Of the 508 Medicare Advantage drug-plan contracts the federal government rated for 2027, 188 earned four stars or more. The Centers for Medicare & Medicaid Services says the enrollment-weighted average star rating for those plans slipped to 3.99 from 4.01 a year earlier. The ratings went onto Medicare Plan Finder on Oct. 8, a week before open enrollment starts.
For anyone in a Medicare Advantage plan that includes drug coverage, the number now attached to that plan is the one most likely to be quoted in a mailer or on a phone call. About 71 percent of these plans’ enrollees are in contracts rated four stars or higher, so most members will see a good-looking rating. The harder question is whether that rating means the plan is the best fit for a specific list of prescriptions between Oct. 15 and Dec. 7.
A contract-wide star rating is an average across the whole plan, and it does not price one person’s prescription list before the Dec. 7 deadline. The 2027 Medicare Open Enrollment Decision Kit compares plans on cost, drugs and doctors with a cost calculator spreadsheet and a prescription-by-plan comparison.
Compare 2027 plans on your own drug list with the Open Enrollment Decision Kit →
Why 37 percent of contracts and 71 percent of enrollees can both be right
The two figures measure different things. The 188 contracts at four stars or more are about 37 percent of the 508 rated contracts, a count of plan contracts. The roughly 71 percent figure counts people, because large contracts hold far more members than small ones. CMS’s own table shows the contract share falling from 44.4 percent in 2026 to 37.0 percent in 2027, while the share of enrollees in four-star-plus contracts stands at about 71 percent.
The enrollment-weighted average is the one in the headline. CMS’s table lists it as 4.07 for 2024, 3.95 for 2025, 4.01 for 2026 and 3.99 for 2027. The count of contracts rated four stars or higher has moved from 242 to 214 to 229 to 188 over the same four years, as the number of rated contracts shrank from 545 to 508.
Five-star plans and the warning icon
Fifteen Medicare Advantage drug-plan contracts earned five stars for 2027, down from 22 in the 2026 table, and CMS highlights those 15 with the high-performing icon on Plan Finder. Four contracts carry the low-performing icon. The agency lists the reason for two of them as Part C, for one as Part C or D and for one as Part D, so a low mark can come from medical-benefit measures, drug measures, or either.
The ratings are not just a consumer label. CMS says they “will impact 2028 MA quality bonus payments,” which means insurers have money riding on the numbers, and that helps explain why plans advertise them.
Standalone drug plans improved
Stand-alone prescription drug plans, the Part D plans people pair with Original Medicare, moved the other way. CMS reports an average Part D rating of 3.22 for 2027 versus 3.01 for 2026. About 27 percent of the active standalone plans, 11 contracts, earned four stars or more, and about 22 percent of standalone plan enrollees are in those contracts, up from roughly 2 percent the year before. None earned five stars.
What moved in the formula
CMS says Medicare Advantage drug plans are rated on up to 43 measures, Medicare Advantage plans without drug coverage on up to 32 and standalone drug plans on up to 13. Each measure is scored from one to five stars against cut points the agency sets, and the overall drug-plan rating is a weighted average of the Part C and Part D measure stars. For 2027 the two measures on improving or maintaining physical health and mental health rose in weight from 1 to 3. New measures with a weight of 1 cover concurrent use of opioids and benzodiazepines, use of multiple anticholinergic medications in older adults, and a respecified colorectal cancer screening measure. Two Part C measures, pain assessment and medication reconciliation after discharge, were retired, and a functional status assessment measure for older adults returns.
The tables also split results by ownership. About 44 percent of nonprofit contracts, 62 of 140, earned four stars or more, against 34 percent of for-profit contracts, 126 of 368. Plans with ten or more years in the program were more likely to reach four stars than newer ones.
Weighing star ratings against drug costs before December 7
The free official tool for the comparison is Medicare Plan Finder, where the 2027 ratings now appear and where a member can enter a drug list to see estimated costs plan by plan. A rating tells a member how the plan performs across measures such as customer service and care quality. It does not say whether a given medication is covered, which pharmacy tier it falls in, or what the deductible will be.
Before comparing, it helps to gather the exact name, dose and monthly quantity of each prescription, the pharmacies used and the doctors seen. Those details drive the costs Plan Finder estimates for each plan. A plan with a lower rating can still be cheaper for one person’s medications, and a five-star plan can drop a drug that someone depends on.
CMS’s performance data page carries the full 2027 data tables dated Oct. 8, 2026, including the contract-level scores behind each rating.
A four-star contract still prices each drug separately
Star ratings average a whole contract, and the cost of one prescription can differ sharply between two plans with the same rating. The 2027 Medicare Open Enrollment Decision Kit’s Excel calculator runs a current plan against others on cost, drugs and doctors, and its prescription-by-plan comparison lays each medication side by side, so the choice to keep, switch or wait comes with a written reason before Dec. 7.
Get the prescription-by-plan comparison and cost calculator for the 2027 enrollment window →
This article was produced with AI assistance and reviewed by The Financial Wire’s editorial team.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
