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What are Medicare Advantage star ratings in 2025?

What are Medicare Advantage star ratings in 2025?

Sidewalks on famous boulevards, military heroes, well-behaved school children, and Medicare Advantage plans all have one thing in common: they can be decorated with stars to represent success. While just about everyone can understand the process behind how to earn a star in a first grade classroom, it might not be as obvious how the stars in the Medicare Advantage (also known as MA plans or Part C) world works. Why are these plans rated? What do those stars tell me as a beneficiary? Should I automatically get a five-star plan? Here are the details behind 2025’s Medicare Advantage and Part D (Prescription drug plans) star rating system.

The basics

Medicare Advantage and Part D plans are rated each year by the Centers for Medicare & Medicaid Services (CMS) on a 5-star scale, with 5 being the highest. These star ratings measure a plan’s quality in areas like customer service, access to care, management of chronic conditions, and member satisfaction. A higher star rating indicates better performance in delivering services and care to members. The main reason for these star ratings to exist is to help beneficiaries and those supporting them to make meaningful choices about what plan fits them just right.

Plans are highly motivated to achieve 5-star ratings because it reflects top-tier quality, which can attract more members. CMS also rewards 5-star plans with higher bonus payment rates, enabling them to invest in even better benefits and services. Ultimately, a 5-star rating enhances a plan’s reputation, improves member satisfaction, and drives business success.

How are star ratings calculated?

The process varies slightly from year to year, but each plan is rated on more than 40 performance measures. These measures fall into five key categories: member experience, customer service, managing chronic conditions, preventive care, and member complaints and satisfaction. CMS collects data from plan members, health care providers, and other sources to assess how well the plan is performing in each area.

As of the writing of this insight, no plans in the state of Michigan have a five star rating.

How star ratings affect your enrollment

These star ratings are usually right at your agent’s fingertips. When they quote a plan for you, s/he should be able to tell you with ease what the star rating of the plan is. And if the plan is a five star plan, that allows you to enroll in it at any time, not just during your Special Enrollment Period or Annual Enrollment Period.

Which is a good thing for everyone: the carrier gets more opportunities to expand their numbers, the agent gets more opportunities to ensure you’re in a fitting plan, and you get to jump ship to the plan with the highest marks whenever it makes sense for you.

So what do star ratings look like in 2025?

In recent years, the number of plans with the coveted five star rating has been dwindling. In 2022, 74 MA plans earned the top rating. That number has been reduced to 7 in 2025.

As time progresses, plans are seeming to settle somewhere in the middle. The number of plans with 3.5 and 3 stars has been rising steadily since 2022.

Star rating 

Overall

Number of Medicare Advantage Contracts
2022 2023 2024 2025
5 stars 74 57 38 7
4.5 stars 96 67 81 86
4 stars 152 136 123 116
3.5 stars 122 116 141 165
3 stars 25 90 126 123
2.5 stars 2 37 32 23
2 stars 0 4 4 1
Total 471 507 545 521
Average Star Rating* 4.37 4.14 4.07 39.2

*Overall star ratings are weighted by enrollment.

Part D prescription drug plans aren’t faring as well as their Part C counterparts. Since a big drop off in 2023, no more than two Part D plans have clawed their way to 5 star status, with most of them settling in the 3.5 or 3 star territory.

Star Rating Overall Number of PDP Contracts
2022 2023 2024 2025
5 stars 10 2 2 2
4.5 stars 5 7 4 6
4 stars 14 7 12 3
3.5 stars 20 11 10 10
3 stars 3 16 14 11
2.5 stars 2 4 2 7
2 stars 0 4 4 2
1.5 stars 0 1 0 0
Total  54 52 48 41
Average Star Rating* 3.7 3.25 3.34 3.06

*Overall star ratings are weighted by enrollment.

So across the board, 11 plans have scored the 5-star rating. Seven are MA-PD plans, two are Part D plans, and two are section 1876 Cost Contract plans. These plans allow members to receive care both inside and outside of the plan’s network. When members use out-of-network providers, Original Medicare steps in to cover the costs as it would with traditional Medicare.

So then which plans are 5 star plans? Get me on one!

Hold on now: there are no plans in the state of Michigan boasting 5 stars in 2025. The highest is 4.5. But if you are outside of our home state and interested in a five star plan, Highmark Health, LMC Family Holdings, Network Health, Alignment Healthcare USA, MHH Healthcare, and Elevance Health all offer one. The two carriers with five star Part D plans are UPMC Health System and Independent Health Association.

But on the flip side, all but one of the lowest performing plans are also outside of the mitten. Those plans are owned by Centene, CVS Health, Zing Health, and Group 1001.

Where are plans excelling and falling short?

Well, this can be difficult to talk about in sweeping averages, since each plan will have different short comings. But there are averages that tell us about the 40 different ways plans have gotten better—or worse—since 2022.

Plans are getting a bit better in improving bladder control and reconciling medications post discharge. Overall readmissions for any reason across the plan have declined – which bumps up ratings, and follow up after hospital care for beneficiaries with multiple conditions has improved, too. Transitions of care have seen quite a bump from 2024.

However, a lot has slipped, too. The biggest drop has been in appeals decisions, which is probably not a surprise to those of us watching the news. Appeals are happening more often, taking longer, and are getting complained about more often. People are leaving plans more often. The nitty-gritty of how each type of care is rated, overall, has crept slightly downward at different rates. The largest drops have been in controlling blood pressure and cardiovascular disease.

So what does this tell me about plans this year?

If you have a chronic condition, make sure to do your homework. Each plan will cover your care a bit differently, and at different costs to you as the beneficiary. Look at the items that matter to you in a plan—if you are worried about preapprovals, check the plan’s star rating in that area. If you speak a second language, make sure the carrier has ample translation services.

Remember too, MA-PD plans aren’t the end all be all either. Medicare Supplement plans are another option, and if you are still working, keeping your employer coverage might be a good choice.

Still looking for help? Call us. We have tons of experience in finding great fits for our clients.

 

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