1. What CMS published on October 8
On October 8, 2026, CMS published the 2027 Medicare Advantage and Part D star ratings and put them on the Medicare Plan Finder. They cover plan year 2027, and they also set the quality bonus payments insurers will receive in 2028 — which is why the industry watches this release far more closely than most beneficiaries do.1
For someone comparing plans this autumn, the rating is the number sitting next to each plan on the screen, and it is usually the first thing the eye lands on. That makes it worth a few minutes of understanding, because a star rating is a genuinely useful piece of information about some things and an actively misleading one about others.
The ratings in front of you changed six days before you could act on them
If you looked at plans in September and looked again this week, some numbers will have moved. That is the 2027 ratings replacing the 2026 ones on the Plan Finder, not the plans themselves changing in a week.
2. The headline numbers, side by side
Here are the figures as CMS published them. Both columns are taken from the same CMS document, which matters more than it sounds: CMS restated the 2026 ratings in the middle of this year after quality-bonus updates, so comparisons drawn from last year’s fact sheet and this year’s do not line up.2
Read down the column and a mixed picture appears rather than a simple decline.
| Medicare Advantage with drug coverage | 2026 | 2027 |
|---|---|---|
| Contracts rated four stars or better | 44% (229) | 37% (188) |
| Members in a four-star-or-better contract | about 67% | about 71% |
| Average rating, weighted by enrollment | 4.01 | 3.99 |
| Contracts with five stars | 22 | 15 |
| Contracts flagged as low-performing | 4 | 4 |
3. Why fewer plans reached four stars
The scoring changed. Two new measures begin with the 2027 ratings: one on the concurrent use of opioids and benzodiazepines, and one on the use of multiple anticholinergic medications in older adults. Both are about medication safety. A measure on functional status assessment for older adults returned after being respecified, colorectal cancer screening was respecified, and two measures — pain assessment for older adults, and medication reconciliation after a hospital discharge — were retired.2
Two existing measures also got heavier. Improving or maintaining physical health and improving or maintaining mental health moved from a weight of one to a weight of three, which means a plan’s performance on those two now counts for three times as much as it did. And CMS recalculates the cut points — the score needed to reach each star level — every single year, based on how all plans actually performed. A plan can hold its own performance perfectly steady and still move up or down a half star because the bar moved.
A half-star drop is a prompt to look, not a verdict
Before concluding that your plan got worse, check what else changed about it: the premium, the drug list, the network, the copays. Those are in your Annual Notice of Change, and they affect you directly in a way a composite quality score does not.
4. Fewer plans, more people — how both are true
This is the most counterintuitive line in the data, and it is worth a moment. The share of contracts rated four stars or better fell — from 44 percent to 37 percent. The share of people enrolled in such contracts rose, from about 67 percent to about 71 percent. Both numbers come from the same table.2
They can both be true because contracts are not people. A contract covering 400,000 members and a contract covering 900 each count once in the first figure and very differently in the second. Several very large contracts improved their ratings this year while a greater number of smaller ones slipped. The enrollment-weighted average barely moved at all, from 4.01 to 3.99 — which is probably the honest summary of the year: broadly flat, with movement underneath.
Annual Enrollment is open
Bring us your plan, your doctors and your prescription list. We will read the ratings with you.
