The Medicare Advantage and Part D Star Ratings are released annually by CMS to evaluate the quality of health and prescription drug services offered by Medicare plans. These ratings provide a standardized way for people with Medicare to assess plan performance across various measures, including quality of care, customer service, and member satisfaction. By focusing on these star ratings, you can gain valuable insights when you compare medicare advantage plans 2025, ensuring you select a plan that meets your healthcare requirements and preferences. The 2025 Star Ratings are particularly important as they will be a key factor for consumers during the 2025 open enrollment period and will influence quality bonus payments to MA plans in 2026.
Key Highlights of 2025 Medicare Advantage Star Ratings
The 2025 Star Ratings provide a snapshot of how Medicare Advantage Prescription Drug (MA-PD) contracts, MA-only contracts, and Prescription Drug Plan (PDP) contracts performed in the past year. MA-PD contracts, which offer both health and drug coverage, are evaluated on up to 40 different quality and performance measures. MA-only plans are rated on up to 30 measures, and PDPs are assessed on up to 12 measures. CMS sets specific performance thresholds, known as “cut points,” for each measure to determine the star rating a contract receives, ranging from 1 to 5 stars.
One notable change for the 2025 Star Ratings is a minor methodological adjustment: the weight for the Part C Plan All-Cause Readmissions measure has been increased from one to three. This change emphasizes the importance of reducing hospital readmissions and improving care transitions. While there were no other major methodological shifts for 2025, previous changes implemented for the 2024 ratings, such as the Tukey outlier deletion in the hierarchical clustering methodology, continue to impact the 2025 ratings. This statistical method helps to ensure more accurate and stable cut points by minimizing the influence of extreme outliers in performance data.
Rating Distribution Trends:
Analyzing the distribution of star ratings reveals important trends in Medicare Advantage plan performance.
- Approximately 40% of MA-PD contracts (209 contracts) for 2025 achieved a rating of four stars or higher. This indicates a significant portion of plans are delivering high-quality care and services.
- When weighted by enrollment, about 62% of MA-PD enrollees are in plans that will receive four or more stars in 2025. This suggests that a majority of Medicare Advantage beneficiaries are enrolled in highly rated plans.
It’s important to note that year-over-year changes in Star Ratings are expected and reflect the dynamic nature of plan performance and CMS’s continuous efforts to raise quality standards. Measure-level cut points are recalculated annually, often increasing as contracts improve their performance and CMS implements policies to drive further quality enhancements. Several factors influenced the changes in measure-level cut points for the 2025 Star Ratings:
- Outlier Removal: The Tukey outlier deletion method resulted in the removal of extreme outliers, primarily from the lower end of performance, leading to upward shifts in cut points for some measures.
- Return to Pre-Pandemic Performance: Performance on some measures is reverting to pre-pandemic levels, contributing to increases in cut points.
- Compressed Score Distribution: A more concentrated distribution of scores generally pushed cut points higher.
- High-Performing Contracts: An increasing number of contracts achieving very high scores on certain measures, such as Breast Cancer Screening, elevated the cut points for those measures.
- Improved Lower-End Performance: Improvements in scores for lower-performing contracts on measures like Colorectal Cancer Screening also contributed to higher cut points.
Table 1: 2022-2025 Overall Star Rating Distribution for MA-PD Contracts
| Overall Rating | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| # of Contracts | % | Weighted by Enrollment | # of Contracts | |
| 5 stars | 74 | 15.71 | 26.59 | 57 |
| 4.5 stars | 96 | 20.38 | 33.21 | 67 |
| 4 stars | 152 | 32.27 | 29.87 | 136 |
| 3.5 stars | 122 | 25.90 | 8.49 | 116 |
| 3 stars | 25 | 5.31 | 1.80 | 90 |
| 2.5 stars | 2 | 0.42 | 0.03 | 37 |
| 2 stars | 0 | 0 | 0 | 4 |
| Total Rated Contracts | 471 | 100 | 507 | |
| Average Star Rating* | 4.37 | 4.14 | 4.07 | 3.92 |
*Average overall MA-PD Star Rating weighted by enrollment.
