Medicare Advantage

Behind the Stars: What CMS Grades on Medicare's Fall Scorecard

People in Columbus can choose from 79 Medicare Advantage plans for 2027, against 92 this year. 27 of this year’s plans are gone, 14 are new to Franklin County, and 28 that continue have changed their premium, deductible, plan type or name, 5 of them under a new name.

COLUMBUS, Ohio — Each fall, just before Medicare's Annual Enrollment Period opens on Oct. 15, the Centers for Medicare & Medicaid Services (CMS) publishes updated Star Ratings for Medicare Advantage and Part D plans. The ratings will shape how plans are described on Medicare.gov during shopping season — but a lot of Columbus readers tell us they still aren't sure what those one-to-five stars are actually measuring. Here's a plain-English look.

What the stars actually measure

Star Ratings run from 1 (poor) to 5 (excellent) and are calculated by CMS using dozens of separate measures. For Medicare Advantage plans that include drug coverage, roughly 40 measures roll up into the overall score. Part D-only plans are rated on a smaller set focused on drug coverage.

The measures fall into a few broad buckets:

• Staying healthy: whether members get recommended screenings, vaccines, and check-ups.
• Managing chronic conditions: how well the plan supports people with diabetes, heart disease, and similar conditions.
• Member experience: survey results on how members rate their care and their plan.
• Member complaints and changes in performance: how often people leave the plan, file complaints, or have problems getting care.
• Customer service: call center performance, appeals handling, and access to needed information.

Notice what's not on that list: premiums, copays, or provider networks. Stars are a quality signal, not a price tag.

How and when the ratings are published

CMS releases the new Star Ratings publicly in October, timed so shoppers can see them during the Annual Enrollment Period (Oct. 15 through Dec. 7). Once posted, the ratings appear alongside each plan on the Medicare Plan Finder at Medicare.gov.

The scores are based on data from the prior measurement year — things like clinical records, pharmacy data, member surveys (CAHPS), and CMS's own monitoring. That's why a rating you see this fall reflects how the plan performed a while back, not last week.

Why the ratings exist

The Star Ratings program was built to give Medicare beneficiaries a standard way to compare plan quality and to give plans a reason to improve. CMS also uses the ratings behind the scenes — for example, plans that earn 5 stars can enroll new members year-round through a special enrollment period, and higher-rated contracts qualify for quality bonus payments.

For consumers, though, the main point is simpler: it's a snapshot of how a plan has been treating its members.

How to use stars when you compare plans

Stars are one input, not the whole decision. In Franklin County, where Columbus sits, dozens of Medicare Advantage and Part D plans are typically available each year, and their star ratings vary. When you're weighing options, it helps to line up several factors together:

• Are your doctors and preferred hospitals in the plan's network?
• Are your prescriptions on the formulary, and at what tier?
• What's the total expected cost — premium, deductible, and cost-sharing?
• How does the plan handle the benefits you use most?
• And then: what's the star rating, and has it been trending up or down?

A plan with strong stars but no coverage for your cardiologist may not serve you well. A plan with fewer stars but a good match to your care team might. Stars help you sort — they don't decide for you.

A few 2027 program facts worth knowing

While you're comparing, keep these Medicare-wide numbers in mind for 2027:

• Part D now has a $2,100 annual out-of-pocket cap on covered drugs.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027.
• The old coverage gap (the "donut hole") was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across monthly payments if you choose.
• IRMAA income-related surcharges start above $109,000 for a single filer in 2026.
• AEP: Oct. 15 – Dec. 7. Medicare Advantage Open Enrollment: Jan. 1 – March 31.

These figures apply nationwide, including here in Columbus.