Choosing the right Medicare Part D plan can feel overwhelming. With so many options available, how do you know which plan will best meet your needs for prescription drug coverage in 2024? The Centers for Medicare & Medicaid Services (CMS) provides a valuable tool to help you compare plans: the Medicare Star Ratings. While the newly released 2025 Star Ratings might seem future-focused, they offer critical insights right now as you evaluate your options for 2024 coverage.
These ratings, announced for 2025 but relevant for your 2024 plan choices, assess the quality and performance of Medicare Advantage (Part C) and Part D prescription drug plans. Think of them as a quality report card, helping you understand how different plans perform across various measures. By understanding these ratings, you can make more informed decisions when selecting a Medicare Part D plan during the upcoming open enrollment period for 2024 benefits.
The Star Ratings are designed to empower Medicare beneficiaries to compare the quality of available plans, alongside cost and benefit information. This allows you to prioritize not just affordability, but also the quality of care and service you can expect. Let’s delve into what the 2025 Star Ratings reveal and how you can use this information to compare Medicare Part D plans effectively for 2024.
Understanding the 2025 Star Ratings: Key Highlights for Plan Comparison
CMS evaluates Medicare Advantage Prescription Drug (MA-PD) contracts, Medicare Advantage-only contracts, and stand-alone Prescription Drug Plans (PDPs or Part D plans) using a Star Ratings system. For Part D plans specifically, up to 12 different measures are considered. These measures are assessed against pre-defined thresholds or “cut points” to determine a star rating from 1 to 5 stars for each measure.
While there were no significant methodological changes for the 2025 Star Ratings, it’s important to note a few key points that impact how plans are evaluated:
- Focus on Quality Improvement: CMS continuously refines the Star Ratings to encourage ongoing quality improvement within Medicare plans. This means plans are incentivized to enhance their services and performance to achieve higher ratings.
- Increased Weight for Readmissions (Part C): While primarily impacting Medicare Advantage ratings, a change in the weighting of the “Part C Plan All-Cause Readmissions” measure to triple its previous weight highlights the importance CMS places on care coordination and reducing hospital readmissions. This indirectly reflects on the overall quality of care within integrated MA-PD plans that include drug coverage.
- Methodological Consistency: For 2025, minor technical adjustments, like applying bi-directional guardrails to the Part D Medicare Plan Finder measure, ensure the rating system remains stable and accurate over time. These adjustments, while technical, contribute to the reliability of the Star Ratings as a comparison tool.
- Impact of Past Rule Changes: Methodological changes implemented in previous years, such as the introduction of Tukey outlier deletion, continue to influence the 2025 Star Ratings. This statistical method improves the accuracy of cut points by minimizing the impact of extreme performance outliers, leading to a more precise assessment of plan performance.
These factors contribute to the overall distribution of Star Ratings and the benchmarks plans need to meet to achieve high ratings. Understanding these nuances can help you interpret the Star Ratings more effectively as you compare Medicare Part D plans.
2025 Star Rating Distribution for Medicare Part D Plans: What to Look For
The distribution of Star Ratings provides a broad view of how Part D plans are performing overall. Looking at the 2025 data, we can observe trends and identify what constitutes a high-performing plan.
Table 1: 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 |
*The average Star Rating is weighted by enrollment.
Here are some key takeaways from the 2025 Part D ratings distribution:
- Fewer High-Rated Plans: The percentage of 5-star and 4.5-star rated Part D plans has decreased from 2022 to 2025. In 2025, only a small fraction of plans achieved these top ratings.
- Majority in the Mid-Range: Most Part D plans fall in the 3-star and 3.5-star categories. This suggests a generally consistent level of performance across many plans.
- Enrollment Concentrated in Mid-Range: A significant portion of enrollees are in plans rated 3.5 stars and 3 stars. However, it’s important to note the weighted enrollment shifts year to year, reflecting plan choices and market dynamics.
- Average Rating Decline: The average Part D Star Rating, weighted by enrollment, has slightly decreased over the years, reaching 3.06 in 2025. This could be due to various factors, including increased performance expectations and evolving measure cut points.
