Medicare Part D

October Star Ratings Release: Medicare Basics for Pawtucket

Every fall, just before Medicare's Annual Enrollment Period begins on October 15, the Centers for Medicare & Medicaid Services (CMS) publishes fresh Star Ratings for Medicare Advantage and Part D drug plans. The 2027 ratings landed in October, giving people in Pawtucket and across Rhode Island a new snapshot to look at as they weigh their coverage through December 7.

Pawtucket, R.I. — Star Ratings are out. Here's what they actually tell you.

Star Ratings can feel like a mystery — a plan gets "4 stars" and you're supposed to know what that means. Here's a plain-English look at what the numbers actually measure, how they're built, and where they fit (and don't fit) in a personal Medicare decision.

What Star Ratings measure

CMS rates Medicare Advantage and Part D plans on a scale of 1 to 5 stars, with 5 being the highest. The rating is a quality and performance summary — not a price tag, and not a measure of which plan is "right" for you.

For Medicare Advantage plans that include drug coverage, CMS looks at dozens of measures grouped into broad categories, including:

• Staying healthy: screenings, vaccines, and preventive checkups
• Managing chronic conditions: how well the plan supports members with diabetes, heart disease, and other ongoing needs
• Member experience: survey results about how members rate their plan
• Member complaints and changes in performance: how often people leave the plan, and whether service is improving
• Customer service: appeals handling, timely decisions, and access to help
• Drug plan measures (Part D): pricing accuracy, medication safety, and adherence for common conditions

Standalone Part D plans are rated on the drug-related measures only.

How the ratings are built and published

CMS pulls the underlying data from several sources: clinical records reported by plans, pharmacy data, the CAHPS member satisfaction survey, the Health Outcomes Survey, and CMS's own administrative data on complaints, appeals, and audits.

Those measures get scored, weighted, and rolled up into an overall Star Rating for Medicare Advantage-with-drug plans, plus separate summary ratings for the Part C (medical) and Part D (drug) sides.

The ratings are refreshed each year and posted publicly on Medicare.gov's Plan Finder in early October, right before AEP opens. That timing is intentional — it gives beneficiaries the newest quality data to look at while comparing options for the coming year.

Why this year's ratings feel different

The 2027 plan year continues the Part D overhaul that began a couple of years ago. A few program-level facts worth knowing as you read this year's ratings:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The Part D deductible maximum is $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments, at no extra charge. You have to opt in.
• IRMAA — the income-related surcharge on Part B and Part D — kicks in above $109,000 in income for a single filer in 2026.

These changes affect what plans have to deliver and, in some cases, how they score on the drug-related measures. If a plan's rating shifted from last year, program changes are one reason among several.

What Star Ratings do not tell you

This is where a lot of people get tripped up. A Star Rating is a quality signal — it is not a personalized recommendation. It doesn't know:

• Which doctors and hospitals you use
• Which prescriptions you take
• Whether your preferred pharmacy is in-network
• What your monthly budget looks like
• Whether you travel, and where

Two people in the same neighborhood can look at the same 4-star plan and reasonably reach different conclusions. That's normal. The rating is one input, not the whole answer.

Availability in the Pawtucket area

Pawtucket is in Providence County, where Medicare plan availability is set at the county level. That means every Medicare-eligible resident of Pawtucket sees the same menu of Medicare Advantage and Part D plans as their neighbors elsewhere in the county. For 2027, Providence County has 18 Medicare Advantage plans from 4 carriers (compared with 23 plans from 4 carriers in 2026); of those, 18 are continuing, 0 are new, 1 is not returning, and 4 have been renamed. The Plan Finder at Medicare.gov will show you the current list once you enter your ZIP code.

Original Medicare (Parts A and B) is available nationwide and isn't tied to your county.

Key dates to keep on the fridge

• October 15 – December 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect January 1.
• January 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 MA plan or return to Original Medicare (with a Part D plan, if needed).