Medicare Advantage

Before You Compare Plans, Here's What a Star Rating Actually Measures

MANSFIELD, Ohio — Every fall, just before the Medicare Annual Enrollment Period opens on October 15, the federal government publishes a fresh set of Star Ratings for Medicare Advantage and Part D drug plans. Those little one-to-five star icons will appear next to plan names on Medicare.gov, and they often carry more weight in a shopper's decision than the details underneath them. Before you lean on a star count this fall, it helps to know what the rating is actually grading — and what it is not.

What the Star Ratings actually measure

CMS scores Medicare Advantage and Part D plans on a five-star scale, with five being the highest. The score is built from dozens of individual measures grouped into broad categories. For Medicare Advantage plans that include drug coverage, those categories cover things like:

• Staying healthy: screenings, tests, and vaccines members received.
• Managing chronic conditions such as diabetes or high blood pressure.
• Member experience with the health plan.
• Member complaints and changes in the plan's performance.
• Customer service, including how the plan handles appeals.
• Drug plan measures like accurate pricing information and safe prescribing.

Notice what is missing from that list: premiums, copays, and specific benefits. A high star rating does not mean a plan is cheaper or has richer benefits than a lower-rated plan. It means CMS judged the plan strong on quality and service measures.

How and when the ratings are published

CMS releases the new Star Ratings each fall, typically in early to mid-October. The ratings then show up on the Medicare Plan Finder at Medicare.gov when the Annual Enrollment Period opens on October 15 and remains open through December 7. If you enroll in a Medicare Advantage plan during that window, you also get one chance to switch during the Medicare Advantage Open Enrollment Period, January 1 through March 31.

The star numbers you see this fall are based on data CMS collected from earlier measurement years — surveys, clinical data, and complaint records — not on the plan's benefit design for 2027. That's an important distinction: the rating grades past performance under one contract, while the benefits you're shopping for apply to next year.

Ratings are set at the contract level, not the plan level

One point that trips up many shoppers: Star Ratings are assigned to a plan's contract with CMS, not to each individual plan option. A single insurer's contract in Ohio may cover several different Medicare Advantage products. All of them share the same star rating, even though their benefits, networks, and drug lists can be very different.

So two plans with the same four-star rating are not identical — and a plan with a lower rating is not automatically a poor fit for your situation. The star number is one input, not a verdict.

Why this matters in Mansfield

Mansfield is in Richland County, where Medicare-eligible residents typically have a wide slate of Medicare Advantage and stand-alone Part D options to sort through each fall. Star Ratings can be a helpful filter when you're staring at a long list on the Plan Finder, but they work best alongside the questions that actually affect your day-to-day care:

• Are your doctors and preferred hospitals in the plan's network?
• Are your prescriptions on the plan's formulary, and at what tier?
• Does the plan cover care when you travel or spend part of the year elsewhere?

Star Ratings don't answer any of those questions. They're a snapshot of quality; the fit is up to you.

A few program-level facts worth knowing this season

While you're comparing options, keep these Part D program rules in mind:

• Part D now has a $2,100 annual out-of-pocket cap on covered prescriptions.
• The Part D deductible is capped at $615 for 2026 and $700 for 2027, though plans can set a lower one.
• The old "donut hole" coverage gap was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly amounts, at no extra charge, if you opt in.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for single filers in 2026.

These apply program-wide, regardless of which plan or star rating you choose.

Common mistakes to avoid

The biggest Star Ratings mistake is treating the number like a scoreboard. A five-star plan that doesn't cover your cardiologist is not a better choice than a three-and-a-half-star plan that does. The second mistake is assuming a star rating tells you anything about cost — it does not. And the third is not checking the rating at all: if two plans otherwise look the same to you, the quality score is a reasonable tiebreaker.