If you’re enrolled in a Medicare Advantage plan—or thinking about making a change—there’s a powerful tool that can help you spot the best options in your area: Medicare’s star rating system.
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates every Medicare Advantage plan and assigns it a star rating from 1 to 5 stars. These scores reflect how well a plan delivers care, supports its members, and helps people stay healthy. A 5-star rating means the plan is performing exceptionally well—and that often translates into better service, more reliable coverage, and fewer headaches for you.
Surprisingly, most people don’t know what their plan’s rating is, or that a 5-star plan unlocks a special enrollment opportunity, allowing you to switch even if it’s not during the usual enrollment window. Let’s walk through what the ratings mean, how to check yours, and how savvy Medicare users are using this system to improve their coverage.
What Medicare Advantage Star Ratings Actually Measure
The star ratings aren’t just for show. Medicare uses them to measure a plan’s overall performance in categories that matter to you. These include:
- Customer service and responsiveness
- Member satisfaction and complaints
- Access to preventive services like screenings and vaccines
- Chronic condition management
- Timeliness and accuracy of claims processing
Plans that earn 5 stars typically do a better job of keeping their members informed, healthy, and supported. If your plan has a lower rating, it might explain things like frequent billing issues, limited provider access, or frustrating customer service.
The 5-Star Special Enrollment Period
Here’s where things get interesting. Medicare gives you a chance to switch into a 5-star Medicare Advantage plan once per year, even if you’re outside the Annual Enrollment Period.
This is called the 5-Star Special Enrollment Period, and it runs nearly year-round—from December 8 through November 30 of the following year. If you’re enrolled in a lower-rated plan and there’s a 5-star option available in your area, you can make a one-time switch.
This gives you flexibility and control over your coverage—especially if your current plan isn’t meeting expectations.
Find a 5-Star Plan Near You
Not every area has a 5-star plan, but more are being introduced every year. You can check your local options by visiting Medicare.gov and using the Plan Finder Tool. Just enter your zip code and review the star ratings listed next to each plan.
If you do see a 5-star plan listed, take time to compare its provider network, copays, benefits, and drug coverage against your current plan. While a higher rating often signals better overall performance, it’s still important to confirm that the plan fits your specific needs.
When It Might Be Worth Switching Your Advantage Plan
Switching to a 5-star Medicare Advantage plan may be a smart move if:
- Your current plan has a star rating below 4
- You’re frustrated with delays, denials, or billing confusion
- Your preferred doctors or hospitals are no longer in-network
- You’re paying more out of pocket than you expected
In many cases, a 5-star plan can offer a smoother experience with fewer surprises. That doesn’t mean it’s the best fit for everyone, but it’s worth exploring—especially when you have the freedom to switch without waiting for October.
Too often, people choose a plan and stick with it simply because it feels easier. But in Medicare, staying passive can cost you. Plans change, networks shrink, and benefits shift year to year. The star rating system exists to help you identify when something better might be available—and the 5-Star Special Enrollment Period gives you the power to act on it.
Get Help Exploring Your Medicare Options
You don’t need to memorize enrollment rules or compare star ratings on your own. At MedicareSchool.com, we help people like you every day understand how their plans stack up and whether something better might be available nearby.
If you’re curious about switching plans, reevaluating your current coverage, or simply want to talk through your Medicare options, we’re ready to help.
Schedule a phone consultation with one of our licensed Medicare Guides, or reach us at 800-864-8890. Our conversations start with listening—because the best advice comes from understanding what matters most to you.