Medicare's 2027 star ratings: 15 five-star plans, and what the score does not cover

Open Enrollment for 2027 runs October 15 to December 7, 2026, and the star ratings that CMS published on October 8, 2026 appear next to each plan in the Medicare Plan Finder, alongside its benefits and costs. They are the closest thing Medicare has to a consumer report card — and they are a contract-level quality score, which is why the number you see first is not always the number that answers your question.

Here is what moved in the 2027 file, what the rating does not measure, and the two enrollment windows that come attached to it.

What a star rating is, and whose rating it is

CMS rates every Medicare Advantage (Part C) and Part D prescription drug contract on a one-to-five scale. For 2027, MA-PD contracts are rated on up to 43 quality and performance measures; Medicare Advantage plans without drug coverage on up to 32; and stand-alone prescription drug plans (PDPs) on up to 13. For each measure CMS sets a threshold — a “cut point” — and the cut points are recalculated every year based on that year’s performance. Part of any year-over-year change is therefore a change in the yardstick, not a change in care.

Two consequences matter when you compare plans:

• The rating belongs to a contract, not to a brand. The 2027 five-star list is a good illustration. Five of the 15 contracts carrying the high-performing icon are Longevity HealthPlan contracts in five different states, all listed under one parent organization; the same table credits UnitedHealth Group, Elevance Health, CVS Health and others with other contracts. “That company is five stars” is not a statement this table supports — the contract is the unit, and the contract is what you enroll in.
• The rating describes a plan’s whole membership. It is not a statement about your doctors, your pharmacy or your prescriptions. Those come from the plan’s own network and drug lists, which is why the Plan Finder shows them next to the rating rather than folding them into it.

The 2027 numbers

These are Tables 1 and 2 of the CMS fact sheet, which is the primary document behind every “Medicare star ratings” headline this month.

Measure	2024	2025	2026	2027
Rated MA-PD contracts	545	521	516	508
MA-PD contracts rated 5 stars	38	9	22	15
Average MA-PD rating, weighted by enrollment	4.07	3.95	4.01	3.99
Rated stand-alone drug plans (PDPs)	48	41	40	41
PDPs rated 5 stars	2	2	2	0
Average PDP rating, weighted by enrollment	3.34	3.12	3.01	3.22

Three more figures from the body of the release:

• About 37% of MA-PD contracts — 188 of the 508 offered for 2027 — earned four stars or higher.
• Weighted by enrollment, about 71% of MA-PD enrollees are in contracts that will have four or more stars in 2027.
• 15 MA-PD contracts carry the five-star high-performing icon for 2027, and six of them also carried it for 2026.

The two numbers that get quoted against each other

37% and 71% are both correct and they answer different questions. The 37% is a count of contracts, so it treats a plan with 800 members and a plan with 360,000 members as equal. The 71% is weighted by enrollment, so it reflects where people actually are. If you want to know how many plans are well rated, use 37%. If you want to know how many people are in a well-rated plan, use 71%. Almost every headline you read this month picks one and implies the other.

The stand-alone drug plan row is the more interesting one. It looks like a jump: enrollees in four-star-or-higher PDPs rose from about 2% to about 22%. Two details qualify it. First, the enrollment-weighted average rating for PDPs moved only from 3.01 to 3.22 — about two-tenths of a star, and still below the 3.34 of 2024. Second, no stand-alone drug plan earned five stars for 2027, the only year in the fact sheet’s four-year table with none, while the share of PDP enrollees in 2.5-star plans rose from about 14% to about 22%.

Read together: the middle of the stand-alone drug market genuinely improved, and the top of it did not. That is a different story from “drug plans are now highly rated,” and it lands in the same market our guide to the 2027 open enrollment window describes — where CMS is ending the temporary premium stabilization for stand-alone plans after 2026.

