CMS says about 71% of people in Medicare Advantage plans that include drug coverage are enrolled in contracts rated four stars or better for 2027. Counted by contract instead of by member, the share is lower: about 37%, or 188 of 508 rated contracts. The agency published the ratings on October 8, and Open Enrollment runs through December 7.
Why 71% and 37% describe different things
The two numbers answer different questions. The 71% is weighted by enrollment: of everyone in a Medicare Advantage drug plan contract, about 71% belong to one rated four stars or higher. The 37% counts each contract once, whether it covers a few thousand members or several hundred thousand, as the agency’s fact sheet lays out.
Both figures are CMS’s, and both describe the same 508 rated contracts. The gap between them means the larger contracts are more likely than the typical one to sit in the four-star-plus group. Anyone choosing among these plans for 2027 should not read “most members are in highly rated plans” as “most plans are highly rated.”
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Stars attach to the contract, the agreement between CMS and an insurer, and one contract can hold several plans with different premiums and networks. A plan’s rating is its contract’s rating. Two plans from the same insurer can carry different stars if they sit under different contracts.
At the top, CMS gave 15 of these contracts its high-performing icon, and eight of them also held it in 2026. At the bottom, four contracts carry the low-performing icon, the same number as last year. The enrollment-weighted average rating across all of them is 3.99.
Ownership shows up in the data. CMS says about 44% of nonprofit Medicare Advantage drug plan contracts earned four stars or more, against about 34% of for-profit ones. The gap is ten percentage points.
Stand-alone drug plans tell a different story
Stand-alone Part D prescription drug plans are rated separately, and CMS lists 41 of those contracts for 2027. About 27% of them, 11 contracts, earned four stars or more. None received five stars, and their enrollment-weighted average Part D rating is 3.22.
By enrollment, about 22% of people in stand-alone drug plans are in a contract rated four stars or better, up from 2% in 2026. The jump is large, but it still leaves roughly four in five of those enrollees in contracts below the line.
These figures cover a different group from the 71% and 37% above. People in Original Medicare who buy a separate drug plan should look at the stand-alone numbers. People in Medicare Advantage with drug coverage should look at the 508-contract numbers.
What changed inside the 2027 formula
CMS builds the overall rating from up to 43 measures for Medicare Advantage drug plan contracts, up to 32 for plans without drug coverage and up to 13 for stand-alone drug plans. Each measure earns one to five stars against cut points that CMS recalculates every year. The agency says changes in star ratings from year to year are normal and expected and vary by measure.
Two measures are new for 2027: concurrent use of opioids and benzodiazepines, and use of multiple anticholinergic medications in older adults. The weight of the improving-or-maintaining physical health and mental health measures rose from 1 to 3. A respecified colorectal cancer screening measure replaced the older version.
CMS retired two measures from the Care for Older Adults and hospital-discharge groups: pain assessment and medication reconciliation after discharge. The medication therapy management completion rate moved to the display page and returns as a star measure in the 2029 ratings.
The agency also adjusted for extreme and uncontrollable circumstances, citing wildfires in California and severe storms in Texas during the 2025 performance period. It says the ratings will affect Medicare Advantage quality bonus payments to insurers in 2028.
How a plan shopper can use the stars before December 7
CMS says the ratings are meant to be read in Medicare Plan Finder next to benefit and cost information, so people can pick the coverage that best fits their health needs. A star rating summarizes measure results for the contract. It does not show whether a given plan covers a given drug or includes a given doctor.
The agency also notes that ratings change from year to year and points shoppers to a plan’s performance over time, not one year. A contract that rose from three stars to four tells a different story from one that has held four for years.
Cost questions stay open at any star level. Premiums, formulary tiers and the doctors in a network decide what a plan costs one person, and those details come from the plan’s own 2027 materials and from Plan Finder.
The two percentages point in opposite directions. A typical enrollee is more likely than not to be in a contract rated four stars or better, at 71%, while a typical contract is not, at 37%. The rating of the member’s own plan, looked up by name, matters more than either number.
Is the current plan on the four-star side of the line?
A star rating narrows the field, but the choice has to be made by December 7, and a rating says nothing about whether a plan covers the drugs and doctors one person actually uses. A highly rated contract can still cost more for a specific prescription list.
The story’s question is quality, and the related job is cost, drugs and doctors. The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus the Open Enrollment calendar. Part 2, The Drug and Doctor Coverage Check, puts a prescription-by-plan comparison beside the star ratings.
Get the plan cost calculator and Open Enrollment calendar for the December 7 decision →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
