Medicare star ratings are a 1 to 5 scale that CMS assigns every year to Medicare Advantage and Medicare Part D drug plans, based on roughly 40 measures covering member satisfaction, care outcomes, and how well a plan manages chronic conditions. For 2026, only 21 contracts nationwide earned the full 5 stars, the enrollment weighted average sits around 3.66 to 3.98, and about 40% of contracts scored 4 stars or higher. If you're comparing Medicare Advantage plans during Annual Enrollment or checking whether your current plan still measures up, the star rating is the single fastest way to see how a plan actually performs, not just what it costs.
What Medicare Star Ratings Actually Measure
The Centers for Medicare & Medicaid Services (CMS) publishes star ratings every October, right before the Annual Enrollment Period (AEP) begins on October 15. The ratings score Medicare Advantage (Part C) plans and standalone Part D prescription drug plans on a scale of 1 to 5 stars, in half star increments, so you'll see plans rated anywhere from 1.5 to 5.0.
The rating pulls from about 40 individual quality and performance measures, grouped into a few broad categories:
- Staying healthy: screenings, tests, and vaccines members receive
- Managing chronic conditions: how well the plan helps members control diabetes, heart disease, and other ongoing health issues
- Member experience: satisfaction surveys, ease of getting appointments and information
- Member complaints and plan performance: how often members leave the plan, appeals, and complaint volume
- Customer service: how the plan handles calls, appeals, and grievances
For Part D drug plans specifically, additional measures look at drug pricing accuracy, medication adherence for conditions like diabetes and high blood pressure, and how often members experience gaps in their coverage.
CMS assigns an overall rating for the whole contract, plus separate summary ratings for the health plan side and the drug plan side if the plan bundles both (a Medicare Advantage Prescription Drug plan, or MA-PD).
Why the Star Rating Matters to You
The star rating isn't just a report card for insurance executives. It affects you directly in three ways.
1. It's a genuine quality signal. Two plans can charge similar premiums and cover similar drugs, but a 4.5 star plan is statistically more likely to have members who report better care coordination, fewer complaints, and better management of chronic conditions than a 3 star plan in the same market.
2. Higher rated plans often have better benefits. CMS pays quality bonus payments to Medicare Advantage plans that earn 4 stars or more. Insurers frequently reinvest that bonus money into richer supplemental benefits like lower copays, dental and vision coverage, or reduced cost sharing. A higher star rating can translate into real savings, not just bragging rights.
3. A 5 star rating unlocks a special enrollment period. If a 5 star Medicare Advantage plan, MA-PD plan, or standalone Part D plan is available in your service area, you can switch into it once per calendar year without waiting for AEP. This window, generally referred to as the 5-Star Special Enrollment Period, runs December 8 through November 30 each year.
2026 Star Ratings: What Changed
CMS raised the bar for the 2026 ratings, tightening cut points (the score thresholds that separate 3 stars from 4 stars, for example) and adjusting how measures are weighted. The biggest shift: patient experience and complaint measures now count for less, while clinical outcome measures count for more. That means plans can no longer lean as heavily on high satisfaction surveys to offset weaker health outcomes.
The practical effect for 2026:
| Metric | 2026 Result |
|---|
| Contracts earning 5 stars | 21 nationwide (about 3.5% of all rated contracts) |
| Contracts earning 4 stars or higher | Roughly 40% of contracts (about 207 total) |
| Enrollment-weighted average star rating | Approximately 3.66 to 3.98 |
| MA-PD enrollees in a plan rated 4 stars or above | Roughly 64% |
| 5-star contracts compared to prior year | Up from 7 the year before, down from 38 two years prior |
The number of 5-star plans has swung significantly over the past few years as CMS tightens and loosens methodology, which is a reminder that a star rating reflects one plan year's performance against that year's specific bar, not a permanent grade.
Community-based and regional health plans tended to outperform larger national carriers in the 2026 ratings cycle, so it's worth checking ratings by specific plan and county rather than assuming a well-known brand automatically scores well everywhere it operates.
How to Check a Plan's Star Rating
You don't need to track down a PDF from CMS. The fastest way to check any plan's current star rating:
- Go to Medicare.gov's Plan Finder. Enter your ZIP code and answer a few questions about your current coverage and prescriptions.
- Compare plans side by side. Each Medicare Advantage and Part D plan listed shows its overall star rating (1 to 5 stars) directly next to the plan name.
- Click into a specific plan to see the breakdown by category, staying healthy, managing chronic conditions, member experience, and complaints, rather than just the overall number.
- Call 1-800-MEDICARE (1-800-633-4227) if you'd rather talk through the ratings with a representative, available 24 hours a day, 7 days a week.
If a plan is too new to have three years of data, CMS marks it as "too new to be measured" rather than assigning a star rating. New plans and plans with major benefit redesigns can carry more uncertainty even without a low official rating.
