Medicare Ratings Guide

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  • Medicare Advantage Star Ratings in Washington 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Washington 2026

    Total MA Plans in Washington 38
    State Average Star Rating 4.1 / 5.0 stars
    Plans Rated 4+ Stars (est.) 36%
    National Average Star Rating 3.9 / 5.0 stars
    Washington vs. National Average Above average (+0.2)
    5-Star Plans (est.) 12% of plans
    4-4.5 Star Plans (est.) 24% of plans

    How CMS Star Ratings Work in Washington

    Every Medicare Advantage plan operating in Washington receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Washington is rated 4.1 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Washington

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 12% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 9% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 15% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 59% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Washington Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Washington, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Washington.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Washington

    To find the current CMS star rating for any Medicare Advantage plan in Washington, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Washington average star rating 4.1 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Virginia 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Virginia 2026

    Total MA Plans in Virginia 44
    State Average Star Rating 4.0 / 5.0 stars
    Plans Rated 4+ Stars (est.) 28%
    National Average Star Rating 3.9 / 5.0 stars
    Virginia vs. National Average Above average (+0.1)
    5-Star Plans (est.) 10% of plans
    4-4.5 Star Plans (est.) 18% of plans

    How CMS Star Ratings Work in Virginia

    Every Medicare Advantage plan operating in Virginia receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Virginia is rated 4.0 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Virginia

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 10% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 6% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 12% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 67% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Virginia Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Virginia, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Virginia.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Virginia

    To find the current CMS star rating for any Medicare Advantage plan in Virginia, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Virginia average star rating 4.0 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Vermont 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Vermont 2026

    Total MA Plans in Vermont 6
    State Average Star Rating 4.0 / 5.0 stars
    Plans Rated 4+ Stars (est.) 28%
    National Average Star Rating 3.9 / 5.0 stars
    Vermont vs. National Average Above average (+0.1)
    5-Star Plans (est.) 10% of plans
    4-4.5 Star Plans (est.) 18% of plans

    How CMS Star Ratings Work in Vermont

    Every Medicare Advantage plan operating in Vermont receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Vermont is rated 4.0 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Vermont

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 10% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 6% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 12% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 67% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Vermont Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Vermont, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Vermont.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Vermont

    To find the current CMS star rating for any Medicare Advantage plan in Vermont, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Vermont average star rating 4.0 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Utah 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Utah 2026

    Total MA Plans in Utah 22
    State Average Star Rating 3.9 / 5.0 stars
    Plans Rated 4+ Stars (est.) 21%
    National Average Star Rating 3.9 / 5.0 stars
    Utah vs. National Average At national average
    5-Star Plans (est.) 8% of plans
    4-4.5 Star Plans (est.) 13% of plans

    How CMS Star Ratings Work in Utah

    Every Medicare Advantage plan operating in Utah receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Utah is rated 3.9 stars — at the national average of 3.9 stars.

    2026 Star Rating Distribution in Utah

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 8% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 3% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 10% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 74% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Utah Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Utah, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Utah.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Utah

    To find the current CMS star rating for any Medicare Advantage plan in Utah, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Utah average star rating 3.9 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Texas 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Texas 2026

    Total MA Plans in Texas 118
    State Average Star Rating 3.8 / 5.0 stars
    Plans Rated 4+ Stars (est.) 13%
    National Average Star Rating 3.9 / 5.0 stars
    Texas vs. National Average Below average (-0.1)
    5-Star Plans (est.) 6% of plans
    4-4.5 Star Plans (est.) 7% of plans

    How CMS Star Ratings Work in Texas

    Every Medicare Advantage plan operating in Texas receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Texas is rated 3.8 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Texas

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 6% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 7% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 82% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Texas Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Texas, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Texas.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Texas

    To find the current CMS star rating for any Medicare Advantage plan in Texas, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Texas average star rating 3.8 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Tennessee 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Tennessee 2026

    Total MA Plans in Tennessee 44
    State Average Star Rating 3.8 / 5.0 stars
    Plans Rated 4+ Stars (est.) 13%
    National Average Star Rating 3.9 / 5.0 stars
    Tennessee vs. National Average Below average (-0.1)
    5-Star Plans (est.) 6% of plans
    4-4.5 Star Plans (est.) 7% of plans

    How CMS Star Ratings Work in Tennessee

    Every Medicare Advantage plan operating in Tennessee receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Tennessee is rated 3.8 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in Tennessee

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 6% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 7% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 82% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Tennessee Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Tennessee, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Tennessee.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Tennessee

    To find the current CMS star rating for any Medicare Advantage plan in Tennessee, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Tennessee average star rating 3.8 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in South Dakota 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: South Dakota 2026

    Total MA Plans in South Dakota 10
    State Average Star Rating 3.7 / 5.0 stars
    Plans Rated 4+ Stars (est.) 9%
    National Average Star Rating 3.9 / 5.0 stars
    South Dakota vs. National Average Below average (-0.2)
    5-Star Plans (est.) 4% of plans
    4-4.5 Star Plans (est.) 5% of plans

    How CMS Star Ratings Work in South Dakota

    Every Medicare Advantage plan operating in South Dakota receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in South Dakota is rated 3.7 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in South Dakota

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 4% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 5% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 86% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for South Dakota Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In South Dakota, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in South Dakota.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in South Dakota

    To find the current CMS star rating for any Medicare Advantage plan in South Dakota, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    South Dakota average star rating 3.7 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in South Carolina 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: South Carolina 2026

    Total MA Plans in South Carolina 36
    State Average Star Rating 3.8 / 5.0 stars
    Plans Rated 4+ Stars (est.) 13%
    National Average Star Rating 3.9 / 5.0 stars
    South Carolina vs. National Average Below average (-0.1)
    5-Star Plans (est.) 6% of plans
    4-4.5 Star Plans (est.) 7% of plans

    How CMS Star Ratings Work in South Carolina

    Every Medicare Advantage plan operating in South Carolina receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in South Carolina is rated 3.8 stars — below the national average of 3.9 stars.

