Medicare Advantage

How Medicare Star Ratings Work Before Fall Enrollment

TEXAS CITY, Texas — With the Medicare Annual Enrollment Period opening Oct. 15 and running through Dec. 7, the Centers for Medicare & Medicaid Services (CMS) is once again publishing its yearly Star Ratings for Medicare Advantage and Part D drug plans. If you've ever looked at plan listings on Medicare.gov and wondered what those little stars actually measure — you're not alone, and you're asking the right question at the right time.

Texas City seniors: here's what those Medicare stars really mean

Star Ratings are one of the few official, standardized tools Medicare gives you to compare plans on quality, not just price. But they're often misunderstood. Here's a plain-language walkthrough before you sit down to shop.

What Star Ratings actually measure

CMS rates most Medicare Advantage and Part D plans on a scale of 1 to 5 stars, with 5 being the highest. The ratings are built from dozens of separate quality measures grouped into big categories, including:

• Staying healthy — screenings, vaccines, and preventive checkups plan members receive.
• Managing chronic conditions — how well the plan helps people with diabetes, heart conditions, and other long-term illnesses.
• Member experience — survey results from people actually enrolled in the plan.
• Member complaints and plan performance — how often members leave, file grievances, or have problems getting care.
• Customer service — how the plan handles appeals, calls, and access to needed care.

For Part D drug coverage, ratings also look at drug pricing accuracy, medication safety, and how well the plan helps members take their medications correctly.

In short, the stars reflect how a plan performed for the people already in it — not a marketing pitch, and not a personal fit score for you.

When and how the ratings are published

CMS releases updated Star Ratings each fall, ahead of Annual Enrollment. Once posted, the new ratings appear on the plan finder at Medicare.gov and in the official "Medicare & You" handbook mailed to beneficiaries.

The ratings you see during shopping season apply to the following plan year. So the stars posted this fall are the ones tied to 2027 coverage decisions.

Ratings can — and do — change from year to year. A plan that earned a high rating one year may be rated differently the next, based on updated data. That's why it's worth checking the current stars each fall, even if you're happy with your coverage.

Why this matters for Texas City residents

Texas City is in Galveston County, where Medicare beneficiaries typically have a wide range of Medicare Advantage and standalone Part D plans to consider each year. With that many choices, Star Ratings can serve as a neutral starting point — a way to narrow the field before you dig into the specifics that matter most to you personally, like whether your doctors are in-network and whether your prescriptions are covered.

Just remember: a rating is a snapshot of past performance across all members. It doesn't tell you whether a plan fits your health needs, budget, or preferred providers.

What Star Ratings are not

This is where a lot of confusion sneaks in. Star Ratings are not:

• A recommendation from Medicare that you pick a certain plan.
• A guarantee of your personal experience with a plan.
• A measure of price or value — they don't rate premiums, deductibles, or copays.
• A ranking of "best" or "worst" carriers.

Think of them more like a restaurant health inspection score than a Yelp review — useful information, but only one piece of the picture.

Other 2027 changes worth knowing while you shop

While you're reviewing plans this fall, keep these program-wide Medicare updates in mind for 2027:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit that, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027.
• Coverage gap ("donut hole"): eliminated as of 2025 — Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread out-of-pocket drug costs across monthly payments instead of paying them all at the pharmacy counter.
• IRMAA: higher-income beneficiaries pay income-related surcharges on Part B and Part D. In 2026, these begin above $109,000 in income for a single filer.

These rules apply program-wide, no matter which plan you pick.