5. What a star rating measures, and what it misses
A star rating is a composite built from dozens of individual measures. It is genuinely informative about some things and silent about others, and the difference matters when you are choosing a plan.3
| Question | Does the star rating answer it? |
|---|---|
| How quickly the plan answers the phone and resolves problems | Yes. Customer service and complaint measures are a real part of the score. |
| Whether members leave the plan, and how often they complain | Yes. These are measured directly and they are informative. |
| How well the plan manages chronic conditions and preventive care | Yes, at the population level — how the plan does across all its members. |
| Whether the drug pricing shown to you is accurate | Yes, for Part D. Pricing accuracy and medication safety are scored. |
| Whether your doctors are in the network | No. Not measured at all. |
| Whether your prescriptions are covered, and on what tier | No. Not measured at all. |
| What you will pay across the year | No. Not measured at all. |
That last column is the point. The three things that decide whether a plan works for you in practice — your doctors, your drugs, your cost — are exactly the three the rating cannot tell you.4
6. Drug plans: no five-star plan, but a large shift underneath
Stand-alone drug plans tell a stranger story. No stand-alone drug plan earned five stars for 2027 at all, down from two last year. At the same time, the share of drug plan enrollees sitting in a contract rated four stars or better jumped from about 2 percent to about 22 percent, and the average rating rose from 3.01 to 3.22.1
That is a very large move in the enrollment figure driven by a small move in the contract figure: 11 of 41 rated contracts reached four stars, against 9 of 40 last year. A couple of the largest drug plans in the country improved, and because they carry millions of members between them, the share of people in a well-rated plan moved far more than the share of plans did.
7. The five-star enrollment window, and who can actually use it
There is a real enrollment right attached to five-star plans. If a five-star plan is offered where you live, you may switch into it once between December 8 and November 30 of the following year, outside the usual windows. It is one of the few genuinely flexible moments in Medicare.
- It only exists if a five-star plan serves your county. Fifteen contracts nationally hold the rating, and between them they cover about 2.25 percent of Medicare Advantage drug-plan enrollment. For most people, in most counties, there is nothing to switch into.
- It is once per year, not once per good idea. Using it on a plan that turns out not to fit your doctors spends the right for the year.
- Five stars does not mean right for you. A five-star plan that excludes your specialist or your pharmacy is still the wrong plan. The rating measures the plan’s performance across its whole membership, not its fit with your life.
Treat it as a useful option to know about rather than a prize to chase. If a five-star plan serves your county and it also covers your doctors and your prescriptions at a price that works, that is a strong combination. If it only meets the first condition, the rating is not enough.4
8. South Florida, specifically
Two of the fifteen five-star contracts nationally are Florida companies. Leon Health, Inc. holds one, with roughly 40,630 members, and it also held five stars last year; its own materials state that Medicare approves it to offer Medicare Advantage plans to residents of Miami-Dade County. Longevity Health Plan of Florida holds the other, a much smaller contract of around 818 members. No five-star contract on the CMS list is based in Broward County.5
We are naming those because they are on a published CMS list, not because we are recommending them, and the distinction is not a formality. Whether either is available where you live, whether it includes the hospital you use, and whether your prescriptions sit on a workable tier are separate questions that the star rating does not touch. In a region where plan networks are drawn tightly around particular hospital systems, those questions usually decide the matter.
9. One thing being reported wrongly this month
One claim is circulating widely this month and it is not correct. Several articles state that, for 2027, a single provider leaving your plan’s network now triggers a special enrollment period. CMS did propose exactly that — removing the requirement that a network change be judged significant before the special enrollment period applies — but it did not finalize the proposal in the CY2027 final rule.3
The significance test still applies for 2027. A network change has to be judged significant before that particular enrollment right opens. CMS has indicated it may return to the question in future rulemaking, which is probably how a proposal came to be written up as a rule. If you have been told you can switch mid-year because one doctor left, check the reasoning before you rely on it — there may well be another enrollment right that applies to you, but it will not be that one.
10. Frequently asked questions
When did the 2027 star ratings come out?
CMS published them on the Medicare Plan Finder on October 8, 2026, a week before Annual Enrollment opened. They apply to plan year 2027 and they also determine the quality bonus payments insurers receive in 2028, which is why the industry pays such close attention to them.
My plan dropped from four stars to three and a half. Did it get worse?
Not necessarily, and this is the most important thing to understand about this year’s ratings. CMS changed the scoring for 2027: it added two new measures, tripled the weight of two others, respecified one and retired two more. It also recalculates the cut points every year based on how all plans performed. A plan can do exactly what it did last year and still land on a different number. A drop is a reason to look, not a reason to leave.
How many plans earned five stars for 2027?
