2027 Medicare Advantage Star Ratings: What Changed
CMS published the 2027 Medicare Advantage and Part D Star Ratings on October 8, 2026. Here's what moved, what it means for 2028 bonus payments, and how to use it with clients before AEP ends.
What Are Medicare Advantage Star Ratings?
The Medicare Advantage Star Rating is a 1-to-5 score CMS assigns each Medicare Advantage and Part D contract every October, based on measures such as screening rates, medication adherence and member complaints. CMS published the 2027 ratings on October 8, 2026, and the enrollment-weighted average slipped from 4.01 in 2026 to 3.99 in 2027.
The rating is not a one-time grade, and it is not one number. CMS rates MA-PD contracts (plans that bundle drug coverage) on up to 43 separate measures, MA-only contracts on up to 32, and standalone Part D drug plans on up to 13. Each measure gets its own cutpoint and star score, and the overall rating is a weighted average of those scores. A rating of 3 stars or lower means a plan met CMS's minimum standard on most measures but did not stand out; 4 stars or higher is the threshold CMS treats as high quality, and it is also the threshold that triggers extra federal payments to the plan, which is covered further down.
How Many Plans Earned Four Stars or More for 2027?
Fewer plans cleared the four-star bar this year. CMS's own tables show that 44.4% of MA-PD contracts (227 of 511) earned four stars or higher for 2026. For 2027, that share fell to about 37%, or 188 of 508 rated MA-PD contracts. The drop looks sharper in contract counts than in enrollment, though: because many of the plans that fell below four stars have relatively small membership, the share of enrollees sitting in a four-star-or-better plan held closer to steady, at roughly 71% weighted by enrollment.
Five-star contracts also shrank. CMS lists 15 MA-PD contracts earning the full five stars for 2027, down from 22 in 2026. These 15 carry a "high-performing" icon on Medicare Plan Finder, the tool CMS uses to help consumers compare plans; eight of them also had five stars the year before. On the other end, four contracts carry CMS's low-performing icon for 2027, the same number as last year.
What Changed in the Rating Methodology?
Two new measures entered the calculation for 2027: Concurrent Use of Opioids and Benzodiazepines, and Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults. Both are clinical process measures built from evidence-based treatment guidelines. CMS also increased the weight of the Improving or Maintaining Physical Health and Improving or Maintaining Mental Health measures from a weight of one to a weight of three, after a specification change to those measures. A contract that scored well on the old, lighter-weighted version of those measures can see its overall rating move for reasons that have nothing to do with a decline in care.
How Do Star Ratings Affect What a Medicare Advantage Plan Can Offer?
A plan's star rating changes its federal payment, not just its marketing claims. Medicare Advantage plans are paid against a county-level benchmark, and a plan rated 4 stars or higher for 2027 gets that benchmark increased by 5 percentage points, or 10 points in certain high-enrollment urban counties. The rebate share of the gap between the benchmark and the plan's bid then scales with the rating. A plan gets 70% of that gap at 4.5 stars or higher, 65% from 3.5 to 4.5 stars, and 50% below 3.5 stars, according to KFF's analysis of the quality bonus program. A carrier earning a higher rebate can fund richer supplemental benefits or lower cost sharing for members the following plan year. Employer- and union-sponsored plans see the largest average bonus gain per enrollee, and special needs plans the smallest, so the same star rating is not worth the same dollar amount to every contract type.
The October 8 ratings do not change 2027 payments. CMS states plainly that the ratings "will impact 2028 MA quality bonus payments," since the program always runs on a one-year lag: this year's performance data sets next year's bonus eligibility. More than two-thirds of Medicare Advantage enrollees are already in a plan that qualifies for some level of bonus payment, so a rating swing of even half a star can shift real money for a carrier, and real benefit design for the member, the following plan year.
Plan counts moved too, and not in one direction. Nationally, the average Medicare beneficiary can choose among 28 Medicare Advantage Prescription Drug plans for 2027, per KFF's county-level analysis. The change by state varies widely: Texas fell from 36 average options in 2026 to 27 in 2027, Illinois from 38 to 30, and Minnesota from 16 to 9, while Alabama rose from 28 to 30 and Mississippi from 20 to 24. A client's options this AEP may look very different from last year's, independent of anything the client did.
What Should Agents Do With This Before AEP Ends?
Pull the current rating for every carrier and plan in your book before you call a client, not after. Medicare Plan Finder shows the live 2027 rating next to each plan, and a client whose plan dropped from 4.5 to 3.5 stars this year may not know it, since the plan's own marketing rarely leads with a rating decline. Flag any client on a plan that lost the high-performing icon, and check whether their plan is one of the four carrying the low-performing icon this year, since CMS has applied that icon to the same number of contracts for two years running.
- Pull the 2027 rating for each client's current plan and compare it against last year's rating, not just the plan's premium.
- Note in the client's record whether the rating moved because of a new measure (like the two added for 2027) rather than a service decline, so the conversation stays accurate.
- Check the carrier's nonprofit or for-profit status and tenure in the program if a client asks why ratings vary; CMS's own data shows nonprofit and longer-tenured contracts trend higher, though neither guarantees a good fit for one person.
- Document the rating you discussed and the date, the same way you would document a Scope of Appointment or plan comparison, so the conversation is defensible later.
Rating changes are also a legitimate reason to reach out before the December 7 AEP deadline, separate from a renewal reminder. A client whose plan fell below four stars is not required to move, and a lower rating does not always mean worse coverage for that specific person's doctors and drugs. But it is a fact the client is entitled to see before they decide, and documenting that you raised it protects the agent as much as it informs the client.
Frequently Asked Questions
What is a good Medicare Advantage Star Rating?
CMS treats 4 stars and above as its quality threshold; that is also the cutoff for a plan to qualify for quality bonus payments. For 2027, about 37% of MA-PD contracts met that bar, down from 44.4% in 2026.
Do Star Ratings change what a Medicare Advantage plan costs?
Not the client's premium directly, but yes for the plan. A higher rating raises the plan's federal benchmark and rebate share, which funds the supplemental benefits and cost-sharing reductions a plan can offer the following year.
When do the 2027 Star Ratings take effect for bonus payments?
The October 2026 ratings do not affect 2027 payments. CMS uses them to set 2028 quality bonus payments instead, a one-year lag that is built into the program.
How many Medicare Advantage plans got five stars for 2027?
Fifteen MA-PD contracts earned the full five stars for 2027, down from 22 for 2026, according to CMS's fact sheet.
Where can I check a specific plan's current Star Rating?
Medicare Plan Finder shows each plan's current rating alongside its benefits and costs, and CMS's fact sheet lists every five-star and low-performing contract by name.
How AgencyView Fits Into This Conversation
None of this changes what an agent needs from a CRM during AEP: a clear view of which clients sit on which carrier and plan, and a record of what was discussed and when. AgencyView connects HealthSherpa's Medicare quoting to the contact record, so an agent comparing a client's current plan against a higher-rated option is working from the same screen where the client's policy, call history and texts already live, and a turning-65 pipeline flags who is coming up for a review before the conversation is overdue. For more on the surrounding calendar, see AgencyView's guides to turning-65 outreach, the OEP window after AEP, choosing between MAPD and Medigap, and the 2027 Part D changes worth reviewing with clients alongside their plan's rating. Learn more about AgencyView at agencyview.net.
Cover photo: Kampus Production / Pexels
Where AgencyView fits
Keep reading
- Medicare 5-Star Special Enrollment Period, Explained
- Medicare Agent Compensation Disclosure: What CMS Requires
- A Medicare Sales Call Review Checklist for Agencies