Medicare’s annual enrollment window is open now and closes December 7. What you can change, and when.
This article is for general educational purposes only and is not insurance or medical advice. We are not affiliated with the U.S. government or Medicare. For official information, visit Medicare.gov or call 1-800-MEDICARE. See our Medical & Financial Disclaimer for details.
You’ve probably noticed the star ratings next to every plan on Medicare’s comparison tools, but it isn’t always clear what they measure — or how much weight they deserve in your decision. CMS published the 2027 ratings on October 8, 2026, a week before enrollment opens. Here is what they measure, what changed this year, why some of the best-known insurers moved by a whole star or more in a single year, and how to use the stars sensibly when you compare plans.
The Short Version
- The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage contracts from 1 to 5 stars. A contract that includes drug coverage is rated on up to 43 quality and performance measures.
- Ratings apply to the contract, not to the plan brochure. One insurer can run several contracts with different ratings, so check the one your plan sits under.
- For 2027, two measures about patients’ own reported health tripled in weight, two new medication-safety measures arrived and two older measures were retired.
- The market average barely moved, but individual insurers swung hard in both directions. The rating that matters is this year’s rating for the plan in front of you.
How the Rating System Works
Each year CMS scores Medicare Advantage contracts across a long list of measures covering preventive screenings and vaccinations, how well the plan helps members manage chronic conditions, member experience, complaints and how quickly problems get resolved, and customer service. For a contract with drug coverage that adds up to as many as 43 separate measures; for one without, up to 32.
Two features of the system explain most of the confusion people have with it.
The first is that ratings attach to contracts, not plans. An insurer may operate several contracts, sometimes in different states, and they can carry different ratings. The star you see advertised nationally is not necessarily the star that applies to the plan you would actually join.
The second is that measures aren’t scored against a fixed standard. For each one, CMS sets thresholds — cut points — that decide how many stars a contract earns on that measure, and those thresholds are recalculated each year from how contracts performed nationally. It is a curve, not a bar. A plan can deliver exactly the same care two years running and see its rating fall because others improved around it.
What Changed for 2027
The changes are set out in the CMS 2027 Star Ratings fact sheet. Four are worth knowing.
Members’ own reported health counts three times as much. The two measures built on whether members say their physical and mental health improved or held steady went from a weight of one to a weight of three. Last year it was patient-experience measures that lost weight; this year it is a different kind of member-reported measure that gained it.
Two new medication-safety measures. One tracks members taking opioids and benzodiazepines at the same time; the other tracks older adults on several anticholinergic medicines at once. Both are combinations that raise the risk of falls and confusion. If you take a lot of medication, these are the measures that speak most directly to you.
Some measures came and went. A functional status assessment for older adults returns after being rewritten, a new version of the colorectal cancer screening measure replaces the old one, and the pain-assessment and post-discharge medication-reconciliation measures were retired.
Appeals data is checked harder. CMS now cross-checks two appeals measures against plans’ own reporting and cuts the score where the data looks incomplete.
The Market Barely Moved
| Contracts with drug coverage (MA-PD), from CMS | 2026 | 2027 |
|---|---|---|
| Average rating, weighted by enrollment | 4.01 | 3.99 |
| Enrollees in contracts rated 4 stars or higher | About 67% | About 71% |
| Contracts earning 5 stars | 22 | 15 |
| Enrollment in 5-star contracts | 2.43% | 2.25% |
| Contracts rated | 516 | 508 |
The 2026 column is the comparison CMS prints in its 2027 fact sheet. It differs slightly from the figures CMS first published in October 2025 (an average of 3.98 and 18 five-star contracts), and we use the newer version. The 67% is our sum of CMS’s own enrollment shares for four, four-and-a-half and five stars; the 71% is CMS’s figure.
Read together, the picture is steady: an average just under four stars, a little over two thirds of members in four-star-or-better contracts, and five-star contracts as rare as ever. Almost nobody is in a five-star plan, and not because members reject them — in most counties there isn’t one to join. Our count of the 2027 plan file finds a five-star plan on sale in about one county in four.
