A Medicare plan with five stars can still be the wrong plan for you.
That sounds strange until you understand what Medicare Star Ratings actually measure. The stars can tell you useful things about a Medicare Advantage or Part D contract’s quality and performance. They cannot tell you whether your doctor is in the network, whether your prescriptions will be affordable, or whether the plan that looks best on paper will cost you less over the year.
For 2027, Medicare Star Ratings are especially timely because they are now available in Medicare Plan Finder for Open Enrollment, which runs from October 15 through December 7, 2026.
The practical approach is simple: use the stars as one comparison tool, not as your entire decision.
What Are Medicare Star Ratings?
Each year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage and Medicare Part D contracts on a scale of one to five stars.
- 5 stars: highest-performing rating
- 4 stars: above-average performance
- 3 stars: roughly average performance
- 2 stars: below-average performance
- 1 star: poor performance
Half-star ratings can also appear in overall ratings.
For the 2027 ratings, Medicare Advantage contracts that include prescription drug coverage can be evaluated on as many as 43 quality and performance measures. Medicare Advantage contracts without Part D coverage can be rated on up to 32 measures, while stand-alone Part D contracts can be rated on up to 13.
Those measures look at different aspects of plan performance, including health care quality, member experience, complaints, appeals, access to care, preventive services, prescription drug performance, and other measures CMS uses to evaluate plans.
That makes the Star Rating useful—but also explains why a single number cannot describe everything that matters to one individual.
What the 2027 Medicare Star Ratings Can Tell You
Think of the stars as a report card for certain parts of a contract’s performance.
They can help answer questions such as:
- How well has the contract performed on Medicare’s quality measures?
- What has member experience looked like on measures CMS tracks?
- How has the contract performed on complaints and appeals?
- How does its measured quality compare with other rated contracts?
- Has the contract earned Medicare’s highest-performance rating?
That information can be valuable when you are comparing several otherwise reasonable choices.
Four stars or more does not automatically make a plan unusual
For 2027, about 37% of rated Medicare Advantage contracts that include prescription drug coverage—188 contracts—earned four stars or more.
Looking at enrollment rather than the number of contracts, CMS says approximately 71% of people currently enrolled in rated Medicare Advantage prescription drug contracts are in contracts that will have ratings of four stars or higher in 2027.
Fifteen Medicare Advantage prescription drug contracts received the five-star high-performing designation for 2027.
Those numbers are useful context. A four-star rating is a positive signal, but it does not eliminate the need to compare two four-star plans—or even a four-star plan against one with a slightly different rating—on the details that affect you personally.
What Medicare Star Ratings Do Not Tell You
This is where people can get tripped up.
A Star Rating summarizes measured quality and performance. It is not a personalized estimate of how well the plan will work for your health care needs or your budget.
| Star Ratings can help you evaluate | They do not tell you by themselves |
|---|---|
| Measured quality and performance | Whether your doctor is in network |
| Member experience measures | Whether your prescriptions are covered affordably |
| Complaints and appeals performance | Your likely total annual cost |
| Performance compared with other rated contracts | Whether your preferred hospital is in network |
| Whether a contract earned a high-performance rating | Which services will require prior authorization |
1. The Stars Don’t Tell You Whether Your Doctors Are in Network
This may be the most important limitation.
Medicare Advantage plans can have provider networks. Depending on the type of plan, going outside that network may mean paying more or, for some non-emergency services, having no plan coverage at all.
A five-star rating does not make an out-of-network doctor suddenly become in network.
Before changing plans, check the doctors, specialists, hospitals, pharmacies, and other providers you actually use. If keeping a particular provider matters to you, consider confirming participation with both the plan and the provider rather than relying on an old directory or assumption.
SavingQueen check: Write down the three to five providers you would be most reluctant to change. Check them before comparing extras such as dental allowances, fitness benefits, or other perks.
2. The Stars Don’t Tell You What Your Prescriptions Will Cost
A high-rated plan is not automatically the least expensive drug plan for your particular medications.
Drug coverage can vary by formulary, drug tier, pharmacy, deductible, copayment or coinsurance, and the plan’s coverage rules.
That means two people taking different medications could reasonably reach different conclusions about the same plan.
When comparing 2027 options, enter your actual prescriptions and preferred pharmacies into Medicare Plan Finder rather than comparing drug-plan premiums alone.
If one plan is $10 cheaper per month but makes one of your regular medicines substantially more expensive, the lower premium may not save you money.
3. The Stars Don’t Tell You Your Total Annual Cost
A $0 Medicare Advantage premium can sound hard to beat. But $0 does not mean $0 health care costs.
Depending on the plan and care you use, you may still face deductibles, copayments, coinsurance, prescription costs, and other out-of-pocket expenses. Medicare Advantage plans also have rules and limits that can differ substantially from one option to another.
Instead of asking only, “What is the premium?” try asking:
“What could this plan realistically cost me for the care I expect to use?”
