Medicare Advantage plans get a star rating from 1 to 5 stars, based on how well they perform on quality and customer service measures

Every Medicare Advantage plan receives a star rating each year from Medicare. The rating reflects how the plan performs on things like how quickly doctors see patients, whether preventive care gets done, and how satisfied members are. Plans are rated on a scale of 1 to 5 stars, with 5 being the highest. You will see these ratings when you compare plans during the annual enrollment period, and they can help you understand which plans other members have found reliable.

The star system is not a perfect measure of whether a plan is right for you — your own doctors, prescriptions, and location matter more than the overall rating. But stars do tell you something real about how a plan has performed in the past year, based on data Medicare collects from the plan itself and from surveys of members.

Key Takeaways

  • Star ratings range from 1 to 5 stars and are updated once each year, usually in October, based on the previous year's performance data.
  • Plans are measured on dozens of specific metrics, including doctor appointment wait times, preventive care rates, member satisfaction, and how quickly claims are processed.
  • A plan with 4 or 5 stars has generally performed well, but a lower-rated plan may still be the right choice if it includes your doctors or covers your medications.
  • You can see star ratings for every plan in your area on Medicare.gov during open enrollment, and the ratings are the same no matter which website you use to compare.

What each star rating means in practice

A 5-star plan has performed at the highest level across most measures. These plans typically have high member satisfaction scores, good preventive care rates, and fast claims processing. However, 5-star plans are not always available in every area, and they may not include your preferred doctors.

A 4-star plan has performed well above average. Most people find these plans reliable and responsive. Four-star plans are more common than five-star plans and still represent strong performance.

A 3-star plan has performed at an average level — neither notably better nor worse than other plans. Three-star plans are common and may be a good choice if they include your doctors or have lower out-of-pocket costs.

A 2-star or 1-star plan has performed below average on one or more important measures. This does not mean the plan is unsafe or that you cannot use it, but it does mean members have reported lower satisfaction or the plan has had slower processing times or lower preventive care rates. You may still choose a lower-rated plan if it is the only one that covers your doctors or medications, but it is worth understanding what the lower rating reflects.

How Medicare calculates the star rating

Medicare measures plans on more than 40 different metrics across five main categories: care coordination, member satisfaction, plan responsiveness, safety, and timeliness of care. Each metric is scored, and the scores are combined into an overall rating. The data comes from two sources: information the plan reports to Medicare (like how many members got preventive screenings) and surveys of plan members (like whether they felt their doctor listened to them).

The star rating you see is updated once per year, usually in October. It reflects performance from the previous calendar year. This means the rating you see in October 2024 is based on how the plan performed during 2023. Plans do not get a new rating mid-year, so the stars you see when you enroll in the fall are the same stars that will explore to your coverage for the entire next year.

Medicare publishes the detailed metrics behind each plan's rating on Medicare.gov. If you want to know exactly why a plan received a certain rating — for example, whether it scored low on appointment wait times or member satisfaction — you can look up the individual measures.

Where to find star ratings when comparing plans

During the Medicare Advantage open enrollment period (October 15 to December 7 each year), you can compare star ratings on Medicare.gov using the Plan Finder tool. Enter your ZIP code and the tool will show you every plan available in your area, along with its star rating, monthly premium, and out-of-pocket costs.

You will also see star ratings on other websites that compare Medicare plans, but the ratings themselves come from Medicare and are the same everywhere. The difference between websites is usually in how they display the information or what additional filters they offer (like filtering by star rating or by whether a plan includes a specific doctor).

Star ratings are also included in the Summary of Benefits document that each plan mails to you before the open enrollment period begins. If you receive a plan's marketing materials in the mail, the star rating will be listed there as well.

How star ratings affect your choices and costs

Star ratings do not directly change your monthly premium or out-of-pocket costs — a 5-star plan does not automatically cost more or less than a 3-star plan. However, plans with higher star ratings sometimes offer extra benefits (like additional dental or vision coverage) as a way to attract members, and those extra benefits may have their own costs.

More importantly, your choice of plan should balance the star rating with other factors that matter to you personally. A plan with a 3-star rating that includes your primary care doctor and covers all your medications may be a better choice for you than a 5-star plan that requires you to switch doctors or pay more for your prescriptions. The star rating is one piece of information, not the only piece.

If you are currently in a plan and unhappy with it, the star rating of your current plan is worth checking. If your plan's rating has dropped significantly, or if you see that other plans in your area have much higher ratings, that may be a signal to look at switching during the next open enrollment period.

Questions to ask your doctor or plan about star ratings

If you are trying to decide between two plans with different star ratings, ask your doctor whether they are in-network for both plans. Ask your plan directly about the specific metrics where it scored lower — for example, if a plan has a low rating for appointment wait times, ask how long the average wait is to see a primary care doctor. Ask whether the plan has made changes since the rating was published that might improve performance.

You can also contact the plan's member services line and ask about their experience with the metrics you care about most. If you are concerned about prescription drug coverage, ask whether your medications are on the plan's formulary and at what tier. If you are concerned about preventive care, ask what screenings and vaccines the plan covers at no cost.

When to seek help understanding your plan's rating

If you are confused about what a star rating means or how it applies to your situation, contact your State Health Insurance information Program (SHIP). SHIP offers free counseling about Medicare plans and can explain what a plan's rating means in practical terms. You can find your state's SHIP by calling 1-800-MEDICARE or visiting Medicare.gov.

If you have already enrolled in a plan and are unhappy with your experience, you can switch to a different plan during the next open enrollment period without penalty. You do not need to wait for your plan's star rating to improve.

Frequently Asked Questions

Can a plan's star rating change during the year?

No. The star rating you see when you enroll is the rating for that entire year. Medicare updates all plan ratings once per year, usually in October, based on the previous year's performance. The rating does not change mid-year even if the plan's performance changes.

Does a higher star rating mean lower out-of-pocket costs?

Not necessarily. Star ratings and costs are separate. A 5-star plan may have a higher monthly premium or higher deductible than a 3-star plan, or it may have lower costs. You need to compare both the star rating and the actual costs for your situation.

What if the only plan available in my area has a low star rating?

You can still enroll in it. Star ratings reflect past performance, but they do not determine whether you can use a plan or whether it will cover your care. If the plan is your only option or the only one that includes your doctors, a lower rating does not prevent you from choosing it. You can always switch during the next open enrollment period if you are unhappy.

Are star ratings the same on every website?

Yes. The star ratings come directly from Medicare and are the same on Medicare.gov, insurance broker websites, and other comparison tools. The websites may display the information differently or let you filter by rating, but the actual ratings are identical.

How do I know which specific measures brought a plan's rating down?

Go to Medicare.gov, use the Plan Finder tool, and select the plan you are interested in. The detailed metrics page will show you the plan's score on each of the 40+ measures Medicare tracks. You can see exactly where the plan scored high and where it scored lower than average.