Medicare Advantage

Medicare Star Ratings: What They Mean Before Fall Enrollment

People in Thousand Oaks can choose from 33 Medicare Advantage plans for 2027, against 35 this year. Eight of this year’s plans are gone, 6 are new to Ventura County, and 25 that continue have changed their premium, deductible, plan type or name, 11 of them under a new name.

Thousand Oaks, California — As Medicare's Annual Enrollment Period approaches on October 15, the Centers for Medicare & Medicaid Services (CMS) is preparing to release its yearly update to the Medicare Star Ratings. For anyone in Ventura County weighing their coverage choices this fall, understanding what those little stars actually measure — and what they don't — can make the shopping season a lot less confusing.

What Star Ratings Actually Are

Star Ratings are a quality tool published by CMS each fall. They give Medicare Advantage and Part D prescription drug plans a score from 1 star (poor) to 5 stars (excellent), based on dozens of measures pulled together into a single rating.

Think of them less as a "review score" and more as a report card. CMS uses data collected from plans, from doctors and hospitals, and from members themselves to build the ratings. They are updated once a year and posted on medicare.gov before the Annual Enrollment Period opens.

What Goes Into a Star Rating

For Medicare Advantage plans that include drug coverage, CMS looks at around 40 different measures. For stand-alone Part D drug plans, it's a smaller set. The measures fall into a few broad buckets:

• Staying healthy: whether members get recommended screenings, tests, and vaccines.
• Managing chronic conditions: how well the plan supports people living with diabetes, heart disease, and similar conditions.
• Member experience: survey answers about how easy it is to get care, appointments, and information.
• Member complaints and plan performance: how often people leave the plan, complaints filed, and problems getting services.
• Customer service: how quickly the plan handles appeals and calls.
• Drug plan performance: pricing accuracy, medication safety, and adherence for common prescriptions.

Each measure gets its own score, and CMS rolls them up into the overall star rating you see on medicare.gov.

When and How They're Published

CMS typically releases the new Star Ratings in early to mid-October, just before the Annual Enrollment Period begins on October 15. Once posted, you can see ratings for any plan available in your area by using the Plan Finder tool at medicare.gov and entering your ZIP code.

Thousand Oaks is in Ventura County, where — like everywhere in the country — the plans available to you and their star ratings are set at the county level. Two people living a few miles apart in different counties may see different plan lineups and different ratings.

How to Use (and Not Overuse) Star Ratings

Star Ratings are useful, but they aren't the whole story. A high rating doesn't guarantee a plan will cover the doctors, hospitals, or medications you personally use. And a lower rating doesn't automatically mean a plan is a poor fit for your situation.

A reasonable way to use the ratings:

1. Start with your needs. List your prescriptions, your doctors, and any regular services you use. 2. Check plan details on medicare.gov. Confirm your medications are covered and your providers are in network. 3. Then look at the stars. Use the rating as a general signal of how the plan performs on quality and service overall.

The stars are a piece of the puzzle — not the whole puzzle.

A Few Program Facts Worth Knowing for 2027

While you're comparing coverage this fall, keep these program-wide numbers in mind for 2027:

• The Part D out-of-pocket cap is $2,100 in 2026 ($2,400 in 2027) for the year.
• The Part D maximum deductible is $615 in 2026 ($700 in 2027).
• The old coverage gap (the "donut hole") was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly amounts, if that helps with cash flow.
• IRMAA income-based surcharges begin above $109,000 for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7.
• Medicare Advantage Open Enrollment: January 1 – March 31.