Medicare Advantage

Medicare Star Ratings: What They Mean This Fall

GREENVILLE, N.C. — As the Medicare Annual Enrollment Period approaches on October 15, older adults across Pitt County will start seeing a familiar symbol on plan finder pages: little gold stars. Each fall, the Centers for Medicare & Medicaid Services (CMS) refreshes its Star Ratings for Medicare Advantage and Part D drug plans, giving shoppers one more tool to size up their options before the December 7 deadline.

Here is a plain-English look at what those stars actually measure — and what they don't.

What Star Ratings Are

Star Ratings are a quality measurement system run by CMS. Every Medicare Advantage plan and stand-alone Part D drug plan gets a score from 1 star (poor) to 5 stars (excellent), with half-stars in between. The ratings are published on Medicare.gov each fall so people can see them during the Annual Enrollment Period.

The goal is transparency. CMS wants people comparing plans to have an at-a-glance sense of how a plan has performed — not just what it costs on paper.

What the Stars Actually Measure

CMS looks at dozens of specific measures grouped into broad categories. For Medicare Advantage plans that include drug coverage, ratings pull from about 40 different measures, including:

• Staying healthy — whether members get recommended screenings, tests, and vaccines.
• Managing chronic conditions — how well the plan supports members with diabetes, heart disease, and similar long-term issues.
• Member experience — survey results on how easy it is to get care and how members feel about the plan.
• Member complaints and changes in performance — including how often people leave the plan.
• Customer service — call center responsiveness, appeals handling, and language access.
• Drug plan quality — pricing accuracy, medication safety, and member satisfaction with drug coverage.

The scores come from member surveys, health records, pharmacy data, and CMS's own monitoring.

How and When Ratings Are Published

CMS releases updated Star Ratings each fall, ahead of the October 15 start of the Annual Enrollment Period. Once published, the ratings appear next to plans on the Medicare Plan Finder at Medicare.gov. The ratings you see during shopping season apply to the following plan year.

Ratings can change from one year to the next. A plan that earned four stars last fall might earn three-and-a-half this fall, or vice versa. That's why it's worth checking again even if you looked last year.

Why This Matters in Pitt County

Greenville is in Pitt County, where Medicare beneficiaries have a wide range of Medicare Advantage and Part D options to sort through each fall. With so many plans on the shelf, Star Ratings give local shoppers one more objective data point — alongside their own doctors, prescriptions, and budget — when they sit down to compare.

Star Ratings are not a ranking of "best" plans, and they aren't a recommendation. Two plans with the same star score can look very different once you check whether your doctors are in-network or your medications are covered. Think of the stars as a starting point, not a finish line.

Other 2027 Numbers Worth Knowing

While you're reviewing your coverage this fall, a few program-level figures are helpful to keep in mind:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending hits that amount, you pay $0 for covered Part D drugs the rest of the year.
• The maximum Part D deductible is $615 in 2026 ($700 in 2027).
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread drug costs across monthly payments instead of paying big amounts at the pharmacy.
• IRMAA income-related surcharges start above $109,000 in income for single filers (2026).
• Annual Enrollment: October 15 – December 7. Medicare Advantage Open Enrollment: January 1 – March 31.