How to Pick the Best Medicare Health Insurance Plan in Your Area

Medicare Learning Center/Dedicated Resources for Everyone/How to Pick the Best Medicare Health Insurance Plan in Your Area

Last Updated: June 2025 Print This Article

Choosing a Medicare plan can be intimidating, but there’s a reliable way to make the process easier: the Medicare Star rating system. Think of it as the Consumer Reports of Medicare—giving you a clear, unbiased view of the quality of plans available in your area.

You can find these ratings on the Medicare Plan Finder at Medicare.gov. Plans are rated from 1 to 5 stars based on over 50 performance measures across five key categories. Here’s what those categories mean and why they matter.

The Star Ratings Scale

Excellent
Above Average
Average
Below Average
Poor

Staying Healthy

This category looks at how well a plan helps members maintain good health through preventive care—things like flu shots, screenings, annual checkups and wellness programs such as gym memberships.

What it means for you:
Plans with high scores often work closely with doctors to keep members healthy. For example, a top-rated plan may encourage doctors to remind patients to get flu shots or preventive screenings. And with a highly rated plan, network doctors are likely to be more proactive—making sure their patients don’t just get healthy but stay that way.

Managing Chronic Conditions

This rating focuses on how well a plan helps members manage chronic conditions to prevent complications.

What it means for you:
Top-rated plans often coordinate with doctors to ensure essential care isn’t overlooked—like reminding them to check diabetic patients for nerve damage. The more proactive the plan, the better the rating.

Member Experience (Responsiveness and Care)

This score reflects how members feel about their care. It includes satisfaction with the plan, how quickly members get appointments and how well doctors communicate.

What it means for you:
High scores suggest that current members feel supported and well cared for—an important sign of a plan’s overall service quality.

Member Complaints and Appeals

CMS tracks how often members file complaints or appeals when care isn’t covered or service falls short. Fewer issues mean better performance.

What it means for you:
Plans with a high Star rating put a lot of emphasis on clearly communicating to members and offering robust benefits so that appeals and complaints can be avoided.

Customer Service

This measures how well a plan handles member calls, paperwork and other services.

What it means for you:
If easy access to help matters to you, look for a plan with a strong customer service rating. It usually means quicker, friendlier support when you need it.

The Takeaway

The Star Rating system is a powerful tool to help you compare Medicare plans objectively. Before you choose a plan, check the ratings and see how well it performs where it counts most—your health and satisfaction.