Medicare Advantage

Star Ratings on Medicare plans: a Billings explainer

Billings, Mont. — With the Medicare Annual Enrollment Period running Oct. 15 through Dec. 7, older adults across Yellowstone County are once again seeing Medicare Advantage and Part D drug plan choices land in their mailboxes. Tucked into that paperwork is a small but important detail: the Medicare Star Rating. Here is what those stars actually measure — and what they don't.

What the Star Ratings Are

The Centers for Medicare & Medicaid Services (CMS) publishes Star Ratings for Medicare Advantage and Part D prescription drug plans every fall, ahead of open enrollment. The ratings run from 1 star (poor) to 5 stars (excellent), in half-star increments.

The point of the ratings is to give people on Medicare — and their families — a quick, standardized way to see how a plan performs on quality and service. They are updated once a year, and the new numbers are posted on medicare.gov each October so shoppers can see them during AEP.

What Goes Into a Star

CMS looks at dozens of measures grouped into broad categories. For Medicare Advantage plans that include drug coverage, that includes things like:

• Staying healthy: whether members get recommended screenings, vaccines, and check-ups.
• Managing chronic conditions: how well the plan supports people living with diabetes, heart disease, and similar ongoing needs.
• Member experience: survey results on how members rate their plan and their care.
• Member complaints and changes in performance: how often people leave the plan, file complaints, or have problems getting care.
• Customer service: how the plan handles appeals, calls, and access questions.

Stand-alone Part D drug plans are rated on a shorter list focused on drug pricing accuracy, safety, customer service, and member experience.

Why the Fall Publication Date Matters

The timing is not an accident. CMS releases the new ratings before AEP begins so people comparing plans have current information in hand. If you looked at a rating last spring, the number posted this fall may be different — plans can move up or down as their performance changes.

For Billings residents, that means the stars you see when you log in to the Medicare Plan Finder in October reflect the most recent full year of data CMS has reviewed.

What Star Ratings Are Not

This is where a lot of confusion happens. A Star Rating is a quality snapshot — it is not a ranking, a recommendation, or a promise about your personal experience. A 4-star plan is not automatically the "right" plan for you, and a 3-star plan is not automatically a bad choice. Ratings say nothing about:

• Whether your specific doctors are in the network.
• Whether your prescriptions are on the plan's drug list.
• What the plan will cost you personally.
• Whether the plan is offered in Yellowstone County at all.

Two people in the same Billings neighborhood can look at the same plan and reach very different conclusions once they check their own doctors, drugs, and budget.

How to Use Ratings When You Decide

Think of Star Ratings as one input among several. A practical order of operations during AEP:

1. Confirm the plan is available where you live. Plan lineups are set at the county level, so Billings shoppers should check Yellowstone County. 2. Check your doctors and hospitals against the plan's network. 3. Check your prescriptions against the plan's drug list (formulary). 4. Look at the total picture of costs, including premiums, deductibles, and out-of-pocket limits. The Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027; the Part D maximum deductible is $615 in 2026 and $700 in 2027. The old coverage gap ("donut hole") is gone as of 2025. 5. Then look at the Star Rating to see how current members and CMS reviewers grade the plan's quality and service.

If drug costs are a concern, ask about the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs across the calendar year in monthly amounts.

Key Dates to Keep in Mind

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment Period. If you are already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare.

Higher-income beneficiaries should also be aware of IRMAA, the income-related surcharge that applies to Part B and Part D premiums. For 2026, IRMAA begins above $109,000 in income for a single filer, based on your tax return from two years earlier.