Table 2: 2022-2025 Part D Rating Distribution for PDPs
| Part D Rating | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| # of Contracts | % | Weighted by Enrollment | # of Contracts | |
| 5 stars | 10 | 18.52 | 0.93 | 2 |
| 4.5 stars | 5 | 9.26 | 4.74 | 7 |
| 4 stars | 14 | 25.93 | 36.21 | 7 |
| 3.5 stars | 20 | 37.04 | 52.84 | 11 |
| 3 stars | 3 | 5.56 | 3.84 | 16 |
| 2.5 stars | 2 | 3.70 | 1.44 | 4 |
| 2 stars | 0 | 0 | 0 | 4 |
| 1.5 stars | 0 | 0 | 0 | 1 |
| Total Rated Contracts | 54 | 100 | 52 | |
| Average Star Rating* | 3.70 | 3.25 | 3.34 | 3.06 |
*Average Part D Star Rating weighted by enrollment.
For stand-alone Prescription Drug Plans (PDPs), approximately 27% (11 contracts) achieved four or more stars for their 2025 Part D Rating. However, enrollment in these higher-rated PDPs is lower, with only about 5% of PDP enrollees in contracts with four or more stars. This difference highlights the importance of carefully evaluating PDP ratings when choosing stand-alone drug coverage.
5-Star Medicare Advantage Plans: High Performers in 2025
A select group of Medicare plans have achieved the highest distinction of 5-star ratings, signifying exceptional performance across all measured domains. For 2025, 11 contracts are recognized as high-performing and are highlighted on the Medicare Plan Finder with a special icon. Seven of these are MA-PD contracts, two are 1876 Cost Contracts, and two are PDPs. Notably, 10 of these high-performing contracts also received the 5-star designation in 2024, indicating consistent excellence. Six of the seven 5-star MA-PD contracts include Dual Eligible Special Needs Plans (D-SNP), designed for individuals who are dually eligible for Medicare and Medicaid, showing high quality options are available for vulnerable populations.
Table A1: MA-PD Contracts Receiving the 2025 High-Performing Icon
| Contract ID | Contract Name | Parent Organization | 10/2024 Enrollment | 5 Star Last Year | Includes SNP Plan Benefit Packages |
|---|---|---|---|---|---|
| H3957 | HIGHMARK CHOICE COMPANY | Highmark Health | 55,015 | Yes | No |
| H4286 | LEON HEALTH, INC. | LMC Family Holdings, LLC | 38,877 | Yes | Yes |
| H5215 | NETWORK HEALTH INSURANCE CORPORATION | Network Health, Inc. | 77,798 | Yes | Yes |
| H5296 | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | Alignment Healthcare USA, LLC | 6,212 | Yes | Yes |
| H5431 | HEALTHSUN HEALTH PLANS, INC. | Elevance Health, Inc. | 56,202 | Yes | Yes |
| H5577 | MCS ADVANTAGE, INC. | MHH Healthcare, L.P. | 284,055 | Yes | Yes |
| H5594 | OPTIMUM HEALTHCARE, INC. | Elevance Health, Inc. | 62,883 | Yes | Yes |
Table A3: PDP Contracts Receiving the 2025 High-Performing Icon
| Contract ID | Contract Name | Parent Organization | 10/2024 Enrollment | 5 Star Last Year |
|---|---|---|---|---|
| S3389 | UPMC HEALTH BENEFITS, INC. | UPMC Health System | 1,474 | No |
| S4501 | INDEPENDENT HEALTH BENEFITS CORPORATION | Independent Health Association, Inc. | 7,329 | Yes |
Consistently Low Performing Medicare Advantage Plans in 2025
Conversely, some contracts have been identified as consistently low-performing, indicated by a special icon on the Medicare Plan Finder. For 2025, eight contracts received this designation, compared to six in the previous year. Seven of these are MA-PD contracts and one is a PDP. Two of the low-performing MA-PD contracts include D-SNP plan benefit packages. These low-performing icons serve as a warning to consumers, suggesting these plans may not be providing the level of quality and service expected. When you compare medicare advantage plans 2025, it’s crucial to be aware of these low-performing plans and consider whether they align with your healthcare needs.
