Choosing the right Medicare Part D prescription plan can feel overwhelming. With numerous options available, understanding how to compare these plans is crucial to ensure you receive optimal coverage and value. The Centers for Medicare & Medicaid Services (CMS) provides a valuable tool to assist in this process: the Medicare Part D Star Ratings. These ratings offer insights into plan quality and performance, helping you make informed decisions about your healthcare.
Each year, CMS releases Star Ratings for Medicare Advantage (MA) and Part D plans, evaluating them on various quality and performance measures. For Medicare Part D prescription drug plans (PDPs), these ratings are particularly focused on aspects like customer service, member experience, and drug pricing accuracy. The 2025 Star Ratings are now available, providing the latest data to guide your plan comparison for the upcoming enrollment period.
This article delves into the 2025 Medicare Part D Star Ratings, highlighting key findings and explaining how you can use this information to compare plans effectively. We will explore the distribution of ratings, factors influencing plan performance, and what these ratings signify for you as a Medicare beneficiary seeking the best prescription drug coverage.
Understanding the Medicare Part D Star Ratings Methodology
To effectively Compare Medicare Part D Prescription Plans, it’s important to understand how the Star Ratings are determined. CMS assesses PDP contracts based on up to 12 unique quality and performance measures. These measures cover several critical areas, including:
- Customer Service: Evaluates aspects like call center foreign language interpreter and TTY availability.
- Member Experience: Considers member complaints about the plan and the rate of members choosing to leave the plan.
- Drug Plan Quality Improvement: Assesses ongoing efforts to enhance the quality of the drug plan.
- Rating of Drug Plan: Reflects overall member satisfaction with the drug plan.
- Access to Needed Prescription Drugs: Measures how easily members can obtain necessary medications.
- Medicare Plan Finder (MPF) Price Accuracy: Examines the accuracy of drug pricing information on the Medicare Plan Finder tool.
- Medication Adherence: Focuses on how well members adhere to prescribed medications for diabetes, hypertension, and cholesterol.
- MTM Program Completion Rate for Comprehensive Medication Review (CMR): Evaluates the completion rate of medication therapy management programs.
- Statin Use in Persons with Diabetes (SUPD): Assesses the appropriate use of statins for people with diabetes.
For each of these measures, CMS establishes “cut points” to determine the star rating a contract receives—from 1 star (lowest) to 5 stars (highest). It’s worth noting that for the 2025 Star Ratings, there were minor methodological adjustments, but no major changes. One example of a minor change is the application of bi-directional guardrails to the Part D Medicare Plan Finder measure after mean resampling if cut points change significantly.
2025 Part D Rating Distribution: Key Trends
Analyzing the distribution of 2025 Part D Star Ratings provides valuable insights into the performance landscape of prescription drug plans. Table 2 from the CMS report summarizes this distribution:
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 Star Rating is weighted by enrollment.
Key Takeaways from the 2025 Part D Rating Distribution:
- Fewer High-Rated Plans: There’s a noticeable decrease in the percentage of PDPs achieving 4 stars or higher in 2025 compared to previous years. Approximately 27% of PDPs received 4 or more stars for 2025, a reduction from previous years.
- Shift in Enrollment: While fewer plans achieved high ratings, enrollment-weighted data reveals that only about 5% of PDP enrollees are in contracts with 4 or more stars in 2025. This suggests that a significant portion of enrollees are in plans with average or below-average ratings.
- Average Star Rating Decline: The average Part D Star Rating, weighted by enrollment, has decreased from 3.34 in 2024 to 3.06 in 2025. This indicates an overall dip in average plan performance across the Part D landscape.
These trends suggest that when you compare medicare part d prescription plans for 2025, you may find fewer top-rated options compared to previous years. It becomes even more critical to carefully evaluate the available plans and understand what these ratings mean for your specific needs.
Factors Influencing Part D Plan Performance
Several factors can influence the Star Ratings of Medicare Part D prescription plans. Understanding these factors can provide context when you compare plans and interpret their ratings:
- Methodological Changes: While no major changes occurred for 2025, minor adjustments in the rating methodology can impact cut points and overall ratings distribution.
- Performance Fluctuations: Star Ratings are designed to capture a contract’s performance during a specific measurement period. Plans may naturally perform better or worse in different years due to various operational and external factors.
- Cut Point Recalculations: CMS recalculates measure-level cut points each year based on performance during the measurement period. Increases in cut points mean plans need to achieve higher performance to maintain a high Star Rating. This year, several factors contributed to increased cut points, including the removal of extreme outliers and a return to pre-pandemic performance levels for some measures.
Tax Status and Plan Performance
The CMS data reveals an interesting correlation between a PDP’s tax status and its Star Rating performance. Non-profit organizations tend to achieve higher ratings more frequently than for-profit organizations. Table 4 illustrates this for 2025 Part D ratings:
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.