Fifteen Medicare Advantage plans with drug coverage carry the high-performing icon for 2027, down from twenty-two for 2026. Only six of the fifteen also had it last year. Among stand-alone drug plans, none earned five stars this year, compared with two last year.
Are there any five-star plans in South Florida?
Two of the fifteen five-star contracts are Florida companies. Leon Health, Inc. holds one; its own materials say Medicare approves it to offer Medicare Advantage plans to residents of Miami-Dade County. Longevity Health Plan of Florida holds the other, and it is a very small contract of around 818 members. No five-star contract on the CMS list is based in Broward County. None of that makes any of them right for you — a five-star plan whose network leaves out your cardiologist is still the wrong plan.
What does a star rating actually measure?
It is built from dozens of measures grouped into areas like staying healthy, managing chronic conditions, member complaints and plan performance, customer service, and for drug coverage things like pricing accuracy and medication safety. What it does not measure is whether your own doctors are in the network, whether your own prescriptions are covered, or what you personally will pay. Those three are usually what decides whether a plan suits you.
What is the five-star special enrollment period?
If a five-star plan is offered where you live, you may switch into it once between December 8 and November 30 of the following year, outside the normal enrollment windows. It is a genuine right. It is also narrower than it sounds: the fifteen five-star contracts hold only about 2.25 percent of Medicare Advantage drug-plan enrollment, so for most people in most counties there is simply no five-star plan to switch into.
Did drug plan ratings get better or worse?
Both, depending on how you count. No stand-alone drug plan earned five stars for 2027, down from two. But the share of drug plan enrollees sitting in a contract rated four or more stars jumped from about 2 percent to about 22 percent, and the average rating rose from 3.01 to 3.22. A handful of very large plans improved, which moves the enrollment figure a long way without changing many contracts.
If fewer plans got four stars, why are more people in four-star plans?
Because contracts and people are not the same thing. The share of contracts at four or more stars fell from 44 percent to 37 percent, while the share of enrollees in such contracts rose from about 67 percent to about 71 percent. Some very large contracts moved up and a greater number of small ones moved down. The average rating weighted by enrollment barely moved at all, from 4.01 to 3.99.
Is it true that one doctor leaving my network now lets me change plans?
No, and this is being reported incorrectly in several places. CMS proposed removing the requirement that a network change be judged significant before it triggers a special enrollment period, but it did not finalize that proposal in the CY2027 rule. The significance test still applies for 2027. CMS has indicated it may revisit the question in future rulemaking, which is probably why the proposal is being described as though it had passed.
Should I switch plans because of a star rating?
On its own, no. A rating is a useful tiebreaker between two plans that both cover your doctors and your drugs at a price you can live with. It is a poor reason to leave a plan that fits you, and a poor reason to join one that does not. Start with your providers, your prescriptions and your total annual cost, and let the stars settle a close call.
11. Sources
- Centers for Medicare & Medicaid Services, 2027 Medicare Advantage and Part D Star Ratings fact sheet, October 8, 2026, and its appendix tables — source for every figure in this article, including both sides of each year-over-year comparison.
- Same fact sheet, measure section — the two new 2027 measures, the return of the functional status assessment measure, the respecified colorectal cancer screening measure, the weight increase for the physical and mental health improvement measures, the two retired measures, and the statement that cut points are recalculated each year.
- Centers for Medicare & Medicaid Services, Contract Year 2027 Medicare Advantage and Part D Final Rule — CMS did not finalize its proposal to remove the significance requirement from the special enrollment period for a change in provider network.
- Medicare.gov — the five-star special enrollment period allows one switch into a five-star plan, where one is offered, between December 8 and November 30 of the following year.
- Leon Health published materials — Medicare approves Leon Health to offer Medicare Advantage plans to people who live in Miami-Dade County.
Please note: This article explains how the Medicare star rating system works and what CMS published for 2027. It is not advice about any particular plan, and naming a plan that appears on a published CMS list is not a recommendation of it. Plan availability, networks and costs differ by county. Confirm anything that affects a decision at medicare.gov or against your own plan documents before you act on it.