Medicare rates Medicare Advantage and Part D (prescription drug plans) by stars. A 5-star rating is the best, while a 1-star rating is the worst.

When you’re trying to choose a Medicare Advantage or Part D (prescription drug) plan, the number of choices can sometimes feel overwhelming. Medicare offers a star rating to give you more information for your decision.

Medicare considers various variables when determining the rating, including plan participants’ ratings and member complaints. The ratings, along with factors such as cost and coverage, can help a person choose the right Medicare Advantage plan.

The Medicare star ratings take into account factors like customer service, preventive care, and the number of people who leave the plan annually.

Keep reading to learn more about Medicare star ratings and how to use them to evaluate potential plans.

The Medicare star rating is designed as a way to help consumers select a Medicare Advantage plan as well as evaluate how well plans that contract with Medicare perform.

Medicare assigns a star rating from 1 to 5, with 5 being the best for both Medicare Advantage and Medicare Part D (prescription drug coverage) plans.

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 with drug coverage, Medicare considers 40 different performance measures under these five categories. For Medicare Advantage plans that don’t have prescription drug coverage, they consider 33 different measures.

To rate Medicare Part D plans, Medicare takes into account 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

The results are a star rating that ranges from 1 to 5, with 5 being the best rating. A 5-star plan has a special symbol, which is a yellow triangle with a white star that has the number 5 inside of it.

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 Medicare Advantage or Part D marketplace to have a star rating. Medicare will let you know when this is the case.

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.

To better interpret the star ratings, 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

Knowing that a plan has a high star rating can give you some peace of mind. You know that other plan participants have rated the plan highly, and the plan’s participants have good health outcomes.

However, a star rating isn’t the only factor to take into account regarding your plan of choice. You can also consider the following:

  • Cost: A 5-star plan doesn’t necessarily mean it’s expensive. However, it must be affordable and have terms that can help you stay within your annual healthcare budget.
  • Coverage: You should also evaluate a health plan based on the coverage it offers. This includes considerations for in-network providers, covered prescription drugs, and additional services you may wish to receive under Medicare Advantage. These may include dental, vision, and hearing coverage.

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

Medicare times the release of its star ratings in time to help you make decisions about your plan for the upcoming year.

Medicare typically releases its ratings in October each year. For example, in October 2024, Medicare will release star plan ratings for 2025.

For 2024, 42% of Medicare Advantage plans with prescription drug coverage earned 4 stars or better for the year. An estimated 74% of Medicare Advantage enrollees with prescription drug plans were enrolled in a plan rated at 4 stars or better.

Medicare offers a special enrollment period during which a person can sign up for a 5-star plan, provided one is available in their area. This time period is from December 8 through November 30 of the following year. A person can switch to only 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 Medicare Advantage or prescription drug 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 received 3-star ratings for three consecutive years.

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.

If you are 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.

Medicare star ratings can help you get a sense of how well a plan performs for its members. While they aren’t the only factors to understand when choosing a plan, they can be helpful.

Medicare typically releases these ratings in October for the upcoming year, so stay tuned to the Medicare website (or call the Medicare line) to learn about your desired plan’s performance.