Savvy Senior: How to use Medicare's star ratings system during open enrollment

Dear Savvy Senior,

What does Medicare factor into their star rating system? I need to find a new Medicare plan during the open enrollment period and want to get it right this time.

-Medicare Shopper

Dear Shopper,

If you’re shopping and comparing Medicare Advantage plans (the alternative to original Medicare) or Part D prescription drug plans during the open enrollment (Oct. 15 – Dec. 7), you’ll likely find a dizzying number of options to choose from. The Medicare star rating system is a terrific tool to help you narrow down your choices. Here’s what you should know.

Understanding Star Ratings

The Medicare star ratings, which you’ll find in the Medicare’s online Plan Finder tool at Medicare.gov/plan-compare, offers a shorthand look at how Medicare Advantage and Part D plans measure up for quality and member experience.

In this annual rating system, five stars means excellent, four means above average, three means average, two means below average, and one means poor.

Medicare Advantage plans (but not Part D plans) that get at least a four-star rating get bonus payments from Medicare, which they can use to provide extra benefits.

You should also know that plans that get fewer than three stars for three consecutive years can be terminated by Medicare, so plans are incentivized to keep their quality up. Such low-performing plans show up on Plan Finder with an upside-down red triangle that has an exclamation point inside.

People in these low-performing plans can switch to ones rated three stars or better during Medicare’s Special Enrollment Period for Disenrollment, which is between Jan. 1 and Dec. 31.

How Ratings Are Comprised

Part D and Medicare Advantage star ratings comprise up to 40 or 30 quality and performance measures, respectively. Ratings for both types of plans are based partly on member experience, customer service, and plan performance.

Part D ratings also assess prescription drug safety and pricing, while Medicare Advantage ratings also look at whether members are staying healthy and if ones with chronic conditions get the tests and treatments typically recommended to them.

Be aware that five-star plans are few and far between. The Centers for Medicare & Medicaid Services (CMS) has revised the Medicare star rating methodology in recent years, making it extremely hard for a plan to earn five stars.

In 2025, just two percent of people with Medicare Advantage/Part D plans and five percent in stand-alone Part D plans have five stars. Four-star plans are much easier to find, as more than 70 percent of people with Medicare Advantage are enrolled in them.

Shopping Tips

Here are some tips to consider when evaluating Medicare Advantage and Part D star ratings during open enrollment:

• Don’t choose or reject a Medicare Advantage or Part D plan only because of its star rating. Costs and access to services or health providers should be your top priority when choosing a plan. But a star rating could be your deciding factor when choosing between two plans with similar out-of-pocket costs and coverage.

• Don’t panic if a plan’s 2026 star rating is slightly lower than its 2025 rating. The downgrade could be due to a blip in the way the ratings are computed from year to year. It’s best to look at a plan’s star-rating history over several years.

• If you’re fine with the cost and coverage of a plan but concerned about its star rating, click through the Medicare Plan Finder for the star ratings subcategories. You’ll be able to see how the plan scored in the specific quality and member satisfaction yardsticks that matter to you.

If you have questions or need help choosing a plan, contact your State Health Insurance Assistance Program (877-839-2675, ShipHelp.org), which offers free unbiased Medicare counseling in person or over the phone.

Send your questions or comments to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, email questions@savvysenior.org, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.