Key Observations:
- Higher Ratings for Non-profits: Approximately 41% of non-profit PDPs achieved 4 or more stars, compared to only about 17% of for-profit PDPs.
- Enrollment Concentration: A significant portion of enrollment in higher-rated plans is concentrated in non-profit PDPs.
When you compare medicare part d prescription plans, considering the tax status of the plan organization might offer an additional layer of insight into potential plan quality and performance.
Plan Experience and Star Ratings
Another factor to consider when you compare Medicare Part D prescription plans is the plan’s experience in the program. While the relationship isn’t as pronounced for PDPs as it is for MA-PDs, plans with more years of experience may demonstrate better performance. Table 6 provides data on this aspect:
Table 6: Distribution of 2025 Part D Ratings by Length of Time in Program for PDPs
| 2025 Part D 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 | 0 | 0.00 | 1 | 33.33 | 1 | 2.70 |
| 4.5 stars | 0 | 0.00 | 1 | 33.33 | 5 | 13.51 |
| 4 stars | 0 | 0.00 | 0 | 0.00 | 3 | 8.11 |
| 3.5 stars | 0 | 0.00 | 1 | 33.33 | 9 | 24.32 |
| 3 stars | 0 | 0.00 | 0 | 0.00 | 11 | 29.73 |
| 2.5 stars | 0 | 0.00 | 0 | 0.00 | 7 | 18.92 |
| 2 stars | 1 | 100.00 | 0 | 0.00 | 1 | 2.70 |
| Total Rated Contracts | 1 | 3 | 37 |
Observations:
- Limited Newer PDPs: There are very few PDPs with less than 10 years of experience, making it challenging to draw strong conclusions.
- Potential for Experienced Plans: The data suggests that more experienced plans might have a slightly higher likelihood of achieving better ratings, but the sample size for newer plans is very small.
While plan experience is a less significant factor for PDPs compared to MA-PDs, it’s still a dimension to consider when you compare medicare part d prescription plans, especially if you are looking at plans with very different operating histories.
Average Star Ratings by Part D Measure
Examining the average Star Ratings for each Part D measure provides a granular view of performance trends over time. Table 9 shows these averages for PDPs from 2022 to 2025:
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 |
Measure-Specific Trends:
- Customer Service Measures: Call Center and Complaint measures show relatively stable or slightly declining average ratings.
- Member Retention: “Members Choosing to Leave the Plan” measure shows a slight downward trend in average ratings.
- Drug Plan Improvement: “Drug Plan Quality Improvement” has seen some fluctuation but remains around a 3-star average.
- Access and Satisfaction: “Getting Needed Prescription Drugs” and “Rating of Drug Plan” measures show relatively stable average ratings around 3.5 stars.
- Price Accuracy: “MPF Price Accuracy” average rating decreased in 2025 after slight increases in previous years.
- Medication Adherence: Measures related to medication adherence for diabetes, hypertension, and cholesterol generally show declining average ratings over the years.
When you compare medicare part d prescription plans, you can delve into these measure-specific ratings to understand how plans perform on aspects that are most important to you. For example, if price accuracy is a top concern, you might prioritize plans with higher ratings on the “MPF Price Accuracy” measure.
High-Performing and Low-Performing PDPs
For 2025, two PDP contracts received the high-performing icon for achieving 5-star ratings:
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 |
Conversely, one PDP contract received the low-performing icon for consistently low quality ratings:
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 |
|---|---|---|---|---|
| S6946 | CLEAR SPRING HEALTH INSURANCE COMPANY | Group 1001 | Part D | 340,855 |
Identifying these high and low performers can be a starting point when you compare medicare part d prescription plans. However, remember to consider your specific needs and preferences beyond just the overall star rating.
Conclusion: Leverage Star Ratings to Compare Medicare Part D Plans Effectively
The 2025 Medicare Part D Star Ratings provide valuable data to help you compare medicare part d prescription plans and make informed choices. While the average Part D ratings have slightly declined, and fewer plans achieved top ratings in 2025, the Star Ratings remain a crucial tool for assessing plan quality and performance.
When comparing plans, consider these key takeaways from the 2025 Star Ratings:
- Focus on Measures that Matter to You: Explore measure-specific ratings beyond the overall star rating to understand plan strengths and weaknesses in areas like customer service, drug access, or price accuracy.
- Consider Plan Type and Tax Status: Be aware of potential performance differences between for-profit and non-profit plans.
- Utilize the Medicare Plan Finder: The Star Ratings are integrated into the Medicare Plan Finder, making it easier to compare plans alongside cost and benefit information.
By leveraging the 2025 Medicare Part D Star Ratings and understanding the factors influencing plan performance, you can confidently compare plans and select the prescription drug coverage that best meets your healthcare needs and preferences.
