Medicare Advantage

Medicare Star Ratings: Fall Refresh for Chambersburg

CHAMBERSBURG, Pa. — As the Medicare Annual Enrollment Period opens Oct. 15 and runs through Dec. 7, one of the most talked-about tools on Medicare.gov is quietly refreshed for the new plan year: the Medicare Star Ratings. Understanding what those stars actually measure — and what they don't — can help Franklin County residents make calmer, better-informed choices this fall.

What Star Ratings actually measure

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage and Part D plans on a scale from 1 to 5 stars, with 5 being the highest. The score is a summary of dozens of separate quality measures.

For Medicare Advantage plans that include health coverage, CMS looks at areas like:

• How well the plan helps members stay healthy (screenings, tests, vaccines).
• How it manages chronic conditions.
• Member experience and complaints.
• Customer service, including how quickly appeals are handled.

For Part D drug coverage, CMS looks at drug pricing accuracy, patient safety, and member experience with the pharmacy benefit.

Star Ratings do not measure whether a plan is cheap, whether it covers a specific medication, or whether your doctor is in the network. Those are separate questions you'll want to answer on your own.

When and where the new ratings appear

CMS refreshes Star Ratings once a year, in the fall, ahead of the Annual Enrollment Period. When you use the Plan Finder at Medicare.gov during AEP, the star icons you see next to each plan reflect the newest scores for the upcoming plan year.

That timing matters. If you shop early in October, you're looking at plans for next year with the freshest quality data CMS has published.

How Chambersburg residents can use them

Chambersburg is in Franklin County, where a range of Medicare Advantage and stand-alone Part D plans are available each year. Star Ratings are one data point among several. A reasonable way to use them:

1. Make a short list of plans that cover your doctors, your hospital, and your prescriptions. 2. Then look at the Star Rating as a quality check on that short list. 3. Weigh the rating alongside your total expected costs and the plan's rules.

A high rating doesn't guarantee a plan is right for you, and a lower rating doesn't automatically mean a plan is a poor fit. The stars describe the plan's overall performance — your experience depends on your own health needs.

What's new for 2027 to keep in mind

While you're comparing plans this fall, a few program-wide facts are worth knowing:

• Part D has a $2,100 out-of-pocket cap on covered prescriptions in 2026.
• The Part D deductible cannot exceed $615.
• The old coverage gap ("donut hole") has been eliminated since 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly payments — it's optional and free to join.
• IRMAA surcharges for higher-income beneficiaries start above $109,000 in income for a single filer in 2026.

These rules apply across the board, regardless of which plan you choose.

Key dates for this enrollment season

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare.

Coverage from an AEP choice starts Jan. 1.

Where to get unbiased help in Chambersburg

You don't have to sort through this alone. Free, one-on-one counseling is available through Pennsylvania's State Health Insurance Assistance Program, known here as APPRISE. Counselors are trained volunteers who don't sell insurance.

You can also:

• Visit Medicare.gov to use the Plan Finder and view current Star Ratings.
• Call 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Contact your local Area Agency on Aging serving Franklin County for in-person help.