What are Medicare Star Ratings?
This educational resource is provided by CHL Insurance Solutions, a local independent agency. This page is intended for informational purposes only and does not constitute medical, legal, tax, financial advice, nor is it an offer of insurance or a sales solicitation.
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Understanding your health and drug coverage options is an important part of managing your Medicare benefits. To help beneficiaries compare plans, Medicare uses a performance measurement system known as Star Ratings.
How the Star Rating System Works
Medicare evaluates plans based on a 5-star rating system. These ratings are updated annually to reflect the most recent performance data available. This system applies specifically to Medicare Advantage (Part C) and Medicare Prescription Drug plans (Part D).
Because these ratings are refreshed each year, it is important to review the current plan year's Star Ratings to see how a plan is performing right now.
What Do the Stars Measure?
Star Ratings are not a general endorsement; rather, they measure how well a plan performs in specific categories. Medicare scores plans on several performance metrics, including:
Staying Healthy: How often members receive screening tests, vaccines, and checkups.
Managing Chronic Conditions: How effectively the plan helps members manage long-term health issues.
Member Experience: Ratings based on surveys regarding the ease of getting appointments and the quality of customer service.
Member Complaints: How often members filed complaints about the plan and whether performance improved year-over-year.
Pharmacy Services (for Part D): Accuracy of drug pricing and how often members followed their prescribed drug regimens.
Using Ratings as a Comparison Tool
The Star Rating system is designed to provide an objective way for you to look at plan performance side-by-side. When you use the Medicare Plan Finder tool at Medicare.gov, you can see these ratings assigned to various individual plans.
While Star Ratings provide a snapshot of a plan's performance over the past year, they do not guarantee future healthcare outcomes or specific clinical results. They are one of several tools—including costs, provider networks, and drug formularies—that can help you make an informed decision about your coverage.
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Required Disclaimer: Every year, Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent 5 organizations which offer 55 products in your area. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Note: Organization and Product counts are based on the Gainesville, FL area. Actual plans available may vary based on your zip code.
Non-Government Entity: CHL Insurance Solutions, LLC is a private, licensed insurance agency (FL Lic: L131407; GA Lic: 241106). We are not part of the federal Medicare program.
