Included Open Medicare Enrollment People picking options for 2025 often have a dizzying number of options to choose from this season Part D Drug Schedules and private insurers Medicare Advantage Plans. Medicare star ratings can help you narrow down your choices—if you understand what they mean.
But few Medicare recipients bother to look at the stars, according to the KFF Health Policy Research Group. “When asked whether these star ratings influenced their decision-making when selecting a plan, the majority of participants said “no,” a 2023 KFF report says.
You are making a mistake.
What Medicare Star Ratings Can Tell You
The star ratings you can find on the Medicare website Plan Finder The Part D and Medicare Advantage Plan Comparison Tool (the alternative to Original Medicare) provides a quick overview of how the plans compare in terms of quality and member experience.
“It’s an imperfect system at best, but it’s the best we have,” says Dr. Sachin Jain, president and CEO of SCAN Health Plan, a large Medicare Advantage plan.
In the annual ratings from the Centers for Medicare and Medicaid Services (CMS), 5 stars means excellent, 4 means above average, 3 means average, 2 means below average, and 1 means poor. In Medicare’s Plan Finder, a 5-star plan is highlighted: a large star with the number 5 in it.
The data used to create these ratings is somewhat outdated — the 2025 ratings are based on plans’ performance in 2023, says Suzanna-Grace Tritt, senior actuary at health care consulting firm Wakely.
Medicare Advantage insurers strive for 4 stars or more
Something else you may not know: Medicare Advantage plans (but not Part D plans) get hefty bonuses from Medicare if they achieve at least 4 stars – worth more than $11.8 billion in 2024, according to KFF .
“If they receive higher payments, they may be able to provide additional services,” says Jeannie Fuglesten Biniek, deputy director of the Medicare policy program at KFF. “But it’s not necessarily a one-to-one correlation as to whether a 5-star plan provides more benefits.”
However, few Part D or Medicare Advantage plans receive 1 or 2 stars. “In practice, it’s more like a 2.5- to 5-star system,” says Jain.
How to recognize a low performer
If a plan gets less than three stars for three consecutive years, Medicare can cancel it, so plans have an incentive to maintain their quality, Tritt says. Such underperforming plans are displayed in the Plan Finder with an inverted red triangle with an exclamation mark inside.
People in these low-performing plans can switch to plans rated 3 stars or better during Medicare’s special enrollment period between January 1 and December 31.
What goes into a Medicare star rating
Star ratings for Part D and Medicare Advantage consist of up to 40 and 30 quality and performance metrics, respectively. Broadly speaking, ratings for both types of plans are based in part on member experience, customer service, and plan performance.
Part D ratings also assess the safety and pricing of prescription drugs, while Medicare Advantage ratings also examine whether members are staying healthy and whether people with chronic conditions are receiving the tests and treatments typically recommended for them.
“If I wanted to understand how good my experience with the plan would be, the star could be an indication of that,” says Tritt. “It is not a direct indication of how good your performance is or how good your performance is [doctor’s or hospital] Network, will be.”
The 5-Star Unicorns of Medicare
However, if you’re the type of person who only wants to sign up for a 5-star plan, you’re probably out of luck.
CMS has overhauled Medicare’s star rating methodology in recent years, making it extremely difficult for a plan to earn five stars, says Lisa Winters, a consulting actuary at Wakely.
Star ratings have been kept artificially high during the pandemic so plans won’t be accused of quality deficiencies beyond their control.
According to CMS, by 2025, only 2% of people with Medicare Advantage/Part D plans and 5% with standalone Part D plans will be in five-star plans. There were significantly more 5-star plans for 2024 than for 2025.
When I gave Plan Finder a test run to see my Part D and Medicare Advantage offers in suburban New Jersey, I found no 5-star plans.
Tritt’s advice for people in open enrollment: “You’re probably going to live in an area this year where you don’t even see a five-star plan.”
4-star plans are easier to find
It’s far easier to find a plan with at least four stars. “More than 70% of people with Medicare Advantage are enrolled there,” Biniek says.
She noted that the 5-star Medicare Advantage plans do not receive larger bonuses than the 4½-star plans, so insurers generally see little benefit in aiming for five. But some insurers are pushing 5-star plans because they use them as a marketing tool, says Biniek.
The push for Medicare Advantage plans to earn at least four stars is why insurers are so popular Humana, UnitedHealth GroupSCAN health and Elevance Health have asked CMS in court to revise their star rating upwards.
Advice on Medicare Star Ratings
Here are the experts’ tips and tricks for evaluating Part D and Medicare Advantage star ratings during open enrollment:
- Don’t choose or reject a Part D or Medicare Advantage plan based solely on its star rating. “I think cost and access to services or health care providers may be at least as important as the overall rating of the plan when a person makes a decision,” Biniek says. But a star rating could be your deciding factor when choosing between two plans with similar deductible costs and coverage.
- Don’t panic if a plan’s 2025 star rating is slightly lower than its 2024 rating. The downgrade could be due to an error in calculating ratings from year to year. “Unfortunately, if you find that your plan’s star rating fluctuates, it will likely continue to do so,” says Tritt. That’s why it’s best to look at a plan’s star rating history over several years.
- If you’re happy with the cost and coverage of a Part D or Medicare Advantage plan but are concerned about the overall star rating, click through the Medicare Plan Finder to see the star ratings in the subcategories. You can see how the plan performed on the specific quality and member satisfaction measures that matter to you.
“It often happens that plans don’t all work out,” says Tritt. “They almost always have a weakness.”
If you’re wondering why a Part D plan became faulty because pharmacists performed poorly in helping their members take medications, it’s because CMS evaluates the plans for medication adherence, Tritt says.
A low score on this measure suggests that the insurer’s preferred pharmacies are not doing a good job of ensuring members follow doctor’s orders.
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