No stand-alone Medicare prescription drug plan earned five stars in the government’s 2027 quality ratings, which came out October 8. Two stand-alone plans held the top rating for 2026. The change lands in the middle of open enrollment, which started October 15 and runs through December 7, 2026.
The ratings are published by the Centers for Medicare & Medicaid Services, the federal agency that runs Medicare.
What the 2027 drug-plan ratings show
CMS’s 2027 Star Ratings fact sheet lists zero five-star contracts among stand-alone prescription drug plans, known as PDPs, down from two for 2026. CMS rated 41 stand-alone drug plans for 2027, compared with 40 for 2026.
Four stars or more was still reached by 11 of the 41 plans, about 27 percent, according to the agency’s newsroom summary. Weighted by enrollment, about 22 percent of people in stand-alone drug plans are in a contract rated four stars or higher for 2027, up from about 2 percent in 2026.
The average rating moved up too. CMS puts the enrollment-weighted average for stand-alone drug plans at 3.22 for 2027, compared with 3.01 for 2026.
How to choose when no plan has five stars
CMS rates stand-alone drug plans on up to 13 measures, and each measure is scored from one to five stars against cut points that are reset every year. A plan’s star count says how well it performs on those measures. It does not say whether the plan covers a particular person’s medications at a price that person can afford.
That is the question Medicare’s own Plan Finder is built to answer. CMS says the 2027 ratings appear on Plan Finder alongside benefits and costs, so people can compare plans and choose coverage that fits their health needs.
Someone who is picking a drug plan for 2027 can sort the 41 plans by stars, but the star count cannot settle which is best. The comparison that matters is each plan’s premium, deductible and price for the exact drugs taken, and open enrollment has until December 7 for that work.
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Does this include Medicare Advantage drug coverage?
It does not. The zero is a count of stand-alone drug plans, the kind a person on Original Medicare adds on its own. Medicare Advantage plans that include drug coverage, called MA-PDs, are rated separately by CMS.
Fifteen of the 508 rated MA-PD contracts earned five stars for 2027 and carry the high-performing icon on Medicare Plan Finder. About 37 percent of MA-PD contracts, 188 in all, reached four stars or more, and the average overall rating was 3.99, compared with 4.01 for 2026.
A person who is on Original Medicare and picks a separate drug plan is the one affected by the zero. No stand-alone plan carries the five-star label this year, so the rating cannot be used to pick a winner.
CMS also notes that cut points, the score lines between one and five stars, are recalculated each year from that year’s performance. A plan can therefore lose a star without getting worse, if its competitors improve faster.
What does the ratings cycle mean for 2028?
CMS says the 2027 Star Ratings will also feed 2028 quality bonus payments to Medicare Advantage plans. That payment link applies to Medicare Advantage, not to stand-alone drug plans, so the ratings are mainly a shopping signal for people choosing a drug plan.
The agency’s fact sheet says the ratings were adjusted for extreme and uncontrollable circumstances, which for the 2025 performance period included California wildfires and Texas severe storms. It also reports that the nonprofit plans (about 28 percent at four stars or more) and for-profit plans (about 27 percent) perform at similar levels.
CMS says only five stand-alone plans have less than 10 years of experience, and all five earned 3.5 stars or fewer. A plan’s age alone does not predict a high rating, but a newer plan has not yet shown a record of four stars.
Picking a drug plan with no five-star option?
With no five-star stand-alone plan, a medicine list that is longer than a few drugs can cost more under a four-star plan that leaves one brand-name prescription off its formulary. A person who picks on stars alone and finds out in January is stuck until the next enrollment period.
The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, and a prescription-by-plan comparison. Its Automatic Cost Calculator is an Excel file, and Part 2 is the Drug and Doctor Coverage Check.
Get the drug-plan cost calculator and prescription-by-plan comparison →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
