Medicare Advantage

How Medicare Star Ratings Work Before Oct. 15

KAHULUI, Hawaii — With the Medicare Annual Enrollment Period opening October 15, the Centers for Medicare & Medicaid Services will once again post its yearly Star Ratings for Medicare Advantage and Part D drug plans this fall. The ratings are not a ranking or a shopping list — they are a snapshot of how plans performed on dozens of quality measures, and they can help Kahului residents ask sharper questions before they enroll.

What Star Ratings actually measure

CMS rates Medicare Advantage and standalone Part D plans on a scale of 1 to 5 stars, with 5 being the highest. The scores pull together data from member surveys, health records, pharmacy claims, and CMS's own monitoring.

For Medicare Advantage plans that include drug coverage, CMS looks at roughly 40 measures across categories like:

• Staying healthy (screenings, tests, vaccines)
• Managing chronic conditions
• Member experience and complaints
• Customer service and appeals
• Drug pricing accuracy and safe medication use

Standalone Part D plans are rated on a smaller set of measures focused on the drug benefit.

Why the ratings come out in the fall

CMS releases updated Star Ratings each October, timed so they are live in the official Medicare Plan Finder when the Annual Enrollment Period begins on October 15. That gives people a full window — through December 7 — to review current-year performance before choosing coverage that starts January 1.

Ratings are refreshed once a year. A plan's star count can move up or down from one year to the next as new data comes in, so last fall's number may not match this fall's.

What Star Ratings do not tell you

This is where a lot of confusion starts. A star score is a quality signal, not a personal fit score. It does not tell you:

• Whether your doctors or the hospital you use are in the plan's network
• Whether your specific prescriptions are on the plan's formulary
• What you personally would pay in premiums, copays, or out-of-pocket costs

Two people in the same ZIP code can look at the same plan and have very different experiences with it. That is why CMS and Medicare counselors encourage using ratings alongside — not instead of — a check on doctors, drugs, and total costs.

How Kahului residents can look ratings up

Kahului is in Maui County, where Medicare Advantage and Part D plan choices are set at the county level. Once the new ratings post in October, you can see them by:

1. Going to medicare.gov and using the Plan Finder — star ratings appear next to each plan. 2. Calling 1-800-MEDICARE (TTY 1-877-486-2048), available 24/7. 3. Contacting Hawaii SHIP (Sage PLUS Program) for free, one-on-one counseling from trained volunteers who do not sell insurance.

Program changes worth knowing this season

Star Ratings are only one piece of the 2027 picture. A few program-level updates also take effect that may shape how you weigh a plan:

• The Part D out-of-pocket cap is $2,100 in 2026.
• The Part D maximum deductible is $615.
• The coverage gap (the old "donut hole") has been eliminated since 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments if you opt in.
• IRMAA income-related surcharges begin above $109,000 for a single filer in 2026.

These are program rules — they apply the same way regardless of which plan you pick.

Key dates to circle

• October 15 – December 7: Annual Enrollment Period. Coverage chosen now starts January 1.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you are already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.