But Individual Insurers Swung Hard
Underneath that steady average, whole companies moved by a long way. We matched every 2027 plan in the CMS plan file to its new rating and grouped the plans by parent company. Counting plans, not members:
- Humana went from 35.5% of its rated plans at four stars or better to 93.6%.
- Aetna went the other way, from 72.0% to 48.2%. UnitedHealth fell from 79.5% to 62.1%.
- HealthSpring, the former Cigna business, fell from 39.7% to 4.6%.
Humana is the instructive case. It spent 2025 suing CMS over its ratings and lost twice: the first suit was dismissed in July 2025 because it had not exhausted its administrative appeals, and the second was dismissed with prejudice on October 14, 2025, on CMS’s policy of counting unanswered test calls to interpreter lines against the plan, according to Healthcare Dive. A year later its plans are the best-rated of any large insurer.
The lesson is the same in both directions. Humana’s care did not collapse in 2026 and it did not transform in 2027. A rating is a score on a specific set of tests, some of them narrow, measured against a bar that moves each year. Treat a single year’s number as a snapshot of that measurement, and the full list of who rose and who fell is in our count of the best-rated insurers for 2027.
Where the Good Ratings Are: By Plan Type and by State
CMS publishes ratings by contract. To see what that means for someone shopping, we matched all 5,522 plans on sale for 2027 to their contract’s rating and counted them by plan type and by state. 4,992 plans carry a rating; the other 530 belong to contracts too new or too small to have been measured, and show “No rating available” in the Plan Finder.
| 2027 plans, by type | Rated plans | Mean rating | Rated 4 stars or more | Five-star plans |
|---|---|---|---|---|
| Ordinary PPO | 1,320 | 3.92 | 74.6% | 22 |
| Ordinary HMO | 2,025 | 3.86 | 60.7% | 28 |
| Special needs PPO | 296 | 4.12 | 73.3% | 30 |
| Special needs HMO | 1,340 | 3.74 | 45.9% | 28 |
Two things stand out. PPOs are rated better than HMOs, among ordinary plans and special needs plans alike, which is the reverse of what many people assume about the tighter, more managed HMO model. And special needs HMOs, the largest group of plans for people with Medicaid or chronic conditions, are the weakest group on the table: fewer than half reach four stars.
| States with 40+ plans | Plans for 2027 | Mean rating | Rated 4 stars or more |
|---|---|---|---|
| Puerto Rico | 63 | 4.79 | 100% |
| Utah | 51 | 4.15 | 93.0% |
| Florida | 560 | 4.09 | 82.8% |
| Colorado | 104 | 3.94 | 81.3% |
| … | |||
| Connecticut | 48 | 3.73 | 43.8% |
| Georgia | 161 | 3.75 | 41.1% |
| Tennessee | 155 | 3.78 | 40.9% |
| Oregon | 95 | 3.31 | 25.6% |
Our own count from the CMS CY2027 Landscape file and the 2027 Star Ratings Data Tables, every plan counted once per state, special needs plans included. Every state is in our downloadable state table and in our state-by-state analysis.
Where you live changes the odds a great deal. In Florida more than four in five rated plans reach four stars; in Oregon only one in four does. That doesn’t mean a good plan is impossible to find in Oregon, or that every Florida plan is a good one. It means the share of the menu you can rule out on ratings alone is very different from one state to the next, and so is the importance of checking each plan individually.
Why Insurers Fight Over Half a Star
Four stars is not a marketing milestone, it is a payment threshold. Contracts at or above it qualify for Quality Bonus Payments from CMS — additional money that, as covered in our guide to how Medicare Advantage is funded, feeds into the rebate dollars plans must spend on extra benefits, lower cost sharing or a lower premium.
That is the connection that matters to you. When a contract drops below four stars, the money that paid for the dental allowance, the over-the-counter card and the reduced copays shrinks — though not right away. The bonus a contract earns from this fall’s ratings feeds into the benefits it can offer the following year, so a rating that fell for 2027 is an early warning about 2028.
