Medicare Advantage

Star Ratings Explained: What Those 1-to-5 Scores Really Measure

Methuen, Mass. — Every October, just before Medicare's Annual Enrollment Period opens, the federal government publishes fresh Star Ratings for Medicare Advantage and Part D drug plans. The 2027 ratings are landing now, and if you live in Methuen and are about to compare coverage, it helps to know what those stars are actually grading — and what they are not.

Star Ratings are a quality measurement tool from the Centers for Medicare & Medicaid Services (CMS). They are not a shopping ranking, and they are not a promise about your personal experience with a plan. Understanding the difference can help you avoid a common enrollment mistake: picking a plan on stars alone.

What Star Ratings actually measure

CMS scores Medicare Advantage plans on up to 40 quality measures and standalone Part D plans on up to 12. The measures fall into broad buckets:

• Staying healthy — whether members get recommended screenings, vaccines, and checkups.
• Managing chronic conditions — how well the plan supports people living with things like diabetes or heart disease.
• Member experience — survey results on how members rate their care and their plan.
• Member complaints and plan performance — how often people leave the plan, file appeals, or run into problems.
• Customer service — call center responsiveness, appeals handling, and access to information in the languages members speak.
• Drug pricing and patient safety (for Part D) — accuracy of pricing information and safe prescribing practices.

Each measure gets a score, those scores roll up into category scores, and the plan gets one overall rating from 1 to 5 stars, in half-star steps.

What Star Ratings do not measure

This is where readers get tripped up. Star Ratings do not grade:

• Monthly premiums or deductibles.
• Whether your specific doctor or hospital is in the plan's network.
• Whether your specific medications are on the plan's drug list.
• The size of any extra benefits like dental, vision, or hearing coverage.

A 4-star plan is not automatically "better for you" than a 3-star plan. It means the plan performed well on CMS's quality yardsticks — which is useful information, but it is only one piece of the picture.

How and when the ratings are published

CMS releases the ratings each fall, typically in early to mid-October, on Medicare.gov and in the Medicare Plan Finder tool. The timing is deliberate: the ratings are meant to be available to people during the Annual Enrollment Period (Oct. 15 – Dec. 7), when most Medicare beneficiaries can change coverage for the following year.

You will see the star count listed next to each plan when you compare options on Medicare Plan Finder. If you use the phone, 1-800-MEDICARE representatives can look up the same information.

Using ratings without letting them mislead you

If you live in Methuen, you are in Essex County for Medicare purposes, and the plans available to you are set by county. Here is a straightforward way to use Star Ratings without over-relying on them:

1. Start with what you need: your doctors, your pharmacy, your prescriptions, and how you like to get care. 2. On Medicare Plan Finder, filter for plans that cover those things in Essex County. 3. Then look at the Star Ratings among that shorter list. Stars can help you compare quality among plans that already fit your life.

Skipping steps 1 and 2 is the mistake to avoid. A 5-star plan that does not cover your cardiologist is not a good match, no matter how the stars look.

A few program facts worth knowing for 2027

While you are comparing coverage this fall, keep these program-wide numbers in mind — they apply regardless of which plan you land on:

• The Part D out-of-pocket cap is $2,100 for 2026.
• The Part D maximum deductible is $615.
• The old coverage gap ("donut hole") was eliminated in 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 — it is optional and does not lower total cost.
• IRMAA income-based surcharges start above $109,000 for a single filer in 2026.