Compare Plans with Medicare Star Ratings

Medicare star ratings can help you compare Medicare plans’ quality, performance and member satisfaction. This is important when you’re shopping for a Medicare Advantage plan or a Medicare Part D prescription drug plan. Maybe you’ve found one that has the coverage you need at a cost you can afford. How can you tell whether it’s a good Medicare plan?

Medicare star ratings are calculated by the Centers for Medicare & Medicaid Services, or CMS. Medicare Advantage plans and Part D plans are sold by private health insurance companies, but they're monitored and regulated by the government.

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^[0]

• 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).

Medicare Advantage star ratings

All Medicare Advantage, or Medicare Part C, plans receive star ratings for health coverage in the following five areas^[0]

• 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?

• 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?

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 areas^[0]

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

• 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?

• Member experience: How do members rate the plan?

• 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^[0]

• Medicare Advantage plans with prescription drug coverage have an average overall star rating of 4.04 for 2024. Approximately 74% of beneficiaries enrolled in a Medicare Advantage plan with prescription drug coverage are in one with at least 4 stars in 2024.

• Stand-alone Medicare Part D plans have an average summary rating of 3.11 stars for 2024. Approximately 2% of beneficiaries enrolled in a stand-alone Part D plan are in one with at least 4 stars in 2024.

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.

» MORE: How to compare Medicare Advantage plans

Signing up for Medicare plans with a 5-star rating

You can sign up for a 5-star Medicare Advantage or Part D plan during the following enrollment periods^[0]

• Initial enrollment period (around your 65th birthday).

• Open enrollment period (Oct. 15 to Dec. 7 each year).

• Medicare Advantage open enrollment period (Jan. 1 to March 31 each year if you already have a Medicare Advantage plan).

• Special enrollment period, as described below.

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^[0]

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^[0]