Medicare Advantage star ratings are essential for beneficiaries choosing a health plan. These ratings not only reflect the quality of service and care but also influence plan bonuses and enrollment. As we head into 2025, understanding how these star ratings work—and how they’re evolving—is critical for making informed decisions.
What Are Medicare Advantage Star Ratings?
The Centers for Medicare & Medicaid Services (CMS) uses a 5-star rating system to evaluate the performance of Medicare Advantage (MA) and Part D prescription drug plans. These ratings are updated annually and based on various quality measures such as:
- Member satisfaction
- Preventive care services
- Chronic condition management
- Customer service
- Drug pricing and safety
Plans are rated from 1 to 5 stars, with 5 being excellent and 1 being poor.
How Do Star Ratings Work?
Medicare star ratings are based on over 40 different performance measures across several categories. Each category is weighted, and a composite score is generated. The categories include:
- Staying Healthy – Screenings, vaccines, and checkups
- Managing Chronic Conditions – Monitoring care for long-term health issues
- Member Experience – Satisfaction surveys
- Customer Service – Response time, accuracy, and complaint resolution
- Drug Plan Services – Safety and accuracy in prescription drug usage
Plans that achieve 4 or more stars are considered high-performing and are eligible for bonus payments from CMS.
What’s New for 2025?
Enhanced Weighting on Patient Experience
In 2025, CMS continues its emphasis on patient experience and complaints, giving these measures greater weight in the overall star rating. This reflects a growing priority on how beneficiaries perceive their care—not just the clinical outcomes.
Measures Phasing Out and New Additions
Some older metrics are being phased out in favor of updated, patient-centered measurements. Expect to see more focus on health equity, mental health, and digital access to care in the 2025 framework.
What Are the 2026 Star Measures?
While the 2025 star ratings are finalized, CMS has released advance notice of changes for 2026, including:
- Greater emphasis on social determinants of health
- New metrics related to telehealth utilization
- Adjusted cut points to account for market-wide performance trends
These upcoming changes will influence how plans position themselves for 2026 and beyond.
What’s the Best Medicare Advantage Plan for 2025?
The “best” Medicare Advantage plan will vary depending on your needs, location, and health profile. However, plans with a 5-star rating offer several advantages:
- Special Enrollment Period access
- Higher CMS bonus payments (leading to richer benefits)
- Proven excellence in member satisfaction and care delivery
To find the best plan in your area:
- Visit the Medicare Plan Finder
- Compare by star rating, premiums, out-of-pocket limits, and network providers
What Is the Best Part D Drug Plan for 2025?
For those with stand-alone Part D plans, the star rating system similarly applies. Look for Part D plans that:
- Have 4 stars or more
- Offer a robust formulary (covered drug list)
- Minimize prior authorizations and restrictions
Top-rated Part D plans in 2025 will balance affordability with comprehensive coverage and ease of use.
Why Star Ratings Matter to You
Choosing a high-star-rated Medicare Advantage plan in 2025 can lead to:
- Better care outcomes
- Lower overall costs
- Higher satisfaction
- Fewer administrative headaches
These ratings also signal how a plan is likely to perform in the future, offering peace of mind to enrollees.
Final Thoughts
Understanding the Medicare Advantage star rating system for 2025 gives you a competitive edge in selecting the right plan. As CMS continues to evolve its quality metrics to reflect real-world care and patient feedback, being informed is more important than ever.
