Medicare Advantage

How CMS Grades Medicare Plans: A Star Ratings Primer

Orange County has 111 Medicare Advantage plans for 2027. Compared with 2026, 21 plans are not coming back, 28 are new, and 51 continuing plans changed in some way you should check before December 7, 19 of them under a new name. This guide covers what those numbers mean for Laguna Niguel, not which plan to pick.

LAGUNA NIGUEL, Calif. — Every fall, just before Medicare's Annual Enrollment Period opens on Oct. 15, the Centers for Medicare & Medicaid Services (CMS) publishes fresh Star Ratings for Medicare Advantage and Part D plans. The 2027 ratings arrive on the Medicare Plan Finder in October, and they are one of the few apples-to-apples measures a shopper can use before the Dec. 7 deadline. Here is what those stars actually measure — and what they do not.

What Star Ratings actually measure

Star Ratings are CMS's report card on plan quality. Medicare Advantage plans that include drug coverage are scored on roughly 40 measures; stand-alone Part D plans are scored on about a dozen. The measures fall into broad buckets: how well the plan helps members stay healthy (screenings, vaccines, managing chronic conditions), how members rate their experience, how quickly complaints and appeals are handled, and — for drug coverage — accuracy, safety, and medication adherence.

Each plan gets an overall star score from 1 (poor) to 5 (excellent), rounded to the nearest half-star. CMS uses survey data, clinical records, pharmacy data, and its own complaint tracking to build the scores.

What the stars do not measure

This is where readers often get tripped up. Star Ratings do not tell you:

• What a plan costs, or what its premium, deductible, or copays look like.
• Whether your doctor or hospital is in the network.
• Whether your specific medications are on the formulary.
• Whether the plan offers extras like dental or vision.

A 4-star plan is not automatically a good fit for you, and a 3-star plan is not automatically a bad one. The rating is about how the plan performs on quality metrics — the rest of the shopping still has to happen.

When and where the 2027 ratings appear

CMS releases Star Ratings each October, and they are loaded into the Medicare Plan Finder at medicare.gov in time for the Oct. 15 opening of Annual Enrollment. The ratings you see during AEP apply to the following plan year — so the numbers you read this fall are the 2027 ratings.

Laguna Niguel is in Orange County, where a wide selection of Medicare Advantage and Part D plans is available. When you look up plans on Plan Finder using your ZIP code, the star score appears next to each plan.

How ratings tie into 2027 changes

There is a lot moving in Medicare for 2026. The Part D out-of-pocket cap rises to $2,100, the maximum Part D deductible is $615, and the coverage gap remains gone — replaced in 2025 by a three-phase drug benefit. The optional Medicare Prescription Payment Plan lets you spread drug costs across the calendar year. IRMAA surcharges for higher-income beneficiaries begin above $109,000 for a single filer in 2026.

Star Ratings do not change any of that, but they can help you gauge how well a plan handles the things that matter alongside price — customer service, pharmacy accuracy, and care coordination.

How to use the ratings without being steered

Think of Star Ratings as one input, not the whole decision. A sensible approach:

1. Start with your doctors, your medications, and your budget. 2. Narrow the list of plans that fit those needs. 3. Then look at the star scores as a tiebreaker or a quality check.

If you want a neutral second set of eyes, your State Health Insurance Assistance Program (SHIP) offers free, one-on-one counseling. In California, that program is called HICAP.