Table A4: Contracts Receiving the Low Performing Icon for the 2025 Star Ratings
| Contract ID | Contract Name | Parent Organization | Reason for Low-Performance Warning | 10/2024 Enrollment |
|---|---|---|---|---|
| H0724 | BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. | Centene Corporation | Part C or D | * |
| H2853 | CENTENE VENTURE COMPANY TENNESSEE | Centene Corporation | Part C or D | * |
| H4982 | AETNA BETTER HEALTH OF CALIFORNIA INC. | CVS Health Corporation | Part C or D | 26,484 |
| H5475 | MERIDIAN HEALTH PLAN OF MICHIGAN, INC. | Centene Corporation | Part C or D | 23,615 |
| H6713 | WELLCARE OF ILLINOIS, INC. | Centene Corporation | Part C or D | 10,819 |
| H7330 | ZING HEALTH, INC. | Zing Health Consolidator, Inc | Part C or D | 3,360 |
| H8553 | WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. | Centene Corporation | Part C or D | 1,952 |
| S6946 | CLEAR SPRING HEALTH INSURANCE COMPANY | Group 1001 | Part D | 340,855 |
*No enrollment is showing for this contract in the CMS enrollment files.
Factors Influencing Medicare Advantage Star Ratings: Tax Status and Program Experience
The 2025 Star Ratings data also reveals interesting correlations between plan performance and organizational characteristics, such as tax status and years of experience in the Medicare program.
Tax Status: Non-profit organizations tend to achieve higher star ratings more frequently than for-profit organizations. Approximately 50% of non-profit MA-PD contracts received four or more stars, compared to 36% of for-profit MA-PDs. Similarly, for PDPs, about 41% of non-profit PDPs achieved four or more stars, while only 17% of for-profit PDPs reached this level. This suggests that the organizational structure and mission focus of non-profit plans may contribute to higher quality of care and service delivery.
Table 3: Distribution of 2025 Overall Star Ratings for For-profit and Non-profit MA-PDs
| 2025 Overall Rating | Number of Contracts that are For-Profit | % For-Profit | Weighted By Enrollment For-Profit | Number of Contracts that are Non-Profit | % Non-Profit | Weighted By Enrollment Non-Profit |
|---|---|---|---|---|---|---|
| 5 stars | 6 | 1.66 | 2.09 | 1 | 0.63 | 0.75 |
| 4.5 stars | 48 | 13.30 | 21.04 | 38 | 23.75 | 55.87 |
| 4 stars | 75 | 20.78 | 33.31 | 41 | 25.63 | 25.12 |
| 3.5 stars | 118 | 32.69 | 32.06 | 47 | 29.38 | 12.71 |
| 3 stars | 95 | 26.32 | 10.43 | 28 | 17.50 | 4.80 |
| 2.5 stars | 18 | 4.99 | 1.07 | 5 | 3.13 | 0.74 |
| 2 stars | 1 | 0.28 | 0.01 | 0 | 0.00 | 0.00 |
| Total Rated Contracts | 361 | 160 |
Table 4: Distribution of 2025 Part D Ratings for For-profit and Non-profit PDPs*
| 2025 Part D Rating | Number of Contracts that are For-Profit | % For-Profit | Weighted By Enrollment For-Profit | Number of Contracts that are Non-Profit | % Non-Profit | Weighted By Enrollment Non-Profit |
|---|---|---|---|---|---|---|
| 5 stars | 1 | 4.35 | 0.01 | 1 | 5.88 | 1.27 |
| 4.5 stars | 2 | 8.70 | 0.46 | 4 | 23.53 | 19.02 |
| 4 stars | 1 | 4.35 | 3.48 | 2 | 11.76 | 9.09 |
| 3.5 stars | 6 | 26.09 | 48.51 | 4 | 23.53 | 21.96 |
| 3 stars | 5 | 21.74 | 8.45 | 5 | 29.41 | 47.94 |
| 2.5 stars | 6 | 26.09 | 30.03 | 1 | 5.88 | 0.73 |
| 2 stars | 2 | 8.70 | 9.06 | 0 | 0.00 | 0.00 |
| Total Rated Contracts | 23 | 17 |
*One PDP is missing information about tax status.
Program Length: Experience in the Medicare Advantage program also appears to be correlated with higher star ratings. MA-PD contracts with 10 or more years in the program are more likely to achieve four or more stars compared to newer contracts (fewer than five years). While the relationship is less clear for PDPs due to fewer new entrants in that market, the data suggests that longer-tenured plans tend to perform better, likely due to accumulated expertise and established quality improvement processes.
