Medicare Advantage Star Ratings Explained: How to Use Them to Pick a Better Plan

When you compare Medicare Advantage plans on Medicare.gov, you will see a star rating next to each plan -- anywhere from 1 to 5 stars. Many people ignore these ratings and focus only on premiums and benefits. That is a mistake.

Star ratings are Medicare's quality report card for insurance plans. A plan's star rating tells you how well it actually performs -- not just what it promises on paper. Here is how the system works and how to use it.

The Medicare Star Rating System (formally called the Overall Star Rating) is a quality measurement program run by the Centers for Medicare & Medicaid Services (CMS). Every Medicare Advantage plan and standalone Part D drug plan receives an annual rating on a scale of 1 to 5 stars:

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

Ratings are published each fall and apply to the following plan year. The ratings you see for 2026 plans are based on data collected in 2024-2025.

CMS evaluates plans across dozens of individual measures grouped into several categories. For Medicare Advantage plans with drug coverage (MA-PD plans), the overall rating combines scores from:

• Staying healthy: Screenings, tests, and vaccines (flu shots, breast cancer screenings, colorectal cancer screenings, diabetes screenings)
• Managing chronic conditions: How well the plan helps members control diabetes, blood pressure, cholesterol, and other conditions
• Member experience: Results from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey -- members rating their plan, their doctors, and getting needed care
• Member complaints and appeals: How often members file complaints, how quickly appeals are resolved, and whether members choose to leave the plan
• Health plan customer service: Call center performance, accuracy of plan information

• Drug plan customer service: Call center responsiveness, accuracy
• Member complaints about the drug plan
• Drug pricing and patient safety: Medication adherence for diabetes, hypertension, and cholesterol medications; avoiding high-risk medications in older adults
• Member experience with the drug plan

A 4- or 5-star plan has demonstrated better performance on clinical quality measures. Members of higher-rated plans tend to receive recommended preventive screenings, have better chronic disease management, and report higher satisfaction.

Beneficiaries can switch to a 5-star plan at any time during the year -- not just during Annual Enrollment Period (October 15 - December 7). This is called the 5-Star Special Enrollment Period. If a 5-star plan is available in your area, you can enroll in it any month of the year.

Plans with consistently low star ratings face financial penalties from CMS and may eventually be terminated. Enrolling in a low-rated plan carries the risk of the plan being discontinued, forcing you to switch.

CMS pays quality bonus payments to plans rated 4 stars or higher. These bonus payments allow higher-rated plans to offer richer benefits -- lower premiums, lower copays, more supplemental benefits like dental and vision. In other words, a 4- or 5-star plan often has better benefits precisely because it earns more from CMS.

The easiest way to see star ratings is on Medicare.gov/plan-compare:

1. Go to Medicare.gov and click "Find health & drug plans"
2. Enter your ZIP code and Medicare information
3. Plans display their star rating prominently
4. You can filter by star rating to see only 4- and 5-star plans

You can also find ratings in the Medicare & You handbook published each fall.

As a general guideline:

• 4.5-5 stars: Excellent -- these plans consistently perform well across quality measures
• 4 stars: Good -- above average performance, eligible for bonus payments
• 3-3.5 stars: Average -- meets minimum standards but room for improvement
• Below 3 stars: Below average -- consider carefully; plans rated 2.5 stars or below for three consecutive years may be terminated by CMS

Most Florida Medicare beneficiaries have access to at least some 4-star plans. In competitive markets like the Orlando, Tampa, Jacksonville, and Miami metro areas, 4.5- and 5-star plans are often available.

Star ratings are important, but they are not the only factor. Here is how to think about the tradeoff:

Never choose a plan based on star rating alone. A 5-star plan with a narrow network that excludes your doctors is not the right choice. But all else being equal, higher stars mean better performance.

Star ratings are recalculated annually. A plan that earned 4 stars last year may earn 3.5 or 4.5 this year. Changes happen because:

• CMS adds or modifies quality measures
• The plan's actual performance improves or declines
• Member survey results shift
• The plan changes ownership or administration

This is why it is important to review your plan every fall during Annual Enrollment Period -- even if you are happy with your current plan. Your plan's rating may have changed, and a better-rated option may now be available.

New Medicare Advantage plans do not have enough performance data to receive a full star rating in their first year. CMS assigns new plans a provisional rating (typically 3 stars) until sufficient data is collected. Be cautious about enrolling in a brand-new plan -- you have no track record to evaluate.

Medicare star ratings are a valuable -- and underused -- tool for choosing a better plan. They measure real-world quality: how well members get their care, how chronic conditions are managed, and how satisfied members are. Higher-rated plans also tend to offer better benefits because they earn CMS quality bonuses.

When comparing Medicare Advantage plans in Florida, use star ratings as one important filter -- alongside premiums, network, drug formulary, and extra benefits.

Want help comparing Medicare Advantage plans in your area of Florida? Call William Gray at (386) 871-3858 or schedule a free consultation. As an independent specialist, William compares plans from all major carriers -- not just one company.