2027 Star Ratings and Plan Finder Timing: What Independent Medicare Agents Should Tell Clients

Independent Medicare agents need to keep three dates and concepts separate heading into the 2027 plan year:

•       Medicare releases information about next year’s plans beginning in October.
•       Prospective marketing for the upcoming plan year begins October 1, subject to CMS and carrier requirements.
•       Medicare Open Enrollment begins October 15 and ends December 7.

Clients often combine those dates into one question:

“When can I see next year’s plans, and when can I change?”

The agent’s job is to explain the difference clearly without relying on preliminary information.

What Happens in Early October, and What Waits Until October 15?

Early October is when beneficiaries begin getting access to finalized information about the upcoming Medicare Advantage and Part D plan year.

CMS states that information for next year’s plans becomes available beginning in October.

That information can include:

•       Available Medicare Advantage plans
•       Part D plans
•       Premiums
•       Deductibles
•       Benefits
•       Formularies
•       Star Ratings
•       Other approved plan-year information

However, access to next-year plan information does not mean the Annual Enrollment Period has begun.

Medicare Open Enrollment runs:

October 15 through December 7.

During that period, beneficiaries may make eligible Medicare Advantage and prescription drug plan changes for coverage beginning January 1.

A simple client explanation is:

October is when next-year information becomes available. October 15 is when AEP enrollment begins.

Should Agents Quote 2027 Premiums in September?

Do not present preliminary information as final.

During September, agents and organizations may receive preliminary or industry-facing plan information through carriers, FMOs, quoting platforms, or CMS processes.

That does not mean the information should automatically be presented to beneficiaries as finalized 2027 plan data.

Before giving a beneficiary a specific premium, benefit, formulary, network, or cost-sharing amount for 2027:

1.     Confirm that the information is final.
2.     Use an approved source.
3.     Make sure the material is authorized for beneficiary use.
4.     Follow the applicable prospective marketing date and carrier requirements.

If the information is preliminary, say so internally and wait for finalized beneficiary-facing information before representing it as final.

What Should Agents Tell Clients in September?

Keep the message simple.

For example:

“Your plan may change for 2027. We can review your ANOC now and identify the questions we need to revisit once finalized 2027 plan information is available in October.”

That is more accurate than giving a client an unconfirmed premium or benefit.

September is useful for:

•       ANOC reviews
•       Updating medication lists
•       Updating providers
•       Updating pharmacies
•       Identifying travel needs
•       Confirming Medicaid or LIS status
•       Documenting plan concerns
•       Preparing October follow-up

It should not become a period for presenting unapproved prospective plan information as final.

What Are the 2027 Star Ratings?

Medicare Star Ratings help beneficiaries compare Medicare Advantage and Part D plan quality.

CMS publishes Star Ratings annually and displays them through Medicare’s plan-comparison resources.

Before final publication, Medicare Advantage and Part D sponsors receive plan preview periods.

The second plan preview generally occurs in September and includes preliminary Star Rating information so sponsors can review the data before it becomes public.

That preliminary information should not be treated as a final beneficiary-facing rating.

Should Agents Talk About Draft Star Rating Cutpoints?

Generally, not with beneficiaries.

Draft or preliminary cutpoints can be useful for internal industry analysis.

They are not the number the beneficiary should use to make a plan decision.

If an agent sees preliminary information suggesting a contract’s Star Rating could change, the safer process is:

•       Wait for the final rating.
•       Verify it using the official Medicare plan information.
•       Then explain the final rating if it is relevant to the beneficiary’s comparison.

Do not call a beneficiary in September and tell them that their plan “lost a star” based solely on preliminary preview data.

Are the 2027 Star Ratings Rules Changing?

CMS finalized changes to the Star Ratings program for 2027 and later years.

One important distinction is timing.

CMS finalized removal of 11 measures as part of its effort to streamline the Star Ratings measure set, but agents should not casually describe every 2027 rating movement as being caused by those measure removals.

Star Ratings methodology is technical, and different changes apply to different measurement and rating years.

For beneficiary conversations, focus on the final plan rating displayed by Medicare rather than trying to interpret preliminary cutpoint mechanics.

How Should Agents Explain a Star Rating Change?

Use neutral language.

For example:

“Medicare updates Star Ratings each year using its quality methodology. This plan’s current rating is X stars. The rating is one factor we can consider along with your doctors, prescriptions, costs, network, and benefits.”

Do not imply:

•       A higher-rated plan is automatically the best plan for everyone.
•       A lower-rated plan is automatically a bad plan.
•       Star Ratings replace an individualized coverage review.

Star Ratings are one comparison factor.

What’s Changing With Medicare Advantage Provider Directories?