Table 5: Distribution of 2025 Overall Star Ratings by Length of Time in Program for MA-PDs
| 2025 Overall Rating | Number of Contracts with Fewer than Five Years | Percent Fewer than Five Years | Number of Contracts with Five years to Fewer than 10 Years | Percent Five Years to Fewer than 10 Years | Number of Contracts with 10 or More Years | Percent 10 or More Years |
|---|---|---|---|---|---|---|
| 5 stars | 2 | 1.37 | 0 | 0.00 | 5 | 1.76 |
| 4.5 stars | 14 | 9.59 | 11 | 12.09 | 61 | 21.48 |
| 4 stars | 25 | 17.12 | 23 | 25.27 | 68 | 23.94 |
| 3.5 stars | 49 | 33.56 | 35 | 38.46 | 81 | 28.52 |
| 3 stars | 42 | 28.77 | 20 | 21.98 | 61 | 21.48 |
| 2.5 stars | 13 | 8.90 | 2 | 2.20 | 8 | 2.82 |
| 2 stars | 1 | 0.68 | 0 | 0.00 | 0 | 0.00 |
| Total Rated Contracts | 146 | 91 | 284 |
Average Star Ratings Across Measures
Examining the average star ratings for individual Part C and Part D measures provides further insights into areas of strength and areas needing improvement across Medicare plans.
Part C Measures: Table 7 shows the average star ratings for Part C measures from 2022 to 2025. Several measures have seen a decrease in average star ratings over time, including Breast Cancer Screening and Colorectal Cancer Screening. Conversely, some measures show improvement, such as Health Plan Quality Improvement. Measures related to customer service and plan administration generally maintain higher average ratings compared to clinical care measures.
Table 7: 2022-2025 Average Star Rating by Part C Measure
| Measure | 2022 Average Star | 2023 Average Star | 2024 Average Star | 2025 Average Star |
|---|---|---|---|---|
| Breast Cancer Screening | 3.9 | 3.7 | 3.7 | 3.4 |
| Colorectal Cancer Screening | 3.9 | 3.8 | 3.7 | 3.4 |
| Annual Flu Vaccine | 3.4 | 3.2 | 3.1 | 3.2 |
| Monitoring Physical Activity | 3.1 | 3.2 | 3.0 | 3.1 |
| Special Needs Plan (SNP) Care Management | 3.6 | 3.3 | 3.4 | 3.4 |
| Care for Older Adults – Medication Review | 4.4 | 4.4 | 4.1 | 4.1 |
| Care for Older Adults – Pain Assessment | 4.4 | 4.3 | 4.0 | 4.2 |
| Osteoporosis Management in Women who had a Fracture | 3.1 | 2.6 | 2.8 | 2.7 |
| Diabetes Care – Eye Exam | 3.8 | 3.7 | 3.5 | 3.4 |
| Diabetes Care – Blood Sugar Controlled | 4.3 | 4.1 | 3.8 | 3.7 |
| Controlling Blood Pressure | NA | 3.5 | 3.4 | 3.0 |
| Reducing the Risk of Falling | 2.5 | 2.9 | 2.9 | 2.6 |
| Improving Bladder Control | 2.7 | 3.3 | 3.2 | 3.0 |
| Medication Reconciliation Post-Discharge | 3.5 | 3.4 | 3.4 | 3.6 |
| Plan All-Cause Readmissions | NA | NA | 2.9 | 3.1 |
| Statin Therapy for Patients with Cardiovascular Disease | 3.5 | 3.5 | 3.3 | 3.0 |
| Transitions of Care | NA | NA | 2.5 | 3.0 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | NA | NA | 3.0 | 3.2 |
| Getting Needed Care | 3.6 | 3.4 | 3.4 | 3.3 |
| Getting Appointments and Care Quickly | 3.6 | 3.5 | 3.5 | 3.5 |
| Customer Service | 3.8 | 3.4 | 3.6 | 3.5 |
| Rating of Health Care Quality | 3.6 | 3.4 | 3.3 | 3.5 |
| Rating of Health Plan | 3.5 | 3.2 | 3.1 | 3.2 |
| Care Coordination | 3.7 | 3.5 | 3.6 | 3.6 |
| Complaints about the Plan | 4.7 | 4.3 | 4.1 | 4.2 |
| Members Choosing to Leave the Plan | 4.1 | 3.5 | 3.6 | 3.6 |
| Health Plan Quality Improvement | 3.7 | 2.6 | 2.9 | 3.6 |
| Plan Makes Timely Decisions about Appeals | 4.6 | 4.6. | 4.3 | 4.2 |
| Reviewing Appeals Decisions | 4.6 | 4.4 | 3.7 | 3.7 |
| Call Center – Foreign Language Interpreter and TTY Availability | 4.6 | 4.3 | 4.5 | 4.0 |
Part D Measures: Tables 8 and 9 present average star ratings for Part D measures for MA-PDs and PDPs, respectively. Similar to Part C measures, some Part D measures show a decline in average ratings over time, particularly in medication adherence measures and Statin Use in Persons with Diabetes. This may indicate challenges in these specific areas of prescription drug management. Conversely, measures related to plan administration, such as Complaints about the Plan, tend to have higher average ratings.
