Definition. Star Ratings are CMS's yearly quality scores for Medicare Advantage and Part D plans, from 1 to 5 stars. CMS publishes them each fall, and you can see each plan's rating on Medicare.gov's Plan Finder. This site explains how the ratings work but doesn't show ratings for individual plans.
What it means
CMS rates plans on many measures, grouped into areas such as:
- Staying healthy: screenings, tests and vaccines.
- Managing chronic conditions.
- Member experience with the plan.
- Member complaints, people leaving the plan, and changes in performance.
- Customer service.
- For drug coverage: drug safety and accuracy of drug pricing.
Five stars means excellent and one star means poor. Medicare.gov flags plans that scored below three stars for three years in a row. Ratings describe a plan's past performance across all its members; they don't tell you whether a plan covers your doctors or drugs, so check those separately.
In Oregon
Ratings are set by contract nationally, not by county, so the same rating appears wherever a plan is offered. To compare plans where you live, use Medicare.gov's Plan Finder, see plans for your ZIP code on PlanMatch, or request a call from a licensed insurance agent.
Sources
Frequently asked questions
Where can I see a plan's Star Rating?
On Medicare.gov's Plan Finder, or by calling 1-800-MEDICARE (1-800-633-4227). Plans must also include their rating in their enrollment materials.
Can I switch to a 5-star plan outside Open Enrollment?
Yes. If a plan rated 5 stars serves your area, you can switch into it once between December 8 and November 30 of the following year, using the 5-star Special Enrollment Period.
Medicare in your Oregon county
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