Medicare Advantage

How CMS updates Medicare Star Ratings each October in Gastonia

GASTONIA, N.C. — As the fall Annual Enrollment Period runs from October 15 through December 7, Medicare shoppers in Gaston County will once again see little clusters of gold stars next to Medicare Advantage and Part D plans. Those Star Ratings, updated by the Centers for Medicare & Medicaid Services (CMS) each October, are one of the most cited — and most misunderstood — numbers in Medicare. Here is what they actually measure, and what they don't.

What CMS Star Ratings actually measure

Star Ratings are a quality scorecard. CMS grades Medicare Advantage and Part D plans on a 1-to-5 scale, with 5 being the highest. The score is built from dozens of individual measures grouped into broad categories, including:

• 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 results about how easy the plan is to use and how members rate their care.
• Member complaints and plan performance: how often people leave the plan, complaints filed, and problems getting needed care.
• Customer service: call center performance, appeals handling, and access to information.
• Drug plan measures (Part D): medication safety, adherence for common conditions, and pricing accuracy.

In short, the stars measure how a plan operates — not the size of a premium, not the network in Gastonia, and not whether a specific drug is covered on the formulary.

What Star Ratings do NOT tell you

This is where a lot of shoppers get tripped up. A 4-star rating does not mean the plan is the right fit for you. It doesn't tell you:

• Whether your doctors at CaroMont or Atrium Health are in-network.
• Whether your specific prescriptions are on the plan's formulary.
• What you'll pay out of pocket for the care you actually use.
• Whether the plan offers extras that matter to your situation.

Two people in the same Gastonia neighborhood can look at the same 4-star plan and reach opposite conclusions — and both can be right. The stars are one input, not a verdict.

How and when the ratings are published

CMS releases updated Star Ratings each fall, typically in early to mid-October, so the numbers are fresh when the Annual Enrollment Period opens October 15. You can view them on Medicare.gov's Plan Finder, where the stars appear right next to each plan as you compare options for your ZIP code.

Ratings can shift year to year. A plan that earned 4 stars for 2026 may earn 3.5 or 4.5 for 2027, depending on how it performed on the underlying measures. That is why CMS recommends checking the current ratings each fall, even if you liked your plan last year.

Using stars alongside local plan availability

Gastonia is in Gaston County, where Medicare beneficiaries typically have a wide range of Medicare Advantage and stand-alone Part D options to compare during AEP. The exact list of plans and carriers available in Gaston County is set at the county level and posted on Medicare.gov each fall.

A sensible way to use Star Ratings is as a tiebreaker, not a starting point. First narrow your list based on:

1. Are my doctors and preferred hospitals in-network? 2. Are my prescriptions covered, and at what tier? 3. What are the total expected costs — premium plus expected out-of-pocket?

Then look at the stars to see how the remaining plans have performed on quality and service.

2027 program facts worth knowing

While you're comparing plans for 2027, keep these Medicare-wide numbers in mind. They apply across plans and aren't tied to any one carrier:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug spending hits this ceiling, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that spreads your drug costs into monthly payments across the year. It doesn't lower the total cost — it just smooths it out.
• IRMAA (higher Part B and Part D premiums for higher earners) starts above $109,000 in income for a single filer in 2026.

Key dates for Gaston County shoppers

• October 15 – December 7: Medicare Annual Enrollment Period. Change your Medicare Advantage or Part D plan for coverage starting January 1.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you get one chance during this window to switch to another MA plan or return to Original Medicare.