Medicare 2026

Five-Star Medicare Plans and the Special Enrollment Period That Lets You Switch

If you've been reading up on Medicare, you've probably seen plans described with stars — one, two, three, four, or five. Those stars come from Medicare's own quality rating system, and they matter for more than bragging rights. A plan that earns an overall 5-star rating unlocks a special opportunity: a once-a-year chance for eligible people to switch into it, outside the usual enrollment windows. Here's how the system works and what to think about before you use it.

What the stars actually mean

Medicare uses a 1-to-5 star scale to rate Medicare Advantage plans and stand-alone Part D (drug) plans on things like how members rate the plan, how well it manages chronic conditions, customer service, pharmacy experience, and how often members get recommended screenings and care. CMS publishes updated ratings each October for the following plan year, so when the Annual Enrollment Period opens, the stars you see reflect fresh scores.

A 5-star overall rating is the highest a plan can earn. It doesn't mean the plan is the right fit for you — it means the plan has performed strongly across the measures CMS tracks.

The 5-star Special Enrollment Period

Most people choose or change their Medicare coverage during Medicare's Annual Enrollment Period — October 15 through December 7, with coverage starting January 1 of the next year. For the 2027 plan year, that window runs October 15 through December 7, 2026.

Outside of that window, your options to switch are limited. The 5-star SEP is one of the exceptions. Here's how it works:

• If a Medicare Advantage plan, Medicare drug plan, or Medicare Cost plan in your area has an overall 5-star rating, you can use this SEP to switch into it.
• You can use the 5-star SEP once between December 8 and November 30 of the following year.
• Because ratings refresh each October, a plan that was 5 stars one year may not be the next, and vice versa.

One thing to watch carefully: if you're in a Medicare Advantage plan that includes drug coverage and you use the 5-star SEP to switch to a 5-star plan that doesn't include drug coverage, you may lose your drug coverage — and you might not be able to add a stand-alone drug plan until the next valid enrollment window. Confirm whether the 5-star plan you're considering includes Part D before you make the switch.

Quality is one factor — not the whole picture

Star ratings are a snapshot of quality and service. They don't tell you whether your preferred doctors are in the plan's network, whether your medications are on the plan's formulary, or what your copays and out-of-pocket costs would be for the care you actually use. Those details are in each plan's own documents (the Summary of Benefits and Evidence of Coverage).

Before switching, it's worth checking:

• Are my doctors, hospitals, and specialists in the plan's network?
• Are all my prescriptions covered, and at what tier?
• What are the copays, coinsurance, and out-of-pocket maximums?
• If I take specialty drugs, how does the plan handle them?

A 5-star plan that doesn't cover your medications or include your doctor may not serve you as well as a lower-rated plan that does.

Medicare Advantage vs. Original Medicare + Medigap — a quick, neutral note

Some people considering a plan switch also weigh whether to stay in (or move to) Medicare Advantage versus going with Original Medicare plus a stand-alone drug plan and possibly a Medigap policy. Both paths have trade-offs. Medicare Advantage plans bundle coverage and often include extras but use networks and plan rules. Original Medicare lets you see any provider that accepts Medicare, and a Medigap policy can help with out-of-pocket costs, but you'd pay separate premiums and buy a Part D plan on your own. Neither path is "better" in general — it depends on your health, budget, and preferences.

If you have Medicaid or Extra Help

If you qualify for Medicaid or the Extra Help program for Part D costs, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch from one stand-alone Part D plan to another. If you're a full-benefit dual-eligible (you have both Medicare and full Medicaid), you can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month. These options exist alongside the 5-star SEP.

A few program numbers for 2027

As you compare plans for 2027, keep these national Part D figures in mind:

• The Part D out-of-pocket cap for 2027 is $2,400 (up from $2,100 in 2026).
• The most any Part D plan may charge as a deductible in 2027 is $700.
• The Part D base beneficiary premium for 2027 is $41.33 — a national figure used to calculate the late-enrollment penalty. Actual plan premiums are set by each plan.
• Social Security announced a 3.6% cost-of-living adjustment for benefits payable starting January 2027.

The 2027 Part B standard premium and deductible, and the IRMAA income brackets, had not been announced at the time of writing. CMS typically announces those figures in the fall.

Where to go next

To check current star ratings, confirm whether a 5-star plan is available where you live, and compare specifics like networks, formularies, and costs, use the Plan Finder at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week. For background on how the ratings are built, see CMS's materials on Medicare Star Ratings.