I'm confused by all the star ratings for Medicare plans. Do they actually mean anything for the care I'll receive?

Question

Satoshi Aoki · Accepted Answer

Medicare Star Ratings measure the quality of Medicare Advantage and Part D plans.
If you have a Medicare Advantage plan, you should know about the star rating on your plan.
Star rating uses a 1 to 5-star scale. 
A 5-star rating means excellent performance. The ratings are based on factors like member satisfaction, customer service, and health care quality. Plans with higher stars often offer better care and service. Ratings are updated yearly by Medicare to help beneficiaries compare plans and make informed choices. Choosing a higher-rated plan can improve your overall experience and access to care. 

You may also switch to a 5-star plan during a special enrollment period, even outside of the usual enrollment times.

Clarence &quot;Mark&quot; Christiansen · Answer

The star ratings are real and based on customer feedback and experience with the different plans. As an agent, my focus is more toward plan benefits than star ratings but the star ratings are worth noting.

Answered by Clarence "Mark" Christiansen on April 4, 2025

Agent Licensed in WI, AZ, CA & 16 other states

Answered by Clarence "Mark" Christiansen Medicare Insurance Agent

Steven Graves · Answer

That’s a really good question! Medicare plan star ratings can definitely feel confusing, but they do offer useful insight—though they’re not the whole picture.

What Star Ratings Mean:
Medicare uses a 1-to-5 star system to rate plans on quality and performance.

Ratings are based on factors like:

Member satisfaction

Customer service

How well the plan manages chronic conditions

Drug safety and accuracy

Preventive care services

How Star Ratings Relate to Your Care:
Higher-rated plans tend to provide better service and coordination of care.

They often have fewer complaints and better customer support.

Higher ratings can mean better management of your health needs and medication safety.

What Star Ratings Don’t Tell You:
They don’t guarantee you’ll like every doctor or hospital in the network.

They can’t predict individual experiences or specific coverage needs.

Ratings can vary by location and plan changes each year.

Bottom line:
Star ratings are a useful starting point when choosing a plan, but they should be combined with your personal health needs, preferred doctors, and budget.

If you want, I can help you interpret star ratings alongside other important factors to find the best plan for you.   Call us at Medicare4USA.com      214-989-7900

James Carlson · Answer

Five star is the highest value.  The rating comes from Medicare.  The higher the value, the better the service and the company's ability to pay claims in the future.

Daniel Maisel · Answer

Sure they do, Medicare Advantage (MA) plans also known as Part C plans are rated annually by the Centers for Medicare & Medicaid Services (CMS) on a 1-5 star scale, with 5 stars being the highest. These ratings help consumers compare plans and assess their quality and performance. 

Star ratings help consumers compare the quality and performance of different Medicare Advantage and Part D plans. 

I hope this info is helpful. 

Daniel Maisel Insurance - Medicare Agency 
(909) 319-5324.          Www.InsureItDan.com 
http://planenroll.com/?purl=yZLgRcNz

David Quintal · Answer

Star ratings are used by the Centers for Medicare and Medicaid (CMS) to evaluate Medicare Advantage plans (part C) and Prescription Drug plans (part D). Star ratings range from one star to five stars. Star ratings assist individuals by allowing them to compare plans and choose the best one for their needs. The higher the star rating, in most cases, indicates better performance and may include additional benefits or programs.

Answered by David Quintal on April 21, 2025

Broker Licensed in NH, AL, AZ & 14 other states

Answered by David Quintal Medicare Insurance Agent

Nathan Danovski · Answer

Medicare gives plans a 1 to 5-star rating (5 is best) based on several factors, including:
	•	Member satisfaction (from surveys)
	•	Customer service
	•	Managing chronic conditions
	•	Preventive services (like screenings and vaccines)
	•	Drug safety and accuracy (for Part D)	

Higher-rated plans usually have better customer service, fewer complaints, and do a better job helping members stay healthy.
	•	Plans with 4 stars or more are generally considered high quality.
	•	Bonus payments go to plans with 4+ stars, which can mean more money for extra benefits (like dental, vision, or OTC allowances).

