Navigating Medicare enrollment can be complex, especially with the different periods available throughout the year. One unique opportunity that beneficiaries may not be aware of is the 5-Star Special Enrollment Period (SEP) for Medicare Advantage plans. In 2025, this SEP continues to offer a valuable window for eligible individuals to upgrade to a top-rated plan. Here’s everything you need to know.
What Is the 5-Star Special Enrollment Period?
The 5-Star Special Enrollment Period allows individuals enrolled in Medicare to switch to a Medicare Advantage (Part C), Medicare Part D, or Medicare Cost Plan that has received a 5-star rating from the Centers for Medicare & Medicaid Services (CMS). These ratings are based on annual performance reviews of plan quality, member satisfaction, health outcomes, and service.
In 2025, beneficiaries can use this SEP once per year between December 8, 2024, and November 30, 2025, to switch from their current plan to a 5-star plan, if one is available in their service area.
Why 5-Star Ratings Matter
CMS assigns star ratings from 1 to 5, with 5 stars representing “excellent” performance. These ratings are based on factors such as:
- Customer service and complaints
- Managing chronic conditions
- Preventive care
- Member satisfaction
Choosing a 5-star Medicare Advantage plan ensures access to higher-quality services and customer care. It also gives you flexibility outside of the usual enrollment periods.
Who Is Eligible for the 5-Star SEP?
You qualify for this special enrollment if:
- You’re already enrolled in Original Medicare, a Medicare Advantage plan, or a Medicare Part D plan
- A 5-star plan is available in your area for the upcoming plan year
- You haven’t already used this SEP in the current year
Importantly, this SEP does not require a qualifying life event, unlike other special enrollment periods.
How to Use the 5-Star SEP in 2025
If a 5-star Medicare Advantage plan is available in your ZIP code in 2025, you can:
- Visit Medicare.gov
- Use the Plan Finder Tool
- Identify any available 5-star plans
- Enroll online or call 1-800-MEDICARE
Enrollment through this SEP can only be used once per year, so it’s essential to make an informed decision.
What If You Switch to a 5-Star Medicare Advantage Plan?
When you switch:
- Your new coverage begins the first day of the month following enrollment.
- You are disenrolled from your current plan automatically.
- If you’re switching from a Medicare Advantage plan to another one, make sure your new plan covers your doctors and prescriptions.
If you switch to a 5-star Medicare Part D plan, ensure your drug coverage continues seamlessly.
Can You Return to Original Medicare?
Yes. If you’re in a Medicare Advantage plan and want to go back to Original Medicare, you can do so during the Medicare Advantage Open Enrollment Period (January 1 – March 31) or the Annual Enrollment Period (October 15 – December 7). However, the 5-star SEP does not allow switching back to Original Medicare unless the 5-star plan you choose is Original Medicare (rare).
Other Key Enrollment Periods to Know
Understanding the other Medicare enrollment periods helps ensure you don’t miss important deadlines:
- Initial Enrollment Period (IEP): 7 months around your 65th birthday
- Annual Enrollment Period (AEP): October 15 – December 7
- Medicare Advantage Open Enrollment Period (MA-OEP): January 1 – March 31
- Medicare Part D Special Enrollment Periods: For people who qualify due to changes in circumstances
How Often Can You Change Medicare Plans?
You can switch Medicare plans during:
- Annual Enrollment Period (once per year)
- Medicare Advantage Open Enrollment Period
- Special Enrollment Periods like the 5-Star SEP
Each has different rules and timing. The 5-star SEP can be used once per calendar year, making it a strategic opportunity if you’re seeking better quality coverage.
What to Expect from Medicare Advantage Plans in 2025
In 2025, Medicare Advantage plans continue to offer enhanced benefits such as:
- Dental, vision, and hearing services
- Over-the-counter (OTC) allowances
- Wellness and fitness programs
- Telehealth services
- Premium reductions in some markets
Selecting a 5-star plan ensures you’re choosing one of the best-rated options available.
Final Thoughts
The 5-Star Special Enrollment Period for Medicare Advantage in 2025 is a powerful tool for beneficiaries seeking top-tier coverage without waiting for the standard enrollment periods. If a 5-star plan is available in your area, you have a once-per-year chance to upgrade and enjoy better service and care.
Related Searches People Ask
- What are the 3 enrollment periods for Medicare?
- Medicare Advantage Open Enrollment Period explained
- What qualifies you for a Special Enrollment Period?
- Can you go back to Original Medicare from an Advantage plan?
- How often can you change Medicare plans?
- Medicare Enrollment period 2025 breakdown
- Medicare Advantage plans 2025 updates