    2026 Star Rating Distribution in South Carolina

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 6% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 0% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 7% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 82% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for South Carolina Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In South Carolina, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in South Carolina.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in South Carolina

    To find the current CMS star rating for any Medicare Advantage plan in South Carolina, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    South Carolina average star rating 3.8 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Rhode Island 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Rhode Island 2026

    Total MA Plans in Rhode Island 12
    State Average Star Rating 4.1 / 5.0 stars
    Plans Rated 4+ Stars (est.) 36%
    National Average Star Rating 3.9 / 5.0 stars
    Rhode Island vs. National Average Above average (+0.2)
    5-Star Plans (est.) 12% of plans
    4-4.5 Star Plans (est.) 24% of plans

    How CMS Star Ratings Work in Rhode Island

    Every Medicare Advantage plan operating in Rhode Island receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Rhode Island is rated 4.1 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Rhode Island

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 12% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 9% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 15% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 59% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Rhode Island Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Rhode Island, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Rhode Island.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Rhode Island

    To find the current CMS star rating for any Medicare Advantage plan in Rhode Island, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Rhode Island average star rating 4.1 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.

  • Medicare Advantage Star Ratings in Pennsylvania 2026: CMS Plan Ratings Data

    CMS Medicare Advantage Star Ratings: Pennsylvania 2026

    Total MA Plans in Pennsylvania 62
    State Average Star Rating 4.0 / 5.0 stars
    Plans Rated 4+ Stars (est.) 28%
    National Average Star Rating 3.9 / 5.0 stars
    Pennsylvania vs. National Average Above average (+0.1)
    5-Star Plans (est.) 10% of plans
    4-4.5 Star Plans (est.) 18% of plans

    How CMS Star Ratings Work in Pennsylvania

    Every Medicare Advantage plan operating in Pennsylvania receives an annual star rating from the Centers for Medicare & Medicaid Services (CMS), ranging from 1 to 5 stars. CMS evaluates plans on more than 40 quality measures across five domains: managing chronic conditions, member experience and complaints, health plan customer service, drug plan quality (for MAPD plans), and preventive care and screening. The average Medicare Advantage plan in Pennsylvania is rated 4.0 stars — above the national average of 3.9 stars.

    2026 Star Rating Distribution in Pennsylvania

    Star Rating Estimated Share of Plans CMS Bonus Payment What It Means for Members
    ⭐⭐⭐⭐⭐ 5 Stars 10% Highest bonus (5%) Exceptional quality — special enrollment right any time of year
    ⭐⭐⭐⭐½ 4.5 Stars 6% High bonus (3.5%) Above average — strong quality metrics
    ⭐⭐⭐⭐ 4 Stars 12% Standard bonus (1.5%) Good quality — meets CMS benchmarks
    ⭐⭐⭐½ 3.5 Stars 67% No bonus Average — consider comparing alternatives
    ⭐⭐⭐ or below 5% No bonus Below average — CMS may flag for improvement

    Why Star Ratings Matter for Pennsylvania Medicare Beneficiaries

    CMS star ratings directly affect what you pay and what you get. Plans rated 4 stars or higher receive quality bonus payments from CMS — typically 1.5% to 5% of their revenue — which insurers pass on to members through lower premiums, richer benefits, or reduced cost-sharing. In Pennsylvania, plans rated below 3 stars for three consecutive years can be terminated by CMS, protecting members from persistently poor-quality coverage.

    There is also a special enrollment right: if a 5-star plan is available in your area, you can switch to it at any time during the year — not just during the Annual Enrollment Period (Oct 15 – Dec 7). This is one of the most underused Medicare rights in Pennsylvania.

    CMS Star Rating Measures: What Gets Scored

    Domain Key Measures Weight in Overall Rating
    Staying Healthy (Preventive Care) Flu shots, breast cancer screening, colorectal cancer screening, cardiovascular care, diabetes care High
    Managing Chronic Conditions Diabetes control, blood pressure management, cholesterol management, COPD management, medication adherence Very High
    Member Experience Getting needed care, getting appointments, rating of health plan, rating of drug plan Very High
    Complaints and Changes Complaints to Medicare, plan improvement over time, members choosing to leave the plan Medium
    Customer Service Call center performance, appeals upheld, appeals response time Medium

    How to Find the Star Rating for Your Plan in Pennsylvania

    To find the current CMS star rating for any Medicare Advantage plan in Pennsylvania, visit medicare.gov/plan-compare and enter your ZIP code. Each plan’s star rating is displayed prominently. You can filter by star rating to see only 4-star and above plans available in your area. CMS publishes updated star ratings each October for the following plan year.

    2026 CMS Star Ratings: National Context

    2026 National Star Rating Benchmark Data
    Plans achieving 5 Stars nationally 18 contracts
    Plans achieving 4.5 Stars nationally 73 contracts
    Plans achieving 4 Stars nationally 116 contracts
    % of MA members in 4+ star plans 78%
    National average star rating 3.9 / 5.0
    Pennsylvania average star rating 4.0 / 5.0

    Source: CMS Medicare Advantage and Part D Star Ratings, 2026. Data reflects contracted plan ratings; individual plan-level ratings vary. CMS is recalculating certain 2026 star ratings as of June 2026 following court rulings on the star rating methodology.