Use star ratings as a starting point, but not the only factor. Always also check:
	•	Your doctors’ network participation
	•	Your prescriptions and their cost tiers
	•	Maximum out-of-pocket limits
	•	Extra benefits that matter to you (like travel coverage)

If you travel a lot or have specific health needs, sometimes a lower-rated plan might actually serve you better than a 5-star plan.

Steven Bleicher · Answer

The only aspect of the Star rating system that can be helpful is if a company's plan has received a 5 Star rating (this is rare), it creates a new SEP or Special Election Period where changing to that plan can occur whenever there is no other valid period to use.

Answered by Steven Bleicher on May 4, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

Medicare Star Ratings, a 1 to 5-star system, assess the quality and performance of Medicare Advantage (Part C) and Part D prescription drug plans based on factors like member satisfaction, health outcomes, and plan operations. Typically, the higher the star rating, the better the plan services.

Answered by Timothy Brown on April 8, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Michael Pyers · Answer

The star ratings are based on diffferent criteria as shown on the Medicare Site. Also they strive to get the highest quality rating they can as star ratings also relate to the bonus they receive from the Government. (CMS)

Answered by Michael Pyers on May 16, 2025

Broker Licensed in OH & MI

Answered by Michael Pyers Medicare Insurance Agent

Steven Lovell · Answer

The star rating system helps the center for medicare services rate the performance of medicare advantage and part drug companies.  

It also helps individuals rate quality of care and performance

Cleo Martin · Answer

The stars help to guide you. The more stars the better the service that the people receive. The stars are based on number of complaints received by CMS. So the better the service the more stars. You should try to find a plan with 4 or 5 stars. Meaning it is better ten a plan with 2 or 3 stars.

Answered by Cleo Martin on May 17, 2025

Agent Licensed in SC, FL, GA, MI & NC

Answered by Cleo Martin Medicare Insurance Agent

Becki Jennings · Answer

Star ratings are a tool Medicare utilizes to "score" Medicare Health Plans and Prescription plans. Center for Medicare and Medicaid Services (CMS) uses the star ratings to measure key performances by the plan; such as beneficiary satisfaction, complaints, resolutions, screenings, as well as dozens of other indicators to determine ratings.

Answered by Becki Jennings on July 21, 2025

Agent Licensed in MO

Answered by Becki Jennings Medicare Insurance Agent

Mike Henry · Answer

No just on how they pay their bills.  The care you receive is based on the hospital Dr and nurses. Has nothing to do with your plans

Deborah Webster · Answer

Star ratings determine how Medicare (CMS) ranks Medicare plans. Low star ratings can be a warning sign that beneficiaries have been unsatisfied with a plan. Medicare may not allow the plan to continue offering benefits if star ratings stay below a certain score. Work with an independent agent who can offer multiple carriers and plans to help you choose a plan that is going to work for your particular concerns.

Answered by Deborah Webster on July 11, 2025

Broker Licensed in Ia & SC

Answered by Deborah Webster Medicare Insurance Agent

Carol Thompson · Answer

The ratings are there to share the opinions of other Medicare beneficiaries/ members  of their experience regarding plans.

William Scott · Answer

Yes they do. The Star Ratings gives you an overall view as to how you can expect the plan you chose to perform.

Mel Stevens · Answer

Star ratings are based on items like customer service, paying claims on time and overall customer care. Star ratings range for 1 to 5 with 5 being the highest. The higher the rating, the greater the reimbursement from the government to fund the benefits offered to clients. Therefore, it behooves all Medicare Insurance companies to achieve a 5-star Medicare rating. One extra bonus with 5-star plans. If there is a 5-star plan within your area, an SEP or special election period exists where you can enroll into the plan throughout the year.

