Every fall, the Centers for Medicare & Medicaid Services (CMS) publishes a quality score for every Medicare Advantage and Part D plan in the country, using a 1-to-5-star scale. Most people never look at it, and instead compare plans on premium alone. That’s understandable, since premium is the number that’s easiest to see, but star ratings are one of the more useful — and most overlooked — tools available before AEP 2026 opens on October 15. If you’re already working through your AEP prep checklist, checking star ratings for your current plan and any alternatives is worth adding to the list.
What Star Ratings Actually Measure
CMS scores Medicare Advantage and Part D plans across a set of quality and performance categories that generally fall into a few buckets: how members rate their experience with the plan, how responsive the plan’s customer service is, how well the plan manages chronic conditions like diabetes or heart disease, and how often members have complaints or leave the plan altogether. Part D-specific plans are also scored on things like drug safety and accuracy of pricing information. The result is a single overall rating, from 1 to 5 stars, that gets updated every year based on the plan’s most recent performance data.
It’s worth being clear about what this rating is not. It isn’t a measure of how much a plan costs, and it isn’t a ranking of which plan covers the most services. A plan can have a strong drug formulary and a low premium while still earning a middling star rating because of member complaints or slow claims processing. Star ratings are one input into a good decision, not the whole decision.
Why This Matters More Right Now Than Most of the Year
CMS typically releases updated star ratings for the coming plan year in early October — right in the window between AEP prep season and when AEP actually opens on October 15. That timing isn’t an accident from a shopper’s perspective: it means that by the time you’re comparing plans for Plan Year 2027, you’re looking at a fresh score reflecting the plan’s most recent performance, not a rating that’s a year or more out of date.
If you’re doing your AEP homework in August and September, it’s worth checking your current plan’s most recent rating now as a baseline, then checking again once the updated ratings post in October. A plan that held steady at 4 stars for several years can slip, and a plan you dismissed in the past might have improved. Ratings can change meaningfully from one year to the next, which is part of why re-checking annually — even for people happy with their current plan — is worth the ten minutes it takes.
Low-Performing Plans Get Flagged
CMS applies extra scrutiny to plans that fall below 3 stars for three consecutive years, marking them with a low-performing icon on Medicare.gov’s Plan Finder tool. If your current plan carries that flag, it’s a signal worth taking seriously — not necessarily a reason to panic, but a reason to look closely at what’s driving the low score and whether it affects things you personally rely on, like customer service responsiveness or how the plan handles prior authorizations. On the other end, plans that consistently score 5 stars are recognized as top performers and get a specific enrollment advantage described below.
The 5-Star Special Enrollment Period
If a 5-star Medicare Advantage or Part D plan is available in your area, Medicare gives you a special option outside the normal rules: the 5-Star Special Enrollment Period. It runs from December 8 through November 30 of the following year, and it lets you switch into that 5-star plan one time during that window, separate from AEP or any other enrollment period. Not every area has a 5-star plan available, since ratings and plan availability both vary by county, so this option won’t apply everywhere. But where it does apply, it’s a useful backstop — you’re not necessarily locked into waiting for AEP if a genuinely top-rated plan is available where you live.
It’s worth noting this SEP can only be used once per year, and switching plans, even into a highly rated one, is still worth thinking through carefully. A 5-star rating doesn’t guarantee your specific doctors are in-network or that your medications are covered on favorable terms, so the same homework that applies to any plan switch — checking your medication and doctor list — still applies here.
How to Check a Plan’s Star Rating
The most reliable source is Medicare.gov’s Plan Finder tool, which lists the current overall star rating for every Medicare Advantage and Part D plan available by ZIP code, along with a breakdown by category if you want more detail than the single overall number. Your plan’s Annual Notice of Change letter, which arrives every fall, may also reference the rating, though Medicare.gov’s tool reflects the most current figures. If any of the terminology in a plan’s rating breakdown is unfamiliar, our Medicare glossary can help translate it into plain language. And if you’re weighing a switch between plan types entirely, rather than just comparing two Medicare Advantage plans, our Medicare Advantage vs. Medigap comparison covers that broader decision.
Star ratings won’t tell you everything about whether a plan is right for you, but they’re a genuinely useful data point that most people never check. Adding a five-minute look at your current plan’s rating — and any alternatives — to your AEP prep this year is a small step that can prevent an unpleasant surprise down the road, whether that’s a plan with a pattern of member complaints or one that’s been quietly improving and deserves a second look. For a broader rundown of pitfalls people run into during Medicare decisions generally, our common Medicare mistakes page is worth a read before you make any final choice.
Have questions? Kayla Price is a licensed insurance agent serving NC, SC, GA, FL, VA, MD, MI, KS, TX, and OH. Call (866) 648-1578 or visit priceservicesgroup.com.