Medicare Advantage

Behind Medicare's Star Ratings: What Those 1–5 Scores Grade

LACEY, Wash. — Every October, just before Medicare's fall enrollment window opens, the federal government refreshes the Star Ratings for Medicare Advantage and Part D drug plans. The 2027 ratings are scheduled to post on Medicare's Plan Finder ahead of the Oct. 15 Annual Enrollment Period, and for people here in Thurston County comparing coverage, it helps to know what those little stars are actually measuring — and what they are not.

What Star Ratings actually measure

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage and Part D plans on a scale of one to five stars, with five being the highest. The score is a summary of dozens of separate measures grouped into categories such as:

• Staying healthy — whether members get recommended screenings, vaccines, and check-ups.
• Managing chronic conditions — how well the plan supports people living with diabetes, heart disease, and similar issues.
• Member experience — survey answers from current members about how the plan treats them.
• Member complaints and plan performance — how often people leave the plan, and how often problems come up.
• Customer service — how the plan handles appeals and calls.

For Part D drug plans, the measures also include things like drug pricing accuracy and medication safety for members with certain conditions.

Where the data comes from

The ratings are not opinion polls. CMS pulls the numbers from member surveys (called CAHPS), clinical data reported by plans, pharmacy data, and Medicare's own records of complaints, appeals, and disenrollments. Each measure gets its own score, and those roll up into the overall star number you see on Plan Finder.

That means a rating you see in October 2026 for the 2027 plan year is largely built from performance data collected in earlier years. It is a rearview mirror, not a forecast.

When the 2027 ratings go public

CMS typically releases the new Star Ratings in early- to mid-October, right before the Annual Enrollment Period opens on Oct. 15 and runs through Dec. 7. Once posted, the ratings appear next to each plan's listing on the Medicare Plan Finder at Medicare.gov. Anyone with a plan for sale in Thurston County will show a current star score (unless the plan is too new to have one).

There is also a second window — the Medicare Advantage Open Enrollment Period from Jan. 1 through March 31 — when people already in an Advantage plan can switch once.

What the ratings do not tell you

This is where a lot of Lacey readers get tripped up. A high star score is a quality signal about the plan overall — but it will not tell you:

• Whether your doctor at Providence, MultiCare, or a local clinic is in the network.
• Whether your specific prescriptions are on the plan's formulary.
• What your out-of-pocket costs would be for the care you actually use.
• Whether the plan covers extras that matter to you.

In other words, a five-star plan can still be the wrong fit for one person and a great fit for another. Star Ratings are one input, not a ranking of "best" plans.

Program-level facts worth knowing for 2027

While you are comparing coverage, a few numbers set by Medicare — not by any individual plan — apply across the board:

• 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 (plans can set theirs lower).
• The coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that lets you spread drug costs across monthly payments instead of paying at the pharmacy counter.
• IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.

How to use Star Ratings without letting them decide for you

A reasonable approach: look at the star score to check that a plan is not a persistent underperformer, then dig into the details that affect your care — network, drug list, and total costs based on how you actually use health care. Medicare.gov's Plan Finder lets you enter your prescriptions and pharmacies to see estimates.

If comparing on your own feels like a lot, Washington's State Health Insurance Benefits Advisors (SHIBA) program provides free, one-on-one help. Counselors do not sell plans and do not work on commission.