Every fall, people start seeing stars — literally. “My plan has 5 stars!” “This one only has 3.5!” But most folks aren’t exactly sure what those Medicare Star Ratings actually tell them.
If you’ve ever wondered whether you should pick a plan just because it has more stars, this post is for you.
In 2026, Star Ratings are shifting again — and while they still matter, they don’t tell the whole story. Let’s walk through how to read them (and how not to overthink them) before you pick your next plan.
What Star Ratings Measure — and Why They Exist
The Medicare Star Rating System is meant to grade how well each plan performs across several categories, including:
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Customer service and satisfaction
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Chronic condition management
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Preventive care and screenings
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Member experience and complaints
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Drug safety and accuracy (for Part D plans)
Plans are scored from 1 to 5 stars, with 5 being “excellent” and 3 being “average.”
Medicare updates these scores every year based on surveys, claim data, and performance metrics. The idea is to help you compare plans — but what it really gives you is a broad quality snapshot, not a personal guarantee.
What’s Changing With Star Ratings in 2026
For 2026, CMS (Medicare’s governing agency) is updating how plans are scored again — especially around member experience and chronic condition outcomes.
That means plans that perform well on real-world results (like keeping members healthier and out of the hospital) may see higher scores. Meanwhile, plans with high turnover or complaints could drop a full star.
So if your plan’s rating suddenly changes this fall, it doesn’t always mean it’s worse overall — it may just mean Medicare adjusted the formula.
What a “5-Star” Rating Really Means for You
Everyone loves the idea of a 5-star plan — and some agents will lead with it like it’s the holy grail.
Here’s the truth:
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A 5-star rating means the plan performed well across Medicare’s quality measures.
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It doesn’t automatically mean it’s the best fit for you.
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A 3.5 or 4-star plan could still be a better match depending on your doctors, drugs, and costs.
Think of Star Ratings as Yelp reviews for health plans — useful, but not the only thing that matters.
How to Use Star Ratings the Right Way
Here’s how I recommend using Star Ratings when comparing plans during AEP:
1. Start with your needs.
Make sure your doctors, prescriptions, and hospitals are covered first. A 5-star plan isn’t helpful if your doctor isn’t in-network.
2. Then check the stars.
If two plans look similar on coverage and cost, the higher-rated plan may be a safer bet.
3. Read between the stars.
A plan that jumps from 3.5 to 4.5 stars could indicate recent improvements in service or care coordination — that’s a good sign. A drop in stars might suggest customer service or claims issues.
4. Don’t chase stars blindly.
A high-rated plan might have higher copays, tighter networks, or fewer extras. Always look at the full picture.
Common Star Rating Misconceptions
“Higher stars mean lower costs.”
Not necessarily. Some 5-star plans are the most expensive in their area. Ratings reflect quality, not pricing.
“All plans in my county have the same star rating.”
Nope. Ratings vary by plan and contract, not by area. Even similar-sounding plans can score differently.
“My plan dropped a star — should I panic?”
Not at all. Check what changed. Sometimes it’s a technical scoring shift, not a service problem.
When Star Ratings Can Actually Matter
There’s one situation where stars really do matter: Special Enrollment.
If a 5-star plan is available in your area, you can switch to it once between December and November, even outside the Annual Enrollment Period. It’s called the 5-Star Special Enrollment Period.
That can be handy if your current plan isn’t cutting it mid-year — but only if the 5-star plan fits your actual needs.
FAQs
Why did my plan’s Star Rating drop?
Star Ratings can fall if a plan gets more member complaints, worse health outcomes, or lower customer satisfaction scores. It doesn’t always mean the plan is “bad,” but it’s worth a closer look.
Where can I find my plan’s Star Rating?
You can check plan ratings on Medicare.gov when you compare plans during AEP or review your plan’s Annual Notice of Change (ANOC) each fall.
How should I use Star Ratings when choosing a plan?
Use them as a tiebreaker — not a dealbreaker. Once you’ve confirmed your doctors, drugs, and costs, pick the higher-rated plan if everything else is equal.
Stars Help, but They Don’t Tell Your Whole Story
Star Ratings are a solid starting point, but they’re not a one-size-fits-all answer.
Use them to spot strong performers, avoid chronic complaint magnets, and get a feel for consistency. But don’t let stars outweigh your doctors, prescriptions, or budget.
At the end of the day, the best plan isn’t the one with the most stars — it’s the one that fits your life, your care, and your costs.
