

Signing up for 5-star Medicare plans

You can sign up for a 5-star Medicare Advantage or Part D plan during the following enrollment periods

Centers for Medicare & Medicaid Services. Joining a Health or Drug Plan. Accessed Jan 9, 2023.
:

No matter what your current plan is rated, if you want to enroll in a 5-star Medicare Advantage or Part D plan, you can switch to one during a special enrollment period — which exists for this purpose — from Dec. 8 to Nov. 30 of the following year

Centers for Medicare & Medicaid Services. 5-Star Special Enrollment Period. Accessed Jan 9, 2023.
. You may do this once during this time, and it's possible only if a 5-star plan is available in your area. (Not all areas have 5-star plans available.)

If you’re enrolled in a plan that has been rated less than 3 stars for three years in a row, you’re allowed a one-time chance at any time to enroll in a higher-rated plan

Centers for Medicare & Medicaid Services. Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods. Accessed Jan 9, 2023.
.

Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
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