Using Star Ratings to Actually Choose a Plan
A high star rating is a strong signal, but it shouldn't be the only thing you look at. Before you switch plans based on a rating, check these three things too:
- Provider network. A 5 star plan is worthless to you if your doctor or hospital isn't in network. Confirm your specific providers are covered before switching.
- Formulary coverage. Look up your actual prescriptions in the plan's drug list (formulary). A plan can have a great overall rating and still charge more for the specific medications you take.
- Total annual cost. Compare premiums, deductibles, copays, and out-of-pocket maximums together, not just the monthly premium. A slightly lower rated plan with a much lower total cost may still be the better fit for your situation.
The 5-Star Special Enrollment Period, Explained
This is one of the most underused tools in Medicare. Normally, you can only change Medicare Advantage or Part D plans during specific windows: the Annual Enrollment Period (October 15 to December 7), the Medicare Advantage Open Enrollment Period (January 1 to March 31, for people already in an MA plan), or a qualifying life event.
The 5-Star Special Enrollment Period is different. If a 5 star Medicare Advantage plan, MA-PD, or standalone Part D plan is offered in your county, you can switch into it one time during the period running December 8 through November 30 of the following year, regardless of what time of year it is.
A few things to know before using it:
- You can only use it once per calendar year. If you switch into a 5 star plan and then want to switch again, you'll need to wait for the next enrollment window.
- Availability depends on your ZIP code. Not every county has a 5 star plan available. With only 21 contracts nationally earning 5 stars for 2026, many areas simply won't have one to switch into.
- Watch for drug coverage gaps. If you move from a Medicare Advantage plan with drug coverage into a 5 star plan that doesn't include drug coverage, you could lose your prescription benefit and face a Part D late enrollment penalty later.
- The switch takes effect the first of the month after you enroll, not immediately.
Star Ratings and Original Medicare
It's worth noting that star ratings only apply to Medicare Advantage and Part D plans, not to Original Medicare (Part A and Part B). If you're enrolled in Original Medicare with or without a Medicare Supplement (Medigap) policy, star ratings don't apply to your coverage directly, though CMS does publish separate quality data on hospitals, nursing homes, and home health agencies through Medicare's Care Compare tools.
How Often Ratings Change
CMS recalculates and publishes new star ratings every year in October, based on the plan's performance over roughly the prior 12 to 18 months of data. That means a plan's rating this year reflects last year's performance, not necessarily how the plan is performing right now. A plan can improve or decline significantly from one year to the next, so it's worth rechecking ratings annually even if you're happy with your current plan, especially since methodology and cut points can shift the same performance into a different star tier.
Frequently Asked Questions
What is a good Medicare star rating?
Generally, 4 stars or higher is considered strong performance. For 2026, only about 40% of Medicare Advantage contracts reached that bar, and the enrollment-weighted national average landed close to 3.7 to 4.0 stars, so a 4-star plan is meaningfully above the typical plan.
How many 5-star Medicare plans are there for 2026?
CMS awarded 5 stars to 21 contracts nationwide for 2026, made up of 18 Medicare Advantage plans, one cost plan, and two standalone Part D drug plans. That's roughly 3.5% of all rated contracts, so a 5-star plan may not be available in every county.
Can I switch to a 5-star Medicare plan anytime?
Yes, if a 5-star plan is available in your service area, you can use the 5-Star Special Enrollment Period to switch one time during the period running December 8 through November 30, without waiting for the standard Annual Enrollment Period. You still need to confirm the plan covers your doctors and prescriptions before switching.
Do star ratings apply to Medigap or Original Medicare?
No. Star ratings are specific to Medicare Advantage and Part D prescription drug plans. Original Medicare and Medigap supplement policies aren't assigned star ratings, though Medicare publishes separate quality comparison tools for hospitals and other providers.
How is the Medicare star rating calculated?
CMS scores plans on about 40 measures covering categories like staying healthy, managing chronic conditions, member experience, complaints, and customer service. For 2026, CMS increased the weight given to clinical outcome measures and reduced the weight of patient experience surveys, which made the ratings harder to earn than in prior years.
Why did my plan's star rating go down this year?
A lower rating can reflect either weaker actual performance or tighter CMS cut points and methodology changes. For 2026, CMS raised the bar across the board, so some plans saw their rating drop even if their underlying performance held roughly steady compared to the year before.
Does a higher star rating mean lower costs?
Not directly, but often indirectly. Medicare Advantage plans with 4 stars or higher qualify for CMS quality bonus payments, and many insurers use that bonus money to fund richer supplemental benefits or lower cost sharing. Always compare the plan's actual premium, deductible, and out-of-pocket costs alongside the star rating rather than assuming a high rating always means a cheaper plan.