If your plan is one of the four flagged

Four MA-PD contracts are identified on the Plan Finder with the low-performing icon for 2027 for consistently low ratings — the same number as last year. Table A2 of the fact sheet names them:

Contract	Plan	Parent organization	Flagged on	Enrollment, October 2026
H3814	Atrio Health Plans	ATRIO Health Plans	Part C	2,000
H4982	Aetna Better Health of California, Inc.	CVS Health Corporation	Part C or D	9,358
H7389	HealthSpring Life & Health Insurance Company, Inc.	Health Care Service Corporation	Part C	0
H9066	Visiting Nurse Association of Central New York	Visiting Nurse Association of Central New York	Part D	654

The icon is not only a label on a search result. Being enrolled in a plan that carries it is itself a special enrollment period: 42 CFR 422.62(b)(25) for Medicare Advantage and 423.38(c)(32) for Part D both say the period “exists while the individual is enrolled in the low performing” plan. In plain terms, you are not stuck until December — you can move during the year. The practical weight of that is small this year: two of the four contracts have fewer than 2,100 enrollees and one has none, so for most readers this is a rule worth knowing rather than a plan to act on.

The five-star shortcut, and its limits

A five-star plan carries its own enrollment window, separate from Open Enrollment. Under 42 CFR 422.62(b)(15) (Medicare Advantage) and 423.38(c)(20) (Part D), you may use it once for the contract year, and it runs “beginning the December 8th before that contract year through November 30th of that contract year.” For the ratings published this October, that is December 8, 2026 through November 30, 2027.

Three things to keep in mind before you treat that as a better window than the one you are in now:

• It is one election, not a standing right to switch. Use it and it is spent for that contract year.
• A five-star contract has to be sold where you live, and be open to you. Several of the 15 contracts are small — the group ranges from 818 to 360,519 enrollees, and five of the 15 have fewer than 1,500 members each. Whether any of them is an option for you is a county-by-county question, so check the Plan Finder rather than the marketing.
• Check what the plan covers before you move. A Medicare Advantage plan without drug coverage is a different product from an MA-PD, and joining one is not the same as joining the plan you just read about. The rating tells you about quality; it does not tell you about your drugs.

What the rating cannot tell you

The rating is one input, next to benefits and costs. It does not tell you whether your cardiologist is in the network, whether your insulin is on the drug list, what your copays will be, or what the annual out-of-pocket maximum is. Those are plan-specific and they change every year, which is what the annual notice of change you should have received by now is for.

Two further cautions that come straight from the fact sheet:

• The score you are reading is partly an input to future funding. CMS states that the 2027 ratings “will impact 2028 MA quality bonus payments.” A rating is not a description of what you will pay in 2027; the money it moves lands two years later.
• The measurement changed for 2027. Two measures were added (concurrent use of opioids and benzodiazepines, and use of multiple anticholinergic medications in older adults); the weight of the improving-or-maintaining physical health and mental health measures rose from one to three; the colorectal cancer screening measure was respecified; a functional status assessment measure returned; two measures were retired; and one medication-review measure is out of the ratings until 2029. CMS’s own summary of the effect is: “Changes in Star Ratings year-over-year are normal and expected and vary by measure.” A plan that lost a star has not necessarily gotten worse.

Every figure above comes from the CMS fact sheet or the regulations, both of which are on the official sites listed in OMC’s government resources page.

The marketing that follows the ratings

Every year, “five stars” turns into a sales line, and fall is when most Medicare marketing reaches people. Two things are worth separating:

• A rating in an advertisement is a claim. Check it by contract name in the Plan Finder, not in the mailer. Anyone can print a star.
• Nobody legitimate cold-calls to sell you a plan or to “review your Medicare.” 1-800-MEDICARE does not call you with a better offer.
• Never give your Medicare number to someone who contacted you first. It is the key to your coverage and your medical identity.
• Medicare, CMS and Social Security do not charge a fee to enroll, switch plans or “hold your coverage.”

If something sounds wrong, hang up and call 1-800-MEDICARE (1-800-633-4227) yourself, or report it at reportfraud.ftc.gov.

Bottom line

The 2027 file is a flat headline with a real reshuffle underneath it: fewer top-rated Medicare Advantage contracts (15, down from 22), an average that barely moved (3.99, from 4.01), a stand-alone drug market that improved in the middle while producing no five-star plan at all, and four contracts still flagged as consistently low performers. If you are choosing coverage, use the rating to build a short list, then let your own doctors, drugs and out-of-pocket maximum decide. Do it before December 7, 2026, and check the contract — not the brand — by name.

Medicare itself is federal, so the method behind these ratings is the same in every state. What differs is which contracts are sold where: plan offerings and networks vary by county, and for people who also qualify for Medicaid, the state rules that apply to dual-eligible plans vary by state.