Five Star Medicare Advantage Plans
- Every year, Medicare rates Medicare Advantage plans using a 5-star rating scale, with 5-star plans earning the top possible score. Learn how you may be able to enroll in a five-star plan near you.
One of the most important things to consider when shopping for a Medicare Advantage plan (also known as Medicare Part C) is plan quality.
Fortunately, there’s an easy way to determine just how good a plan is. Every year, Medicare evaluates plans based on a 5-Star Rating System.
The Centers for Medicare & Medicaid Services (CMS) evaluates all Medicare Advantage plans (and Medicare Part D prescription drug plans) and assigns each plan a star rating based on how the plan performs on metrics such as customer service, management of chronic conditions and more.
Plans that earn a five-star rating are the highest rated plans and are typically among the most coveted by beneficiaries. In this review, we look at five-star Medicare Advantage plans, including how they earn that distinction, where to find them, how to enroll in one and more.
Depending on your eligibility, you may be able to enroll in a 5-star plan if you're currently enrolled in a plan rated less than 5 stars.
You can search online for Medicare Advantage plans where you live to find out if any 5-star plans are available. You can also get help comparing plan star ratings by calling to speak with a licensed insurance agent.
What Is a 5 Star Medicare Plan?
A five-star plan is one that has been given a perfect five-star rating by the CMS.
- 5 Stars ★★★★★ = Excellent
- 4 Stars ★★★★ = Above average
- 3 stars ★★★ = Average
- 2 stars ★★ = Below average
- 1 star ★ = Poor
There are 28 unique performance measures used to determine a star rating for Medicare Advantage plans and 38 performance measures to rate a Medicare Advantage plan that includes prescription drug coverage (MA-PD plans).
Those performance measures are grouped into the following categories:
- Preventive health coverage, including screenings and vaccines
- Management of chronic conditions
- Member experience with the plan
- Member complaints and changes in the plan’s performance
- Customer service
For Medicare Advantage plans that include prescription drug coverage, an additional four categories are also used.
- Customer service for drug benefits
- Member complaints about drug coverage and changes in the plan’s drug coverage performance
- Member experience with the drug coverage
- Drug safety and accuracy of drug pricing
The information used to score each category is collected from plan member surveys, information that health care providers submit to the CMS and regular monitoring.
Which Medicare Advantage Plans Have the Highest Rating for 2023?
There are 3,998 Medicare Advantage plans available nationwide in 2023. More than 89% of Medicare Advantage plans include prescription drug coverage.1
There are 62 MA-PD contracts that earned a five-star rating for 2023.2 Each contract may include several different local plans, and more than one plan in each contract may have earned a five-star score.
When weighted by enrollment, more than 21% of MA-PD enrollees belong to a five-star plan in 2023. Roughly half (48%) of beneficiaries are enrolled in a plan rated at least 4.5 stars, and over 72% belong to plans rated at least four stars.2
Which States Have 5 Star Medicare Advantage Plans?
Five-star Medicare Advantage plans can be found nearly everywhere in the U.S. Plan selection varies by state, so contact a licensed insurance agent to ask about any five-star plans available where you live.
Five-Star Medicare Advantage Plans in Florida
To get an idea of how five-star Medicare Advantage plans may be broken down within a given state, let’s take a look at Florida, which has the second-most Medicare beneficiaries in the country and is among the best states for Medicare.
Over a third (36%) of Medicare Advantage prescription drug plans in Florida are rated four stars or higher by Medicare in 2023.
What Are the Eligibility Requirements for Five-Star Medicare Plans?
Five-star Medicare Advantage plans have the same eligibility requirements as any other Medicare Advantage plan. This means that you qualify for a five-star plan if you qualify for any other Medicare Advantage plan, as long as a five-star plan is available where you live.
You also have to be enrolled in both Medicare Part A and Part B to be eligible.
When Can You Enroll in a Five-Star Medicare Plan?
There are several different enrollment periods when you may be able to enroll in a five-star Medicare Advantage plan.
Five-Star Special Enrollment Period
If you are enrolled in a Medicare plan rated less than five stars, you may be able to switch to a five-star plan anytime between December 8 and November 30 of the following year, during what's called the Medicare Five-Star Special Enrollment Period.
Initial Enrollment Period
When you first become eligible for Medicare, you get an Initial Enrollment Period (IEP) that begins three months before the month you turn 65 years old and lasts seven consecutive total months. During this time, you may enroll in a Medicare Part A, Part B and a Part C Medicare Advantage plan, including a five-star plan.
Fall Medicare Open Enrollment Period
The Fall Medicare Open Enrollment Period, sometimes called the Annual Enrollment Period, lasts from October 15 to December 7 each year. During this time, you may be able to enroll in, drop or switch Medicare Advantage plans, including five-star plans if they're available where you live.
Special Enrollment Periods
Additional Special Enrollment Periods may be granted throughout the year for a variety of reasons, such as moving to a new area, losing coverage through no fault of your own and more. If you are granted a Special Enrollment Period because of a qualifying circumstance, you may enroll in a five-star plan if one is available in your area.
How Do You Enroll in a Five-Star Medicare Advantage Plan?
Contact a licensed insurance agent and ask about any five-star Medicare Advantage plans available where you live. An agent can help you compare any five-star plans sold in your area as you review the costs, coverage and provider networks of each plan to find the coverage you need with the doctors you like at a rate you can afford.
Freed M, et al. (Nov. 10, 2022). Medicare Advantage 2023 Spotlight: First Look. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-2023-spotlight-first-look/.
CMS. 2023 Medicare Advantage and Part D Star Ratings. (Oct. 6, 2022). https://www.cms.gov/files/document/2023-medicare-star-ratings-fact-sheet.pdf.