Medicare rates Medicare Advantage (Part C) and prescription drug (Part D) plans by stars.

The star rating is designed to help you select the best Part C or Part D plan for you. It’s also used to internally evaluate the performance of plans that contract with Medicare.

Medicare considers the number of stars to mean the following:

  • 5 stars: Excellent
  • 4 stars: Above average
  • 3 stars: Average
  • 2 stars: Below average
  • 1 star: Poor

Ratings are usually released in October ahead of annual open enrollment.

Medicare considers five categories when assigning a star rating to a Medicare Advantage plan:

  • how the plan emphasizes staying healthy, including benefits like screenings, tests, and vaccines
  • how the plan manages chronic conditions
  • how responsive the plan is, as well as the quality of care people with the plan receive
  • member complaint reports, which include problems in getting services, decision appeals, and how many members leave the plan each year
  • plan operations, like how the plan prices their drug formularies, how they make decisions about appeals and the results from audits about the plan’s quality

For Medicare Advantage plans with prescription drug coverage (MA-PD), Medicare considers up to 40 different performance measures under these five categories.

For Medicare Advantage plans that don’t have prescription drug coverage, they consider up to 30 different measures under these five categories.

For Part D or stand-alone prescription drug plans (PDP), Medicare considers up to 12 different measures under the following four categories:

  • customer service for the plan
  • how many members chose to leave the plan, and member complaints and problems getting services
  • member reports about experiences with the drug plan
  • drug pricing and patient safety considerations

Medicare determines these ratings from multiple data sources. These include:

  • complaint tracking
  • grievances and appeals tracking
  • health outcome surveys
  • laboratory data
  • pharmacy data on how well participants adhere to their medications

Sometimes, a plan may be too new in the Part C or Part D marketplace to have a star rating. Medicare will let you know when this is the case.

Medicare offers a special enrollment period where you can sign up for a 5-star plan if one is available in your area.

This time period is from December 8 through November 30 of the following year. You can only switch to a 5-star plan once during this time period.

The 5-star enrollment period is outside of the traditional time period when you can enroll in a new Part C or Part D plan, which is from October 15 through December 7.

It’s important to be aware that Medicare will flag low-performing plans, which are plans that receive 3-star ratings for three consecutive years.

If you’re currently enrolled in a low-performing plan, Medicare will notify you. You also can’t enroll in a low-performing plan on Medicare’s online Plan Finder tool. Instead, you must call Medicare or the plan directly.

One of the easiest ways to learn about Medicare’s plan ratings is to visit Medicare.gov and use the plan finder tool. This tool allows you to search by ZIP code and see available plans and their star ratings.

When shopping for a plan, you may see that low-performing plans are flagged with the symbol of an upside-down triangle that has an exclamation point.

A 5-star plan has a special symbol: a yellow triangle with a white star inside, which represents the number 5.

If the plan finder tool isn’t for you, you can also call Medicare directly at 1-800-633-4227 (TTY: 1-877-486-2048). A person can review plans with you, including 5-star plans, if you want to learn more about these options.