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What is the Medicare Star Rating?

The Centers for Medicare & Medicaid Services (CMS) created a Star Rating system to help beneficiaries and their families compare plan  performance and quality for Medicare Advantage plans, Medicare  Prescription Drug Plans, and Medicare Cost plans.


Medicare plans are rated on a scale of 1 to 5, with a 5-star rating  being the highest score a plan can receive. More stars indicate better  performance and quality:


  • 5-star rating: Excellent
  • 4-star rating: Above Average
  • 3-star rating: Average
  • 2-star rating: Below Average
  • 1-star rating: Poor

For Medicare plans providing health coverage, such as Medicare Advantage or Medicare Cost plans, each plan is given an overall summary rating based on how it performs across five main categories:


  • Staying healthy: Plans are rated on whether members  had access to preventive services to keep them healthy. This includes  physical examinations, vaccinations like flu shots, and preventive  screenings.
  • Chronic conditions management: Plans are rated for care coordination and how frequently members received services for long-term health conditions.
  • Member experience: Plans are rated for overall satisfaction with the health plan.
  • Member complaints: Plans are rated on how  frequently members submitted complaints or left the plan, whether  members had issues getting needed services, and whether plan performance  improved from one year to the next.
  • Customer service: Plans are rated for quality of  call center services (including TTY and interpreter services) and  processing appeals and new enrollments in a timely manner.

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