Medicare Star Ratings: What They Really Mean for You

Every fall, people shopping for Medicare Advantage or Part D drug plans run into the “Medicare Star Rating” system. It looks simple — one to five stars, just like Amazon reviews. But here’s the real question:

Do these stars actually help you figure out which plan is right for you?

Let’s break it down.

What Are Medicare Star Ratings?

Medicare uses a five-star quality scale for Medicare Advantage (MA) and Part D drug plans. Medicare Supplement (Medigap) plans don’t get star ratings.

• 5 Stars = Excellent
• 4 Stars = Above Average
• 3 Stars = Average
• 2 Stars = Below Average
• 1 Star = Poor

That’s the headline. But what goes into those stars?

How Medicare Advantage Plans Are Rated

MA plans are graded in five areas:

• Staying healthy (preventive screenings, vaccines)
• Managing chronic conditions (like diabetes or heart disease)
• Plan responsiveness and care (how well the plan helps when you need it)
• Member complaints and turnover (how many people leave the plan)
• Customer service

If a plan consistently keeps members healthy, responds quickly, and keeps complaints low, it’ll land closer to five stars.

How Part D Drug Plans Are Rated

Drug plans are scored in four buckets:

• Customer service
• Complaints and member turnover
• Member experience
• Drug pricing and patient safety

Translation: Medicare looks at how smoothly the plan runs, how members feel about it, and whether the drug prices and safety checks are on point. If you’re unsure about your drug coverage, it’s worth using tools like the Medicare Doctor Search Tool before choosing a plan.

Why Star Ratings Matter (and Why They Don’t)

Here’s the blunt truth: star ratings aren’t everything.

• Why they matter:
  • A five-star plan earns bonus money from Medicare. Plans often use this to cut premiums or add benefits.
  • If a plan hits five stars, it gets a Special Enrollment Period (SEP). That means you can switch into it once a year outside of normal enrollment windows. Learn more about timing in how to read your Medicare ANOC.
• Why they don’t:
  • Most people don’t pick a plan based on star ratings alone.
  • A four-star plan might actually fit your needs better than a five-star one. Why? Networks. A “perfect” plan doesn’t help if your doctor or hospital isn’t included. If you’re losing coverage, check out what happens when a Medicare Advantage plan ends.

“Too New to Rate” Plans

Ever see a plan listed as “Too New to Rate”? That just means it’s new — not enough data yet. Medicare gives it a behind-the-scenes placeholder of about three and a half stars. Don’t read too much into it.

Bottom Line

Star ratings give you a snapshot of quality, but they’re not the whole story. Here’s what to really pay attention to when choosing a plan:

• Are my doctors and hospitals in-network?
• Are my prescriptions covered — and affordable?
• What will my out-of-pocket costs be?

Stars are nice, but your coverage and costs matter more.

Check Your Plan’s Rating

Want to know how your plan stacks up? Look up your plan’s current Star Rating on Medicare.gov before making any changes.

When Stars Really Matter

Star Ratings should be a tie-breaker, not the first thing you look at. Use them if you’re choosing between two similar plans and want to know which one delivers better service.

Don’t Forget the Basics

Even a five-star plan isn’t worth much if:

• Your doctor isn’t in-network
• Your drugs aren’t covered affordably
• Your out-of-pocket costs are too high

Always check these first.

Too New to Rate? Here’s What It Means

If you see “Too New to Rate,” don’t panic. It just means Medicare doesn’t have enough data yet. Treat it like a middle-of-the-road option and dig deeper into benefits, networks, and costs.