How to Use Star Ratings When Comparing Plans
- Check this year’s rating, at the contract level. Not the carrier’s reputation and not last year’s score. For 2027, both have moved more than usual.
- Put network and formulary first. A four-star plan that doesn’t cover your doctor or your medication is a worse fit than a three-and-a-half-star plan that does.
- Check the out-of-pocket limit as well. For 2027, two in five five-star plans sit at the highest limit any plan carries. A good rating and good protection in a bad year are separate questions, as our count of what better-rated plans cost shows.
- Ask why a rating moved before reacting to it. A drop may reflect tighter national cut points or a reweighting rather than any change in the care you would receive.
If a five-star plan is available in your county, you have an extra way in: the 5-Star Special Enrollment Period lets you switch into it once, any time between December 8 and November 30, outside the standard windows.
Common Questions
When do the 2027 ratings start to apply? They were published on October 8, 2026, and are the ones shown on the Plan Finder for 2027 plans, during the enrollment period that runs from October 15 to December 7. The 5-Star Special Enrollment Period based on them opens on December 8.
My plan’s rating dropped. Do I have to switch? No. Your plan does not change its benefits mid-year because of a rating. But a drop below four stars can mean leaner extras the year after, so it is a reason to look at what else is on offer now, while you can switch freely.
Is a five-star plan automatically the best choice? No. It is a strong general signal, but it says nothing about whether your doctors are in that plan’s network, whether your medicines are on its formulary, or how high its out-of-pocket limit is. Check all three.
Bottom Line
Star ratings are worth reading and worth not over-reading. They score contracts, not plans, on up to 43 measures against thresholds that are redrawn every year — which is why Humana could go from the bottom of the large insurers to the top in twelve months without its members noticing a different company. Use this year’s rating as one input among several, next to the network, the formulary and the out-of-pocket limit.
Check your specific plan’s 2027 rating on the official Medicare Plan Finder, or speak with your local State Health Insurance Assistance Program (SHIP) for free, unbiased guidance.
Sources
- Fact Sheet: 2027 Medicare Advantage and Part D Star Ratings — Centers for Medicare & Medicaid Services, October 8, 2026. Source for the 3.99 and 4.01 enrollment-weighted averages, the roughly 71% of enrollees in contracts of four stars or more for 2027, the enrollment shares from which we summed the 2026 figure, the 15 and 22 five-star contracts, the 2.25% and 2.43% enrollment in five-star contracts, the 508 and 516 rated contracts, the up-to-43 and up-to-32 measures, and every methodology change described above.
- 2026 Star Ratings Fact Sheet — Centers for Medicare & Medicaid Services. Source for the 3.98 average and 18 five-star contracts as first published.
- Part C and D Performance Data — Centers for Medicare & Medicaid Services. Source for the 2027 Star Ratings data tables we matched to the CY2027 Landscape file for the per-insurer plan shares and the one-county-in-four five-star availability. Those calculations are our own; the method is on our editorial methodology page.
- Humana loses Medicare Advantage stars lawsuit for a second time — Healthcare Dive. Source for the July 2025 dismissal and the October 14, 2025, dismissal with prejudice concerning the no-callbacks interpreter policy.
- Special Enrollment Periods — Medicare.gov. Source for the 5-Star Special Enrollment Period running from December 8 to November 30, usable once.
All figures on this page were checked against the sources above on October 12, 2026. The tables by plan type and by state were added on October 18, 2026, from the CY2027 Landscape file and the 2027 Star Ratings Data Tables.
Disclaimer: Star rating figures and methodology details in this article reflect the 2027 and 2026 Star Ratings published by the Centers for Medicare & Medicaid Services (CMS), and change every year. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.
Unai Sampedro founded and edits Medicare Plan Compass. He is not a licensed insurance agent or broker and takes no commission from any insurer; the site is funded by advertising. Articles are written from CMS and Medicare.gov documents and reviewed each year when new figures are published. Nothing here is personalized advice: the goal is to explain the rules in plain language so readers can ask better questions before they speak to someone who can advise them.