Table 8: 2022-2025 Average Star Rating by Part D Measure for MA-PDs
| Measure | 2022 MA-PD Average Star | 2023 MA-PD Average Star | 2024 MA-PD Average Star | 2025 MA-PD Average Star |
|---|---|---|---|---|
| Call Center – Foreign Language Interpreter and TTY Availability | 4.5 | 4.4 | 4.5 | 4.0 |
| Complaints about the Plan | 4.7 | 4.3 | 4.1 | 4.2 |
| Members Choosing to Leave the Plan | 4.1 | 3.5 | 3.6 | 3.6 |
| Drug Plan Quality Improvement | 4.2 | 2.7 | 3.4 | 3.3 |
| Rating of Drug Plan | 3.4 | 3.2 | 3.2 | 3.4 |
| Getting Needed Prescription Drugs | 3.8 | 3.4 | 3.5 | 3.3 |
| MPF Price Accuracy | 4.0 | 4.2 | 3.6 | 3.4 |
| Medication Adherence for Diabetes Medications | 3.7 | 3.0 | 3.3 | 3.2 |
| Medication Adherence for Hypertension (RAS antagonists) | 3.9 | 3.4 | 3.4 | 3.3 |
| Medication Adherence for Cholesterol (Statins) | 3.6 | 3.1 | 3.2 | 3.3 |
| MTM Program Completion Rate for CMR | 4.0 | 3.9 | 3.6 | 3.7 |
| Statin Use in Persons with Diabetes (SUPD) | 3.4 | 3.1 | 2.7 | 2.8 |
Table 9: 2022-2025 Average Star Rating by Part D Measure for PDPs
| Measure | 2022 PDP Average Star | 2023 PDP Average Star | 2024 PDP Average Star | 2025 PDP Average Star |
|---|---|---|---|---|
| Call Center – Foreign Language Interpreter and TTY Availability | 4.2 | 4.1 | 3.6 | 3.6 |
| Complaints about the Plan | 4.8 | 4.4 | 4.6 | 4.6 |
| Members Choosing to Leave the Plan | 4.2 | 4.0 | 3.9 | 3.7 |
| Drug Plan Quality Improvement | 4.1 | 2.2 | 3.0 | 3.0 |
| Rating of Drug Plan | 3.8 | 3.3 | 3.4 | 3.5 |
| Getting Needed Prescription Drugs | 3.9 | 3.5 | 3.5 | 3.7 |
| MPF Price Accuracy | 3.3 | 3.5 | 3.6 | 3.1 |
| Medication Adherence for Diabetes Medications | 3.9 | 2.9 | 2.6 | 2.4 |
| Medication Adherence for Hypertension (RAS antagonists) | 3.5 | 2.7 | 2.6 | 2.9 |
| Medication Adherence for Cholesterol (Statins) | 3.6 | 3.1 | 3.0 | 2.9 |
| MTM Program Completion Rate for CMR | 3.7 | 3.1 | 3.2 | 3.0 |
| Statin Use in Persons with Diabetes (SUPD) | 3.3 | 2.9 | 2.4 | 2.7 |
Conclusion: Leveraging 2025 Star Ratings to Compare Medicare Advantage Plans
The 2025 Medicare Advantage and Part D Star Ratings offer valuable data for consumers seeking to compare medicare advantage plans 2025 and make informed enrollment decisions. While the average star ratings have slightly decreased for MA-PD contracts and PDPs in 2025, a significant portion of plans continue to achieve high ratings, demonstrating ongoing commitment to quality. When you compare medicare advantage plans 2025, pay close attention to the star ratings, considering not only the overall rating but also performance on specific measures that are important to your individual healthcare needs. Utilize resources like the Medicare Plan Finder to explore plan options, compare star ratings, and select a plan that provides high-quality, affordable coverage for 2025. Remember to consider factors like plan type, benefits, costs, and provider networks in addition to star ratings to make a well-rounded and beneficial choice for your healthcare.
