Your Advantage Plan’s Star Rating Counts Appeals Timing and Members Lost. CMS Just Decided to Drop Both.
CMS just quietly removed two Medicare Advantage star measures that reveal what happens when your plan says no. Before they vanish from the scorecard, here is what those numbers actually show and how long you have left to use them.
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Picture a 66-year-old sitting down in October with the Medicare Plan Finder open, comparing three Medicare Advantage plans in her ZIP code. She doesn’t stop at the overall star score, because it wouldn’t tell her what she needs. She opens the detailed measure ratings and looks up two specifically: whether each plan makes timely decisions about appeals, and how many members choose to leave.
Those two numbers are the closest thing a shopper has to a read on what happens when a plan says no. She can find them this fall, and next fall. Then they come off the scorecard.
What CMS Locked In
CMS released its Contract Year 2027 Medicare Advantage and Part D final rule on April 2, 2026, published in the Federal Register days later. It removes 11 Star Ratings measures, having proposed 12 and ultimately retaining Diabetes Care/Eye Exam. It adds a Part C Depression Screening and Follow-Up measure beginning with the 2027 measurement year and the 2029 Star Ratings.
CMS estimates the combined Star Ratings changes will increase Medicare payments to private plans by $18.56 billion over 10 years, through both Quality Bonus Payments and rebate calculations. CMS also declined to implement the Excellent Health Outcomes for All reward, which had not yet taken effect, keeping the older historical reward factor instead.
The cuts land in two waves. In Star Year 2028, the call-center interpreter and TTY measures go, along with statin therapy for cardiovascular patients. In Star Year 2029, eight more follow: Plan Makes Timely Decisions about Appeals, Reviewing Appeals Decisions, complaints about the plan, Medicare Plan Finder Price Accuracy, members choosing to leave, customer service, rating of health care quality, and SNP care management.
Why the Score Drives the Plan You See
Star Ratings set Quality Bonus Payments and rebate levels, which fund the $0 premiums, dental extras and gym memberships that make Advantage plans look free. A 4-star contract collects a bonus a 3.5-star contract does not. CMS’s stated rationale for the removals is not that plans performed badly. It’s close to the reverse: several measures showed performance so uniformly high that they no longer distinguished one plan from another. Whatever the reasoning, the agency’s own modeling shows the combined changes raising payments to plans.
What the shopper loses is narrower and more specific. After the 2029 ratings, the composite leans harder on clinical process measures and patient experience surveys. It stops scoring whether a plan meets its appeal deadlines, and stops scoring how many members walk away.
CMS says the obligation itself survives. Removing the measures “does not diminish plans’ obligations” to process appeals in a timely, accurate and complete way, and the agency says it will keep monitoring through audits and compliance actions. That’s oversight, not a number on a tile you can compare before you enroll.
What This Fall Looks Like
The ratings on Plan Finder from October 15 through December 7 contain every measure on the removal list. So will the ratings posted next fall. They disappear from the 2029 Star Ratings, which shoppers will see in fall 2028. You have two enrollment seasons to use them.
The 2026 standard Part B premium of $202.90 generally continues whether you stay in Original Medicare or choose Advantage, though some plans offer a premium reduction. The $283 Part B deductible is an Original Medicare figure and does not automatically carry over: Advantage plans set their own deductibles and cost sharing. The tradeoff lives there, in network limits, prior authorization and the appeals experience CMS is about to stop scoring. Income-based surcharges from two years back can layer on top, and coverage gaps compound the sticker shock. We mapped the full set in a free guide on the hidden bills retirees run into.
Step by Step
Two enrollment seasons is a short runway, so here’s where to spend it.
- Open the detailed measure ratings, not just the star score. Look up “Plan Makes Timely Decisions about Appeals” and “members choosing to leave” for every plan you’re considering. A weak rating on either is a warning the composite will stop carrying after the 2029 ratings.
- If you’re choosing Advantage for the first time, price a Medigap Plan G or Plan N quote now. A quote today cannot tell you what you’d be offered years from now. What it can tell you is the current market rate, and whether your state guarantees you later access. Absent that guarantee, treat the choice as closer to permanent than the marketing suggests.
- Re-shop even if you’re staying. Formularies, pharmacy networks and prior authorization lists reset every January. Auto-renewal is the most expensive default in Medicare.
The rating will still be there in 2029. Two of the things it currently tells you will not.
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Gerelyn Terzo is the author of dividend investing handbook "Dividend Investing Strategies: How to Have Your Cake & Eat It Too." A veteran financial journalist, she covers agri-finance for outlets like Global AgInvesting and the broader stock market and personal finance for 24/7 Wall Street. She began at CNBC and later helped launch Fox Business in New York. Gerelyn currently resides in Woodland Park, Colorado and dabbles in nature photography as a hobby.
