Medicare Advantage

Behind Medicare's Stars: What CMS Actually Grades Each Fall

People in Franklin can choose from 52 Medicare Advantage plans for 2027, against 52 this year. Six of this year’s plans are gone, 6 are new to Milwaukee County, and 31 that continue have changed their premium, deductible, plan type or name, 12 of them under a new name.

FRANKLIN, Wis. — As the Medicare Annual Enrollment Period opens Oct. 15, Franklin residents comparing coverage on medicare.gov will notice small star icons next to Medicare Advantage and Part D plans. Those Star Ratings, refreshed by the Centers for Medicare & Medicaid Services (CMS) each fall, are one of the few plan-quality signals the federal government publishes — but they are widely misread as a simple "best plan" scoreboard. They aren't.

Here is what the stars actually measure, when they come out, and how a Franklin reader can use them without letting them do all the thinking.

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 score is a weighted average of roughly 40 individual 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 members with diabetes, heart conditions, and similar ongoing needs.
• Member experience: what members say in surveys about their plan and care.
• Member complaints and changes in performance: how often people leave the plan or file grievances.
• Customer service: how the plan handles appeals, calls, and access to care.

For stand-alone Part D drug plans, the measures focus on drug pricing accuracy, safety, customer service, and member experience.

Notice what is not in that list: premiums, copays, or which pharmacy is cheapest. Star Ratings are a quality signal, not a price tag.

When the 2027 ratings come out

CMS typically posts updated Star Ratings on medicare.gov in early to mid-October, just before AEP begins on Oct. 15. Ratings for the 2027 plan year reflect data from prior measurement periods — meaning a plan's current star count is based on how it performed over the last year or two, not a prediction of the year ahead.

The ratings stay visible on the Medicare Plan Finder throughout AEP (which ends Dec. 7) and during the Medicare Advantage Open Enrollment Period from Jan. 1 through March 31.

How Franklin fits in

Franklin is in Milwaukee County, and Medicare Advantage and Part D plan availability — along with the specific plans that receive star scores — is set at the county level. So when a Franklin reader opens the Plan Finder and enters a local ZIP code, the list and the stars shown reflect what's offered across Milwaukee County.

That's worth remembering if you talk to a friend in another county whose choices look different. The stars aren't wrong; the plan lineups simply aren't the same.

Using the stars without letting them decide for you

A high star rating tells you a plan has generally performed well on the measures CMS tracks. It does not tell you whether:

• Your doctors and hospitals are in the plan's network.
• Your prescriptions are on the plan's formulary and at what tier.
• The plan covers care when you travel or spend part of the year elsewhere.
• The out-of-pocket costs fit your budget.

Those answers come from the plan's own documents and from tools like the Plan Finder, where you can enter your drugs and preferred pharmacies.

A useful way to think about it: use Star Ratings as a filter, not a verdict. Two plans with the same star count can still be very different fits for two different people on the same street.

Program-level facts to keep in mind for 2027

While you're comparing, a few Medicare figures apply across the board:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 — once you hit it, you pay nothing for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027 (plans may charge less).
• The old coverage gap ("donut hole") is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs into monthly payments if you choose.
• IRMAA income surcharges start above $109,000 for a single filer in 2026.

These aren't tied to any one plan — they're the rules of the road.

Where to get personal help

For decisions this big, talk to a neutral source before you enroll:

• medicare.gov — the official Plan Finder, with current Star Ratings.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• Wisconsin SHIP (the Wisconsin Board on Aging and Long Term Care / Medigap Helpline) — free, unbiased Medicare counseling for Franklin residents.