2026 Update:
Every fall, the federal government hands out report cards for Medicare Advantage and Part D plans. They are called Star Ratings, and they are one of the few truly independent measures you have when you are trying to compare plans in Lexington, Columbia, Irmo, Chapin, or anywhere in the Midlands.

They are useful. They are also widely misunderstood. A lot of people see a five-star badge in an ad and assume that means it is the best plan for them. It might be. It might also be a plan that does not include your doctor or cover your prescriptions, which would make it the wrong plan no matter how many stars it carries.

Here is what the ratings actually measure, what changed for 2026, and how to use them without letting them make the decision for you.

What the Star Ratings are

The Centers for Medicare and Medicaid Services, or CMS, rates every Medicare Advantage and Part D plan on a scale of one to five stars, with five being the best. Plans can also land on half stars, like 3.5 or 4.5. Think of it as a consumer report card for health and drug plans, published by the government rather than by the insurance companies themselves.

For 2026, CMS scored plans across up to 45 separate quality measures. Those measures fall into a handful of plain-language categories:

• Staying healthy: whether the plan helps members get screenings, vaccines, and routine checkups
• Managing chronic conditions: how well it supports members with diabetes, heart disease, and other ongoing needs
• Member experience: what enrollees say about getting care and dealing with the plan
• Complaints and members leaving: how often people file complaints or drop the plan
• Customer service: how responsive and helpful the plan is when you need it
• Drug plan performance: for plans with Part D, how well they handle prescriptions, pricing accuracy, and medication safety

The rating you see on Medicare.gov is the overall score, built from all of those pieces.

What changed for 2026

Two things are worth knowing.

First, ratings got harder to earn. Over the last few years CMS tightened the scoring methodology and stopped smoothing out the numbers the way it used to. The result is that top ratings are tougher to hit than they were five years ago. The national average overall rating for 2026 came in around 3.66, essentially flat compared to the year before, after several years of steady decline.

Second, five stars stayed rare. For 2026, only about 18 Medicare Advantage contracts nationwide earned the full five stars, up from just seven the year before but still a small slice of the market. Roughly four in ten plans reached four stars or higher. So when you see a five-star badge, understand that it is genuinely uncommon.

Why the ratings matter to you

They give you an independent quality signal. Premiums and benefits are easy to compare on paper. Quality of care and service are not. The Star Ratings let you look past the marketing at how a plan has actually performed for its members.

Higher-rated plans get more money to spend on you. Plans that earn four stars or more receive a bonus payment from the government. Many of them reinvest that into richer benefits, better customer service, and extra perks. That is part of why highly rated plans often look more generous.

There is a special enrollment period for five-star plans. If a five-star Medicare Advantage or Part D plan is available in your area, you are allowed to switch into it one time outside the normal enrollment windows, between December 8 and November 30. That is a real advantage, with one big caveat: five-star plans are rare, and there may not be one available where you live. This is not a reason to wait around hoping one appears.

What the ratings do not tell you

This is the part the ads leave out, and it is the part that matters most.

A star rating is an average across a whole plan and a whole region. It does not know your doctors, your prescriptions, or your health. A five-star plan is not the right plan for you if your cardiologist is out of network, if your medications sit on a bad tier, or if the plan is not even offered in your ZIP code. Around here, plan availability shifts from one ZIP to the next. What is offered in 29072 is not always what is offered in 29212.

The ratings are also a rear-view mirror. They reflect how a plan performed in past years, not how it will perform next year. And they change annually. A plan that was five stars two years ago may not be today, and a plan can be reshaped by the insurer even when its rating holds steady. For 2026 in particular, several large carriers narrowed their networks, trimmed benefits, or pulled out of certain counties entirely, which is exactly the kind of change a star rating will not warn you about in advance.

So use the rating as one input. A strong rating is a good sign. It is not the whole answer.

How to actually use Star Ratings when you compare plans

1. Start with your must-haves, not the stars. Confirm your doctors are in network, your hospital is covered, and your prescriptions are on the formulary at a reasonable cost. This comes first.
2. Then use the rating as a tiebreaker. Between two plans that both fit your doctors, drugs, and budget, the higher-rated one is usually the safer pick.
3. Look at the categories that matter to you. If you manage a chronic condition, the "managing chronic conditions" measures matter more than the overall number.
4. Check the rating every year. Ratings and plans both change. The plan that was right last year may not be this year, and reviewing it is free.
5. Watch for the low-performing warning. CMS flags plans that stay below three stars for several years running with a warning icon. That is a signal to look closely.

The best time to do all of this is during the Annual Enrollment Period, October 15 through December 7, when your changes take effect January 1.

Medicare Advantage Star Ratings: quick answers

What is a good Medicare Advantage star rating? Four stars or higher is considered high quality. Five stars is excellent and uncommon.

When are Star Ratings updated? CMS releases new ratings in early October each year for the following plan year. The 2027 ratings are expected around October 2026.

Can I switch to a five-star plan any time? You can use the five-star special enrollment period once between December 8 and November 30, but only if a five-star plan is actually available in your area.

Does a five-star rating mean it is the best plan for me? Not necessarily. If it does not cover your doctors or drugs, a lower-rated plan that does may serve you far better.

Where do I find a plan's star rating? On the official Medicare Plan Finder at Medicare.gov, or ask a licensed agent to pull it for you.

Let a local agent read the ratings with you

Star Ratings are a good starting point, but they were never meant to replace a real plan comparison. At Mauldin Insurance Group, we sit down with Midlands families every year and line up the ratings next to the things the ratings cannot see: your specific doctors, your medications, your budget, and which plans are genuinely available on your street. As an independent agency, we shop across the carriers offered in your area and give you a straight answer, at no cost to you.

If you want help comparing plans for this year, call or text us. We are right here in Lexington.

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer 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.