Medicare

Star Ratings (Medicare)

CMS Star Ratings help Medicare beneficiaries compare plan quality and affect plan bonus payments and special enrollment eligibility.

Last reviewed: May 2026 · Editorial methodology

Definition

The Medicare Star Ratings system is CMS's annual quality measurement program for Medicare Advantage (Part C) and Medicare Part D plans. Plans are rated on a scale from 1 to 5 stars, with 5 stars indicating excellent performance. Star Ratings incorporate approximately 40 measures including rates of preventive screenings, management of chronic conditions, drug safety metrics, member complaints, appeals outcomes, and member-reported health plan responsiveness. Star Ratings have significant financial consequences: plans rated 4 stars or higher receive quality bonus payments from CMS that allow them to offer richer benefits at lower premiums. Beneficiaries can switch to a 5-star plan at any time during the year using a special enrollment period — the only mid-year plan change permitted outside of standard SEPs. CMS publishes updated Star Ratings each October, coinciding with the start of AEP. Low-rated plans (below 3 stars for three consecutive years) can face CMS sanctions including removal from the Medicare program.

Where this term matters

Medicare →

Tip

Glossary definitions are educational. Always check your own policy language — insurers can define common terms differently from one another. When in doubt, request a written explanation from your agent.

Related terms

Medicare Part C (Medicare Advantage)Medicare Advantage plans deliver all Original Medicare benefits through private insurers and frequently include prescription drug coverage, dental, vision, and hearing benefits.MAPD (Medicare Advantage Prescription Drug)MAPD plans combine the hospital, medical, and drug benefits of Medicare Parts A, B, and D into one integrated plan from a private insurer.Annual Enrollment Period (AEP)The AEP is the primary annual opportunity for Medicare beneficiaries to change their Medicare Advantage or Part D drug plan, with changes taking effect January 1.Medicare Special Enrollment PeriodA Medicare SEP lets you enroll in Medicare without late penalties when you lose qualifying employer coverage or experience other defined life events.

Related guides

Source: Cover Forge USA editorial team|Last verified: May 2026|Methodology
Definitions are educational and may be simplified. Always refer to your policy contract and consult a licensed agent for terms that affect coverage decisions.
CF

Cover Forge USA Editorial Team

Editorial Lead

This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.

Reviewed June 2026

Get Insurance Rate Alerts

We monitor rate filings in all 50 states. Get notified when rates change in your area — and discover new ways to save.

  • ✓State-specific rate change alerts
  • ✓Seasonal enrollment deadline reminders
  • ✓Expert tips to lower your premiums
  • ✓New coverage options in your state

Free forever. Unsubscribe with one click. No spam, ever.

Important Disclaimer

This site provides general educational information only and is not a substitute for professional insurance advice. All rates, data, and coverage details are estimates and may not reflect your actual premiums. Insurance availability and pricing vary by state, insurer, and individual risk factors. Always consult a licensed insurance professional in your state before making coverage decisions.

← Back to Insurance Glossary (355 terms)