How Medicare Advantage Star Ratings Work in 2026
A 5-star plan and a 3-star plan aren't just "better" or "worse" — the rating measures specific, different things, and the bar moved for 2026.
Key takeaways
- CMS star ratings for Medicare Advantage plans run from 1 to 5 stars and are recalculated annually based on a defined set of quality and performance measures.
- For 2026, CMS raised many of the performance cut points — roughly 60% of 4-star benchmarks increased — meaning past performance doesn't guarantee the same rating.
- The weight given to patient-experience and access measures was cut from 4 to 2 for 2026, while outcome measures kept their higher weight, emphasizing measurable health results over satisfaction surveys.
- The enrollment-weighted average star rating ticked up slightly to 3.98 for 2026 (from 3.95 in 2025), with about 40% of contracts earning 4 stars or higher.
Star ratings are one of the most visible numbers attached to a Medicare Advantage plan, but the methodology behind that single number changed meaningfully for 2026 — which means comparing this year's ratings to a plan's rating from a couple of years ago isn't quite an apples-to-apples comparison anymore.
What the star rating actually measures
CMS calculates a star rating for each Medicare Advantage plan on a 1-to-5 scale, built from a defined set of measures covering things like preventive care rates, chronic disease management, member complaints, customer service responsiveness, and patient-experience survey results. The rating is recalculated every year, so a plan's score can move up or down annually even without any change in the plan's actual coverage.
What changed specifically for 2026
What CMS changed in the 2026 star ratings methodology
| Change | Detail |
|---|---|
| Performance cut points raised | Roughly 60% of 4-star benchmarks increased — maintaining the same performance may not maintain the same rating |
| Patient experience/access weight cut | Reduced from 4 to 2, lowering the influence of satisfaction surveys relative to outcome measures |
| Outcome measures | Kept their higher weight, emphasizing measurable clinical results and care management over subjective satisfaction |
The overall 2026 picture
The enrollment-weighted average star rating across Medicare Advantage plans with drug coverage rose slightly for 2026 — to 3.98, up from 3.95 the prior year — even as CMS raised many of the underlying performance cut points. About 40% of contracts (207 total) earned 4 stars or higher, and roughly 64% of Medicare Advantage prescription-drug plan enrollees are in a plan rated 4 stars or above. This means ratings broadly held steady or improved slightly overall, even though the bar for earning each star level moved higher.
Why the rating matters beyond just "good" vs. "bad"
Plans rated 4 stars or higher qualify for CMS bonus payments, and many plans use that additional funding specifically to offer extra benefits — dental, vision, hearing, or over-the-counter allowances — that lower-rated plans may not be able to afford to include. Notably, this bonus system has been reported to direct billions of dollars in additional payments to insurers as cut points and measure weights shift, which is one reason the specific mechanics behind a rating are worth understanding rather than treating the number alone as the full picture.
- A plan's star rating is worth checking not just as a general quality signal but as a practical predictor of whether it can fund the kind of extra benefits that made Medicare Advantage appealing in the first place.
- Because the underlying measures shifted for 2026, it's worth looking at what specifically drove a plan's current rating — genuinely strong clinical outcomes and preventive care, or previously heavier-weighted patient satisfaction scores now weighted less.
- A rating drop between 2025 and 2026 doesn't necessarily mean a plan got worse — it can reflect the raised cut points and reweighted measures rather than any actual change in the plan's care quality.
How to use 2026 star ratings when comparing plans
- Compare a plan's 2026 rating against its 2025 rating with the methodology change in mind, rather than assuming a drop reflects worse care.
- Use Medicare's own plan comparison tool to see a rating's component measures, not just the single overall number.
- Check whether a plan's 4-star-or-higher status is funding meaningful extra benefits (dental, vision, OTC allowances) relevant to you.
- Re-check ratings annually at enrollment time, since they're recalculated every year and can shift even without any plan changes.
- Ask specifically what drove a plan's current rating — clinical outcomes, patient experience, or a mix — if you want a genuine apples-to-apples comparison.
A lower 2026 rating compared to 2025 doesn't automatically mean a plan's actual care quality declined — CMS raised many performance cut points and reweighted measures this year. Check the component measures, not just the headline number, before drawing conclusions.
Frequently asked questions
Why did my plan's star rating change even though nothing about my coverage changed?
Star ratings are recalculated annually, and for 2026 specifically, CMS raised many performance cut points and changed how heavily certain measures are weighted — a plan's rating can shift purely due to these methodology changes, not any change in the plan itself.
Do higher-star plans always cost less?
Not necessarily — star ratings reflect quality and performance measures, not premium cost directly, though 4-star-and-above plans do qualify for bonus payments that many use to fund additional benefits.
How often are Medicare Advantage star ratings updated?
Annually — CMS recalculates and publishes new ratings each year, and as 2026 demonstrates, the underlying methodology itself can also change from year to year.
Where can I see what specifically makes up a plan's star rating?
Medicare's official plan comparison tool breaks a rating down into its component measures, which gives a more meaningful comparison than the single overall star number alone.
Sources
Facts and figures in this guide that come from an outside authority are backed by the sources below. Pricing, program rules, and eligibility details change — always confirm current specifics with the source directly or a licensed professional before acting.
- 2026 Star Ratings Fact SheetCenters for Medicare & Medicaid Services (CMS) · Updated 2026 · Accessed 2026-07-20
- First look at the 2026 Medicare Advantage Star ratingsRISE Health · Updated 2026 · Accessed 2026-07-20
- Early look at 2026 Medicare Advantage Stars: Ratings stabilize without meaningful improvementHealthScape Advisors · Updated 2026 · Accessed 2026-07-20
- CMS posts 2026 Medicare Advantage star ratings: 8 notesBecker's Payer Issues · Updated 2026 · Accessed 2026-07-20
- Medicare Advantage plans win extra $18.6 billion as feds cut star ratings measuresSTAT News · Updated 2026-04 · Accessed 2026-07-20
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