Answered by Mel Stevens on April 3, 2025

Broker Licensed in AZ

Answered by Mel Stevens Medicare Insurance Agent

Robert Simm · Answer

The answer to that question is a no on the star ratings. The star ratings would cover for customer service, preventive care, managing chronic conditions and, plan Administration meaning is the carrier paying for your medical expenses or not. I would recommend a three to five star plan rating because it could have some form of impact on your health insurance whether you knew it or not.

Answered by Robert Simm on April 7, 2025

Broker Licensed in NC, AL, AR & 15 other states

Answered by Robert Simm Medicare Insurance Agent

Jami Mead · Answer

The star Ratings are based off of the reviews, studies and input from patients such as yourself. Ease of communication, care, answers and so forth. They are given as a suggestion of how others have felt about their experience, a suggestion for you as to what you may expect from the company. They are very important when it comes to ease of claims, coverage, and communication with the member.

Answered by Jami Mead on April 14, 2025

Broker Licensed in OH, FL, GA & 11 other states

Answered by Jami Mead Medicare Insurance Agent

Tony Merwin · Answer

They certainly do. Star Ratings are comprised of a few factors with the heaviest weight given to quality of network and evidence of improved health outcomes.

Ron Gambles · Answer

Yes, they absolutely do.  The Star Rating system is a tool created by the Centers for Medicare and Medicaid Services (CMS) for indicating the quality of services provided by Advantage Plans and Prescription Drug Plans.   This system was designed to specifically aide beneficiaries in selecting the best plans possible.

Also, as incentives for Plans to constantly review their processes to maintain CMS standards and excel in patient care.  They are rated in 5 categories that have a direct impact on patient experience.  Plans with an Overall 5-Star rating is the highest possible rating.  A Plan with a 5-Star rating in a single category does not make it the highest ranked Plan.

Scott Klag · Answer

In part yes. The STAR ratings measure several key points that effect the member's experience with the insurance carrier. Examples are customer service and health outcomes with network providers.

Gabrielle Sones · Answer

Most of the star ratings are a compilation of reviews received through the community. The higher the star rating the happier the members of the plan.

Barbara Klie · Answer

Hi. Great question! Medicare Star Ratings are designed to help individuals evaluate the overall quality of each plan. Ratings are from 1 to 5, with 5 being the best. The star ratings can indirectly affect the quality of care you receive. Plans with higher ratings tend to have better member experiences and potentially better health outcomes.

Answered by Barbara Klie on June 19, 2025

Agent Licensed in FL, IN, KY & LA, NY, OH & TN

Answered by Barbara Klie Medicare Insurance Agent

Craig Bodner · Answer

The Star Ratings are one area many people use to help in their choice of Medicare Advantage plans.  The ratings are determined by Medicare (CMS) so you can expect the ratings to not favor one company's plans over another's unless it was earned under their ratings system.  It is a somewhat complicated system that employs a number of questions (this can change each year as needed to address new/different objectives are set by Medicare) but they cover 5 categories:

1) Staying healthy: screenings, tests, and vaccines.
2) Managing chronic (long-term) conditions.
3) Plan responsiveness and care.
4) Member complaints, problems getting services, and choosing to leave the plan.
5) Health plan customer service.

Although plan ratings can be a very useful part of your decision process, it's important to know that there is no guarantee that your experience will match the plan ratings.  I have had clients with surprisingly good experience with middle level ratings (I.e. 3 stars), and poor experiences with very highly rated plans, (I.e. 4 - 5 stars).  Also, there are many other factors that I recommend you consider.  For example, I would argue that a highly rated plan that has such high copays and deductibles that you would be hesitant to get care that you need would not be a good choice.

I'm confused by all the star ratings for Medicare plans. Do they actually mean anything for the care I'll receive?

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I'm confused by all the star ratings for Medicare plans. Do they actually mean anything for the care I'll receive?

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