Medicare Advantage

What Escondido should know about fall Star Ratings

San Diego County has 65 Medicare Advantage plans for 2027. Compared with 2026, 26 plans are not coming back, 18 are new, and 28 continuing plans changed in some way you should check before December 7, 20 of them under a new name. This guide covers what those numbers mean for Escondido, not which plan to pick.

Medicare AdvantageEscondido, CA

ESCONDIDO, Calif. — Every fall, just before Medicare's Annual Enrollment Period opens on Oct. 15, the federal government publishes fresh Star Ratings for Medicare Advantage and Part D drug plans. For Escondido residents weighing their options for 2027, those little half-stars and full stars can feel like a shortcut to a good decision. They are useful — but only if you know what they are measuring, and what they are not.

Here is a plain-English guide to how the Centers for Medicare & Medicaid Services (CMS) builds these ratings, when they land, and how to read them without letting a single number do all the thinking for you.

What Star Ratings actually measure

Star Ratings are CMS's way of grading how Medicare Advantage and stand-alone Part D plans perform on quality and service. Plans are scored on a 1-to-5 scale, with 5 being the highest.

The scores pull from dozens of individual measures. In broad strokes, they look at:

• Staying healthy: whether members get recommended screenings, vaccines and check-ups.
• Managing chronic conditions: how well plans support members living with diabetes, heart disease and similar conditions.
• Member experience: survey answers about ease of getting care, communication and overall satisfaction.
• Member complaints and plan performance: how often members leave, file complaints or appeal decisions.
• Customer service: how promptly plans handle calls, appeals and requests.
• Drug plan measures: for plans with Part D, things like drug pricing accuracy, medication safety and adherence.

Notice what is not on that list: monthly premium, deductible, network size, or which specific drugs a plan covers. Stars grade the experience, not the price tag.

How and when the ratings are published

CMS refreshes Star Ratings once a year, typically in early to mid-October, and posts them on medicare.gov's Plan Finder for the upcoming plan year. That timing is deliberate — the ratings go live just as the Annual Enrollment Period (Oct. 15 through Dec. 7) begins, so shoppers can see them while comparing plans for the next January.

The data behind each rating comes from the prior measurement year. That means the stars you see this fall reflect how a plan performed roughly a year or more earlier, drawn from clinical records, member surveys, pharmacy data and CMS's own monitoring.

Because measures are re-scored every year, a plan's rating can move up or down. Do not assume last year's number still applies.

What Star Ratings do not tell you

Star Ratings are a quality signal, not a personal recommendation. A high-rated plan is not automatically the right fit, and a lower-rated plan is not automatically wrong for you. Two things the stars will never tell you:

• Whether your doctors and hospitals are in the network. That is plan-specific and changes yearly.
• Whether your prescriptions are covered on the plan's formulary, and at what tier. That, too, you have to check.

Cost matters as well. For 2026, Part D has an out-of-pocket cap of $2,100, a maximum deductible of $615, and the old coverage gap ("donut hole") has been eliminated as of 2025, leaving three simpler phases. There is also the optional Medicare Prescription Payment Plan, which lets you spread drug costs across the year. Higher-income enrollees — generally above $109,000 for a single filer in 2026 — may pay IRMAA surcharges on Part B and Part D.

None of that shows up in a star.

How to use the ratings in Escondido

Escondido is in San Diego County, where Medicare Advantage and Part D shoppers have a wide range of plans to compare. Star Ratings can help you narrow that field, but they work best as one filter among several.

A reasonable approach:

1. Start on medicare.gov's Plan Finder and enter your ZIP code and drug list. 2. Look at the star rating alongside the plan's total estimated yearly cost, formulary and provider network. 3. Read the sub-measures if a plan interests you — a 4-star plan may be strong on customer service but average on chronic care, or vice versa. 4. Confirm anything critical (your doctor, your prescriptions) directly with the plan before enrolling.

If you already have coverage, the Medicare Advantage Open Enrollment Period from Jan. 1 to March 31 gives you a second window each year to change your Advantage plan if something is not working.

Where to get personal help

Star Ratings are public, but the decisions built on top of them are personal. Free, unbiased help is available:

• medicare.gov — for Plan Finder, current ratings and plan documents.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• California's State Health Insurance Assistance Program (SHIP), known locally as HICAP, offers free one-on-one counseling to San Diego County residents, including in Escondido.