Medicare Advantage

Medicare Star Ratings arrive each fall in Gallup, NM

GALLUP, N.M. — Every fall, just before Medicare's Annual Enrollment Period opens, the Centers for Medicare & Medicaid Services (CMS) refreshes something called Star Ratings. The 2027 ratings are landing now, and if you live in Gallup or anywhere else in McKinley County, you'll start seeing those little star icons pop up next to plan names on Medicare.gov. Here's what they actually measure — and, just as important, what they don't.

What Star Ratings are

Star Ratings are CMS's yearly report card on Medicare Advantage (Part C) and Medicare Part D drug plans. Plans are scored from 1 star (poor) to 5 stars (excellent), in half-star steps. The rating is meant to give people a plain-language snapshot of how a plan has performed — not a sales pitch, and not a guarantee about the year ahead.

CMS publishes updated ratings each October, timed so shoppers can look at them during Annual Enrollment (Oct. 15 – Dec. 7).

What the stars actually measure

The score isn't a single number pulled out of thin air. CMS blends dozens of separate measures into one rating. In broad strokes, they cover:

• Staying healthy. Whether members are getting recommended screenings, vaccines, and check-ups.
• Managing chronic conditions. How well the plan supports people living with diabetes, heart disease, and similar long-term conditions.
• Member experience. Survey results on how members rate their plan, their doctors, and how easy it is to get care.
• Member complaints and plan performance. How often people leave the plan, file complaints, or run into problems.
• Customer service. How the plan handles appeals, calls, and requests for coverage decisions.
• Drug plan measures (for Part D). Accuracy of pricing information, medication safety, and how well members stick with important prescriptions.

Medicare Advantage plans that include drug coverage get one overall rating that folds in both the medical and drug measures.

What Star Ratings do NOT do

This is where a lot of confusion creeps in. Star Ratings are not a ranking of "best" or "worst" plans for you personally. A 4-star plan isn't automatically the right fit, and a 3-star plan isn't automatically wrong. The ratings don't know:

• which doctors and hospitals you use,
• which prescriptions you take,
• what your budget looks like, or
• whether you travel or split time between states.

Two people in the same Gallup neighborhood can look at the exact same star chart and reasonably land on different plans. The stars are one input — not the decision.

How this fits the 2027 Medicare picture

Star Ratings arrive alongside some real changes taking effect in 2027:

• Part D out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027. Once you hit that in covered drug costs, you pay nothing for covered drugs the rest of the year.
• Part D deductible maximum of $615 in 2026 and $700 in 2027.
• 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 across the year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges (extra premiums for higher-income enrollees) start above $109,000 in income for a single filer in 2026.

None of those numbers show up on the Star Ratings chart, but they shape what Medicare will actually cost you in 2027. Reading the stars without also understanding these rules is only half the picture.

How plan availability works in Gallup

Medicare plan choices are set at the county level, not the city level. Gallup is in McKinley County, so the plans available to a Gallup resident are the same ones offered county-wide. When you compare plans on Medicare.gov and see star icons next to each option, those stars come from the most recent CMS release — and they may shift year to year as measures are updated.

Key dates to keep on your fridge

• Oct. 15 – Dec. 7: Medicare Annual Enrollment Period. Changes you make take effect Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.