A simple comparison might look like this:
| Cost to check | Plan A | Plan B |
|---|---|---|
| Monthly plan premium | $___ | $___ |
| Drug costs | $___ | $___ |
| Primary care visits | $___ | $___ |
| Specialist visits | $___ | $___ |
| Expected tests or treatments | $___ | $___ |
| Medical out-of-pocket maximum | $___ | $___ |
| Star Rating | ___ | ___ |
You may not be able to predict every medical bill, but this exercise is more informative than choosing based on either the premium or the stars alone.
4. The Stars Don’t Tell You Exactly How Prior Authorization Will Affect You
Medicare Advantage plans typically require prior authorization before covering certain services or supplies.
Star Ratings include measures related to plan performance, appeals, and other aspects of service, but the overall rating does not tell you whether the MRI, therapy, procedure, medical equipment, or other care you expect to use will require prior approval.
If you know you are likely to need a particular treatment in 2027, ask the plan about its authorization requirements before enrolling.
That can matter more to your day-to-day experience than a half-star difference between two plans.
5. A 2027 Rating Is Not a Prediction of Everything That Will Happen in 2027
The year printed beside a Star Rating can be misleading if you read it as a real-time score.
CMS explains that Star Ratings capture contract performance during applicable measurement periods. The methodology and thresholds can also change from year to year.
In other words, a 2027 rating is useful information about measured performance—it is not a guarantee about your future experience.
This is another reason not to treat the number as a promise.
What Changed in the 2027 Star Ratings?
CMS made several methodology changes for the 2027 ratings.
Two prescription-drug safety measures were added:
- Concurrent Use of Opioids and Benzodiazepines
- Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults
A functional-status measure for older adults returned following specification changes, and CMS replaced the previous colorectal-cancer-screening measure with a respecified version.
CMS also increased the weight given to its “Improving or Maintaining Physical Health” and “Improving or Maintaining Mental Health” measures from one to three for the 2027 ratings following changes to those measures.
The practical takeaway is not that shoppers need to memorize the formula. It is that a four-star rating this year is not calculated using an eternally fixed recipe.
When ratings change, some of that change may reflect plan performance, while some may reflect changes in measures, thresholds, weighting, or other parts of the methodology.
A Better Way to Use Medicare Star Ratings
If you have several plans available, use this order instead of sorting by stars and stopping there.
Step 1: Check your providers
Confirm the doctors, specialists, hospitals, and facilities that matter to you.
Step 2: Check your prescriptions
Compare your actual medications and pharmacies. Look at more than the drug-plan premium.
Step 3: Compare expected costs
Review premiums, deductibles, copays, coinsurance, drug costs, and the medical out-of-pocket maximum.
Step 4: Check plan rules
Look for prior authorization requirements, referrals, network restrictions, and other rules that could affect care you expect to use.
Step 5: Compare the Star Ratings
Now use the rating as another piece of evidence.
If two plans both cover your important doctors and medications at similar costs, a stronger quality rating can become a useful tie-breaker.
That is a much safer role for the stars than assuming the highest-rated plan must automatically be the best plan for you.
One Important Benefit of a Five-Star Rating
Five stars can matter for more than comparison shopping.
Medicare has a Five-Star Special Enrollment Period. If a Medicare Advantage plan, Medicare drug plan, or Medicare Cost Plan with a five-star rating is available where you live, you may generally use this Special Enrollment Period once between December 8 and November 30 of the following year to switch to a five-star plan.
But check the coverage you are moving into carefully.
For example, Medicare warns that switching from a Medicare Advantage plan with prescription drug coverage to a five-star Medicare Advantage plan without drug coverage could leave you without prescription coverage. You might then need to wait for another enrollment opportunity and could potentially face a Part D late-enrollment penalty.
Five stars are not a reason to skip the fine print.
So, Should You Choose the Plan With the Most Stars?
Not automatically.
A higher Star Rating is useful information. If a plan performs well on Medicare’s quality measures, that deserves consideration.
But your own comparison should start with the parts of the plan that directly affect your health care and budget.
Use this order:
Doctors + prescriptions + expected costs + plan rules + Star Rating.
A slightly lower-rated plan that includes your doctors, handles your medications well, and gives you manageable costs could be a better fit than a five-star option that does not.
The stars are best treated as a quality signal—not a shortcut around comparing the plan.
Before You Enroll: A Quick 2027 Medicare Checklist
- Confirm your preferred doctors and hospitals participate.
- Enter your current prescriptions and pharmacies into Medicare Plan Finder.
- Compare more than monthly premiums.
- Check deductibles, copays, coinsurance, and the medical out-of-pocket maximum.
- Review referral and prior-authorization rules.
- Look at the Medicare Star Rating and the measures behind it.
- Check whether important benefits or coverage changed from your current plan.
- Save copies or notes from your comparison before enrolling.
Medicare Open Enrollment for 2027 coverage runs from October 15 through December 7, 2026. Taking an extra few minutes to compare the details behind the stars could matter much more than choosing the plan with the biggest number beside its name.