How to Use This Data for 2024 Plan Selection:
- Aim for 4 Stars or Higher: While 5-star plans are rare, targeting plans with 4 stars or 4.5 stars can increase your likelihood of enrolling in a high-quality plan.
- Don’t Disregard 3.5 Star Plans: Plans in the 3.5-star range still represent a solid level of performance and may offer a good balance of quality and cost.
- Investigate Lower-Rated Plans: If considering a plan below 3 stars, delve deeper into the specific measures where the plan underperformed to understand potential areas of concern.
Remember that Star Ratings are just one factor in your decision. You should also consider your individual healthcare needs, preferred pharmacy network, drug formulary (list of covered drugs), and costs (premiums, deductibles, copays, and coinsurance) when comparing Medicare Part D plans for 2024.
5-Star and Low-Performing Part D Plans: Key Examples for 2024 Consideration
For 2025, only two stand-alone PDPs achieved the coveted 5-star rating. These plans are highlighted on the Medicare Plan Finder with a high-performing icon, making them easily identifiable.
Table 2: 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 |
Key Observations:
- Limited 5-Star Options: The scarcity of 5-star Part D plans underscores the rigorous standards required to achieve this top rating.
- Regional Focus: The 5-star plans listed are offered by specific organizations, potentially indicating regional strengths in plan performance.
Conversely, it’s also important to be aware of plans identified as “consistently low performers.” For 2025, one PDP contract received a low-performing icon.
Table 3: 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 |
Key Observations:
- Low-Performer Awareness: CMS identifies consistently low-performing plans to signal areas where beneficiaries might experience quality or service issues.
- Part D Specific Low Performance: In 2025, the low-performing icon for PDPs highlights contracts struggling specifically with Part D measures.
Using This Information for 2024 Choices:
- Consider 5-Star Plans (If Available): If a 5-star plan is available in your area and meets your other needs (formulary, network, cost), it could be a strong option to consider for 2024.
- Exercise Caution with Low-Performing Plans: Carefully evaluate plans with a low-performing icon. Investigate the reasons for the low rating and consider if those issues might impact your healthcare experience. While these plans may still be options, due diligence is essential.
Plan Performance Factors: Tax Status and Years in Program
The 2025 Star Ratings data also reveals interesting trends related to plan characteristics, such as tax status and the length of time a plan has been in the Medicare program.
Tax Status and Performance:
Non-profit organizations tend to achieve higher Star Ratings more frequently than for-profit organizations.
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 Observation:
- Non-profit Advantage: A higher percentage of non-profit PDPs (around 41%) achieved 4 stars or higher compared to for-profit PDPs (around 17%). This trend suggests potential differences in organizational priorities and resource allocation that may influence plan quality.
Years in Program and Performance:
For Part D plans, the relationship between years in the program and Star Ratings is less pronounced compared to Medicare Advantage plans, likely due to the smaller sample size of PDPs with less experience. However, the data suggests that newer PDPs may face challenges in achieving high ratings initially.
Table 5: 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 |
Key Observation:
- Experience May Matter: The only PDP with fewer than five years of experience received a lower 2-star rating. While the sample size is small, it hints that newer plans might take time to establish the processes and systems needed for high performance.
Implications for 2024 Plan Selection:
- Consider Non-profit Plans: If quality is a top priority, you might lean towards non-profit Part D plans, given their historical trend of higher ratings.
- Factor in Plan Experience (With Caution): While newer plans aren’t necessarily low quality, you might consider plans with a longer track record in the Medicare program as potentially more stable and established in their performance. However, don’t automatically dismiss newer plans, as they may offer innovative benefits or competitive pricing.
Measure-Level Star Ratings: Drilling Down for Detailed Comparisons
Beyond overall Star Ratings, CMS also provides average Star Ratings for individual measures used to evaluate Part C and Part D plans. Examining these measure-level ratings can provide a more granular comparison of plan strengths and weaknesses.
Table 6: 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 |
Key Measure Categories and Trends:
- Customer Service (Call Center, Complaints): Ratings for customer service measures, while still relatively high, have shown some fluctuation over the years. This suggests that customer service experiences can vary across plans and may be an area to consider when comparing.
