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Part C

What Are 5-Star Medicare Advantage Plans?

Medicare uses a five-star rating system to evaluate Medicare Advantage plans. Medicare star ratings can change from one year to the next. Learn how to compare star ratings for the Medicare Advantage plans offered in your area.

How is a five star Medicare Advantage plan measured?

  1. Screening tests and vaccines
  2. Management of chronic conditions
  3. Member experience with the plan
  4. Member complaints and changes in plan performance
  5. Customer service

All Medicare Advantage plans (Medicare Part C) and Medicare prescription drug plans (Medicare Part D) are assigned an annual star rating by the Centers for Medicare & Medicaid Services (CMS).

A five-star rating system is used, with one star being given to the lowest-rated plans, and five stars being reserved for only the highest-rated plans. Star Ratings are calculated each year and may change from one year to the next.

Five-star Medicare Advantage plans may not be available where you live. You can use the Medicare star ratings to help you compare the plans that are available in your area.

In 2024, roughly 74 percent of beneficiaries in Medicare Advantage plans that offer prescription drug coverage are enrolled in a plan rated 4 stars or higher by Medicare, when weighted by enrollment.1

Compare Medicare Advantage plans today.

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Highest rated Medicare Advantage plans

Medicare determines which Medicare Advantage plans are highest rated based on information gathered from health care providers who accept the plan, plan member satisfaction surveys, positive health outcomes, customer service and more.

A 5-star plan is considered a highest-rated plan. 1-star plans are the lowest-rated plans, and these plans typically earn their low rating due to poor plan performance, low customer satisfaction and/or bad customer service.

The star rating system for Medicare Advantage plans is as follows:

Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

The rating system uses five key metrics in its assessment of a Medicare Advantage plan:

  1. Screening tests and vaccines
    This review criteria evaluates the level of access plan members have to preventive services, including annual physical exams, screenings, and vaccines.

  2. Management of chronic conditions
    This criteria includes the coordination of care under a given Medicare Advantage plan and evaluates how often members received treatment for long-term health conditions.

  3. Member experience with the plan
    This criteria evaluates plan members’ overall satisfaction with the given plan.  

  4. Member complaints and changes in plan performance
    How frequently did plan members submit complaints about the plan, have problems receiving covered services or opt out of the plan? This rating criteria also reflects whether the plan’s performance improved from the previous year.

  5. Customer service
    The quality of call center service and the efficiency of the appeals and enrollment process are closely evaluated as part of the overall plan customer experience.

In addition to an overall rating, each Medicare Advantage plan is rated in each of the five individual categories. Medicare Star Ratings are released in October of each year for the upcoming calendar year.

If a plan receives a rating of fewer than three stars for three consecutive years, it becomes flagged by the CMS as a low-performing plan. If the plan continues to underperform, Medicare may remove the plan entirely from the marketplace.

Looking for a five-star Medicare Advantage plan

Because the availability of Medicare Advantage plans varies from one location to the next, you may want to call to speak with a licensed insurance agent. A licensed sales agent can go over the plan options available in your area and identify if any have a five-star rating.

An agent can also discuss the costs, terms, coverage and other details about available plans, which can be helpful for you to know prior to enrolling. And if you choose to enroll, you’re eligible to enroll and you have a qualifying enrollment period, the agent can walk you through the steps and help you complete the process.

When to enroll in a five-star Medicare Advantage plan

If you are enrolled in a Medicare Advantage plan rated lower than five stars but you find a five-star plan in your area, you may be able to switch to the five-star plan at any time between December 8 and November 30 of the following year. This is called the five-star Special Enrollment Period.

Compare plan Star Ratings online or speak to a licensed insurance agent today to explore the star ratings of Medicare Advantage plans available in your area.

There are certain Medicare enrollment periods during which eligible Medicare beneficiaries may enroll in a Medicare Advantage plan.

The Initial Election Period starts 3 months before your 65th birthday and ends 3 months after your 65th birthday.

1. When you first become eligible for Medicare Advantage

You can sign up for a five-star plan (if you’re eligible, have a qualifying enrollment period and find a five-star plan in your area) when you first become eligible for Medicare Advantage. Your eligibility begins once you are enrolled in both Medicare Part A and Part B.

When you reach Medicare eligibility, you are typically given a 7-month Medicare Initial Enrollment Period. This period begins three months before you turn 65 years old, includes the month of your birthday and continues for three months thereafter.

2. The fall Medicare Open Enrollment Period

If you are already enrolled in Part A and/or Part B, you may sign up for a Medicare Advantage plan during the fall Medicare Open Enrollment Period (also sometimes called the Medicare Advantage Annual Enrollment Period), which lasts from October 15 to December 7 each year.

If you are already enrolled in a Medicare Advantage plan, you may use this time to switch to a different Medicare Advantage plan or drop your plan to remain on Original Medicare.

Compare plans today.

Speak with a licensed insurance agent

1-800-557-6059

3. The Medicare Five-Star Special Enrollment Period

If you are currently enrolled in a plan that is rated as fewer than five stars, you may be able to utilize the Medicare Five-Star Special Election Period to disenroll from your current plan and enroll in a five-star Medicare Advantage plan if one is available where you live.

As mentioned above, this period lasts from December 8 to November 30 of the following year. During this period, you can only switch to a five-star plan.

4. A Special Election Period

Being enrolled in a Medicare Advantage plan with fewer than five stars isn’t the only way to qualify for a Medicare Special Enrollment Period.

Special Enrollment Periods may be granted to individuals for a variety of circumstances, such as but not limited to living outside of the U.S. at the time of your initial Medicare eligibility or residing in a long-term care facility.  

Call to speak with a licensed insurance agent today to learn more about the Medicare Advantage plan options near you.

Compare Medicare Advantage plans today.

Speak with a licensed insurance agent

1-800-557-6059

2024 Medicare Star Ratings for Medicare Advantage

As mentioned above, roughly 74 percent of Medicare Advantage beneficiaries in plans that include prescription drug coverage (called MA-PD plans) are enrolled in 2024 Medicare Advantage plans rated 4 stars or higher.

Approximately 42 percent of all MA-PD plans offered in 2024 are top-rated plans four stars or higher.1

The table below shows the distribution of MA-PD plans based on their Star Ratings.1

2024 Medicare Advantage Prescription Drug Plans Star Ratings
Overall Star Rating Number of Plan Contracts % of Total Plans (Weighted by Enrollment)
5 Stars 31 7.0%
4.5 Stars 75 30.9%
4 Stars 123 35.9%
3.5 Stars 138 17.8%
3 Stars 128 7.1%
2.5 Stars 46 1.4%
2 Stars 4 0.03%
Average Star Rating (weighted by enrollment) 4.37

The Medicare Star Rating system

The Centers for Medicare & Medicaid Services started using the star rating system in 2007 to evaluate Medicare Advantage plan contracts. The goal of the Medicare star rating system is to help Medicare-eligible individuals and Medicare beneficiaries better understand the quality of the plans that are available on the market.

Learn more about the Medicare Advantage plans available where you live and their star ratings. We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

Compare Medicare Advantage plans today.

Speak with a licensed insurance agent

1-800-557-6059

Learn more about Medicare enrollment

Christian

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

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1 Centers for Medicare & Medicaid Services (CMS). (Oct 13, 2023). Fact Sheet2024 Medicare Advantage and Part D Star Ratings. https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-star-ratings.