Medicare Advantage

How Medicare Star Ratings Are Set for Worcester County

For 2027, Worcester is looking at 50 Medicare Advantage plans: 9 new, 17 gone since 2026, and 24 still here but changed on premium, deductible, plan type or name, 4 of them under a new name. Below, how the lineup shifted in Worcester County and what to compare, with no plan ranked or recommended.

WORCESTER, Mass. — Every fall, just before Medicare's Annual Enrollment Period opens on October 15, the federal government refreshes its Star Ratings for Medicare Advantage and Part D drug plans. The 2027 ratings are now part of the picture people in Worcester and across Worcester County can look at as they compare coverage through December 7. But what do those little stars actually measure — and, just as important, what don't they measure?

Here's a plain-English guide.

What Star Ratings actually are

Star Ratings are a quality yardstick published by the Centers for Medicare & Medicaid Services (CMS). Plans are scored on a scale of 1 to 5 stars, with 5 being the highest. The ratings are updated once a year in the fall so shoppers can see how a plan performed heading into the next plan year.

There are two separate rating systems:

• Medicare Advantage with drug coverage (MA-PD) is rated on up to roughly 40 measures.
• Standalone Part D drug plans (PDPs) are rated on a smaller set of measures focused on the drug benefit.

The ratings live on the plan finder at Medicare.gov, right next to each plan listing.

What the score is measuring

CMS groups the measures into a few big buckets. For Medicare Advantage plans, ratings look at things like:

• Staying healthy — whether members get recommended screenings, vaccines, and check-ins.
• Managing chronic conditions — how well the plan supports people living with diabetes, heart disease, and similar conditions.
• Member experience — survey results on how members feel about their care and their plan.
• Member complaints and changes in performance — how often people leave the plan, complaints filed, and whether the plan is improving or slipping.
• Customer service — how the plan handles appeals, calls, and access to care.

For Part D drug plans, measures include drug pricing accuracy, medication safety, how well members stick with important medications, and customer service on the pharmacy side.

In short: the stars are about how the plan behaves, not about how cheap it is.

What Star Ratings do NOT tell you

This is where a lot of shoppers get tripped up. A star rating does not tell you:

• Whether your doctor or hospital is in the network.
• Whether your specific medications are on the plan's formulary.
• What your monthly premium, deductible, or cost-sharing will look like.
• Whether extras like dental, vision, or hearing fit your needs.

A 4-star plan isn't automatically the right fit, and a 3-star plan isn't automatically wrong. The rating is one input among several.

Why the fall release matters

CMS times the release so the ratings are visible before AEP opens on October 15. That's the window — running through December 7 — when people with Medicare can join, switch, or drop a Medicare Advantage or Part D plan for 2027. There's also the Medicare Advantage Open Enrollment Period from January 1 through March 31, when someone already in an MA plan can make a one-time change.

Worcester is in Worcester County, where plan availability is set at the county level. That means neighbors in Worcester, Leominster, and Fitchburg are generally looking at the same menu of plans and the same star scores.

The bigger 2027 picture

Star Ratings aren't the only thing new this fall. A few program-level facts to keep in mind as you compare:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that amount, you pay nothing for covered drugs the rest of the year.
• The Part D deductible can be no more than $615 in 2026.
• The old coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread drug costs into monthly payments instead of paying at the pharmacy counter. It's optional and free to opt into.
• IRMAA — the income-related surcharge on Part B and Part D premiums — kicks in above $109,000 for a single filer in 2026.

These rules apply program-wide, no matter which plan or carrier you pick.

How to use the ratings without getting steered

A sensible approach:

1. Start with your doctors, hospitals, and medications. Make sure they're covered. 2. Look at the total yearly cost the plan finder estimates for you, not just the premium. 3. Then look at the stars as a tiebreaker or a sanity check — especially the customer service and complaints measures.

If a plan has consistently low stars over several years, that's worth a second look. If it just moved from 4 to 3.5, that alone probably isn't a reason to switch.