- Member Experience (Rating of Drug Plan, Getting Needed Drugs, Plan Leaving): These measures reflect overall member satisfaction and access to needed medications. Ratings in these areas are generally in the mid-3-star range, indicating room for improvement across the industry.
- Medication Adherence: Medication adherence measures, particularly for diabetes, hypertension, and cholesterol medications, show a trend of decreasing average ratings from 2022 to 2025. This could signal challenges in helping beneficiaries consistently take their medications as prescribed, which is a critical aspect of Part D plan effectiveness.
- Drug Plan Quality Improvement: Ratings for “Drug Plan Quality Improvement” saw a significant drop in 2023 but have since stabilized. This measure assesses a plan’s efforts to improve its overall quality performance.
- MPF Price Accuracy: The “Medicare Plan Finder (MPF) Price Accuracy” measure, assessing the accuracy of drug pricing information on the Medicare Plan Finder, has also fluctuated, highlighting the importance of verifying pricing details when comparing plans.
Using Measure-Level Data for 2024 Plan Comparisons:
- Identify Your Priorities: Determine which aspects of Part D plan performance are most important to you. Is it customer service, ease of getting medications, or specific aspects of medication management?
- Compare Measure Ratings: Use the measure-level data to compare how different plans perform on the measures that align with your priorities. The Medicare Plan Finder often provides measure-level ratings for specific plans.
- Look for Strengths and Weaknesses: Identify plans that consistently score well on measures important to you. Also, note any significant weaknesses in areas that could impact your experience.
- Consider Trends: Pay attention to trends in measure ratings over time. Are ratings improving or declining? This can provide insights into a plan’s trajectory and commitment to quality.
Conclusion: Leverage 2025 Star Ratings for Smart 2024 Part D Plan Choices
While officially the 2025 Star Ratings, this data is incredibly valuable right now as you prepare to compare Medicare Part D plans for the upcoming 2024 enrollment period. By understanding how plans are rated and what these ratings signify, you can make more informed decisions that go beyond just cost.
Key Takeaways for Comparing 2024 Medicare Part D Plans:
- Star Ratings as a Quality Guide: Use Star Ratings as a primary indicator of plan quality and performance. Aim for plans with 4 stars or higher for a better chance of a positive experience.
- Balance Quality and Cost: Don’t solely focus on the lowest premium. Consider Star Ratings alongside cost and benefit information to find the best value – a plan that offers both quality and affordability.
- Explore 5-Star Options: Check if 5-star rated plans are available in your area and if they align with your needs. These represent the highest level of quality.
- Be Cautious with Low Performers: Carefully evaluate plans with low-performing icons and understand the potential risks.
- Consider Plan Characteristics: Factor in tax status and plan experience as potential indicators of quality, but don’t rely on these factors alone.
- Drill Down with Measure-Level Ratings: For a more detailed comparison, examine measure-level Star Ratings to identify plan strengths and weaknesses in areas important to you.
- Use the Medicare Plan Finder: The Medicare Plan Finder (medicare.gov) is your essential tool for comparing plans. It incorporates Star Ratings, cost information, formulary details, and more to help you make side-by-side comparisons.
By utilizing the insights from the 2025 Star Ratings, you can approach your 2024 Medicare Part D plan comparison with greater confidence and choose a plan that best supports your health and well-being. Remember to visit the Medicare Plan Finder during open enrollment to explore your options and enroll in the plan that meets your individual needs.
References:
- Centers for Medicare & Medicaid Services (CMS). (2024). 2025 Medicare Advantage and Part D Star Ratings Data [Press Release]. https://www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-and-part-d-star-ratings-fact-sheet
- Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies: https://www.cms.gov/files/document/2025-announcement.pdf
- Medicare Program, Contract Year 2021 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program Final Rule (85 FR 33796): https://www.federalregister.gov/documents/2020/06/02/2020-11342/medicare-program-contract-year-2021-policy-and-technical-changes-to-the-medicare-advantage-program
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