Medicare Advantage

Before You Compare Plans in Lake Stevens, Here's What Star Ratings Actually Grade

LAKE STEVENS, Wash. — Fall is Medicare season, and every October the federal government publishes fresh Star Ratings for Medicare Advantage and Part D drug plans. If you live in Lake Stevens and plan to review your coverage between Oct. 15 and Dec. 7, those little one-to-five-star icons on Medicare.gov are meant to be a quality snapshot — not a shopping shortcut. Knowing what they measure (and what they don't) helps you read them the way the Centers for Medicare & Medicaid Services intends.

What Star Ratings actually measure

CMS scores Medicare Advantage and Part D plans on a 1-to-5 scale, with 5 being the highest. The rating is a weighted average of dozens of individual measures grouped into broad categories. For Medicare Advantage plans that include drug coverage, those categories cover:

• Staying healthy — how often members get screenings, vaccines, and check-ups.
• Managing chronic conditions — whether members with diabetes, heart disease, or other ongoing needs get recommended care.
• Member experience — survey results on how members rate the plan and their doctors.
• Member complaints and plan performance — how often people leave the plan, file complaints, or have problems getting care.
• Customer service — how well the plan handles calls, appeals, and new-member questions.

Stand-alone Part D drug plans are scored on a shorter list focused on drug pricing accuracy, drug safety (like avoiding risky prescriptions for older adults), and customer service.

What they don't measure

This is the part that trips people up. Star Ratings do not grade a plan's monthly premium, deductible, copays, drug list, or provider network. Two plans with the same star count can have very different costs and cover very different medications. So a rating tells you something about how a plan runs — not whether it fits your budget or your prescriber at Providence or EvergreenHealth Monroe.

How and when the ratings are published

CMS releases the new ratings each October, just before the Annual Enrollment Period opens on Oct. 15. Once published, they appear on the plan finder tool at Medicare.gov, where you can see the overall star score and drill down into the individual measures. The ratings you see during fall enrollment apply to the coverage year that starts the following Jan. 1.

CMS also uses the ratings behind the scenes — plans that score well can qualify for quality bonus payments, and consistently low-scoring plans can face enrollment restrictions. But for consumers, the ratings are simply a public quality signal.

Using ratings alongside 2027 program changes

The 2027 plan year brings a few program-wide facts worth keeping in mind while you compare:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that number, you pay nothing for covered drugs the rest of the year.
• The Part D deductible can be no higher than $615.
• The coverage gap (the old "donut hole") is gone — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments, if that helps your cash flow.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for a single filer in 2026.

None of these show up in a star score. They apply program-wide, so factor them in separately when you look at any plan's paperwork.

A Lake Stevens snapshot

Lake Stevens is in Snohomish County, where Medicare beneficiaries have a range of Medicare Advantage and stand-alone Part D options each year. Availability is set at the county level, so a plan offered to a neighbor in Everett or Marysville is generally offered to you, too. When the new Star Ratings drop in October, they'll be attached to each of those county-available plans on Medicare.gov's plan finder.

Where to get personalized help

Star Ratings are a starting point, not a decision. For questions specific to your medications, doctors, or budget:

• Visit Medicare.gov to use the official plan finder and see current Star Ratings.
• Call 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Contact Washington's SHIBA program (Statewide Health Insurance Benefits Advisors) for free, unbiased counseling from trained local volunteers.