CMS is implementing changes intended to improve provider-directory information available to beneficiaries.

For the 2027 plan year, Medicare Advantage organizations are required to provide provider-directory data for online publication and attest at least annually that the submitted information is accurate.

CMS also requires MA organizations to update provider-directory data when they become aware of changes, according to applicable requirements and technical guidance.

This is intended to improve transparency and make provider information easier to use during plan comparisons.

It does not eliminate the need for verification.

Should Agents Trust Medicare Plan Finder Provider Information Without Checking?

No.

Use the directory as an important source, not an absolute guarantee.

For any provider that materially affects the beneficiary’s decision:

1.     Search the current plan-year directory.
2.     Verify the specific physician or facility.
3.     Confirm the specific plan, not only the carrier.
4.     When appropriate, confirm participation with the provider.
5.     Document when and where you checked.

Do not say:

“Baylor, CHRISTUS, or another system accepts this carrier.”

Instead ask:

“Does this specific physician or facility participate with this specific plan?”

Provider participation can vary across contracts and products.

Should Agents Screenshot Provider Directory Results?

Documentation can be useful.

If a beneficiary’s plan decision materially depends on a particular provider being in-network, retain appropriate documentation of what was reviewed at the time of the comparison, subject to your organization’s privacy, record-retention, and compliance procedures.

That could include:

•       Date checked
•       Plan
•       Provider
•       Directory source
•       Result
•       Notes from provider confirmation

Do not store unnecessary sensitive information merely for convenience.

What Should I Tell a Client Who Calls in September Asking About 2027 Costs?

Explain that different Medicare costs become final on different timelines.

A client’s Medicare costs may involve:

•       Part B premium
•       Part B deductible
•       Medicare Advantage premium
•       Part D premium
•       Drug deductible
•       Copays
•       Coinsurance
•       IRMAA
•       Other plan-specific costs

Do not combine all of those into one statement such as:

“Your 2027 Medicare cost is $X.”

For MA and Part D, use finalized plan-year information when available.

For Original Medicare Part A and Part B costs, use CMS’s official annual announcements once released.

How Does October 1 Affect Marketing?

October 1 is the beginning of the prospective marketing period for upcoming Medicare Advantage and Part D plan offerings.

Agents should not market prospective 2027 plan offerings before that permitted date.

Beginning October 1, agents may use approved prospective 2027 marketing materials subject to:

•       CMS requirements
•       Carrier requirements
•       FMO or agency compliance requirements
•       Applicable TPMO requirements
•       Applicable Scope of Appointment rules
•       Contact-permission requirements

Do not assume that being able to see preliminary information before October 1 means it may be marketed.

What Changes on October 15?

October 15 begins Medicare Open Enrollment.

From October 15 through December 7, beneficiaries may make eligible changes involving Medicare Advantage and Medicare prescription drug coverage for the upcoming year.

For elections made during AEP, coverage generally begins January 1.

This is when comparison work can move into eligible enrollment activity.

What Should the September-to-October Workflow Look Like?

September 15–30: Prepare

•       Review ANOCs.
•       Update beneficiary providers.
•       Update medications.
•       Update pharmacies.
•       Confirm annual certifications.
•       Review carrier compliance materials.
•       Clean CRM data.
•       Identify clients needing priority follow-up.
•       Prepare approved October communications.
•       Do not present preliminary 2027 information as final.

Beginning October 1: Verify Finalized Information

As finalized 2027 information becomes available:

•       Confirm plan availability.
•       Verify premiums.
•       Review formularies.
•       Verify providers.
•       Review pharmacies.
•       Check final Star Ratings.
•       Update comparison notes.
•       Begin permitted prospective marketing using approved materials.

Do not assume every data element becomes available at exactly the same moment.

Use the authoritative source currently available for each item.

October 1–14: Compare and Prepare

Use the pre-AEP period to:

•       Review finalized information with clients as permitted.
•       Prepare individualized comparisons.
•       Complete applicable Scope of Appointment requirements.
•       Verify providers and medications.
•       Schedule AEP enrollment appointments.

Do not submit an AEP election before the enrollment period opens unless another valid enrollment period applies.

October 15–December 7: AEP

During Medicare Open Enrollment:

•       Complete individualized plan comparisons.
•       Review beneficiary priorities.
•       Verify plan information.
•       Complete required compliance steps.
•       Submit eligible enrollments.
•       Maintain appropriate documentation.

How Should OmniReach Support This Workflow?

OmniReach can be configured to help agents separate stages of the annual review process.

Useful tags or fields may include:

•       ANOC reviewed
•       Provider update needed
•       Prescription update needed
•       Pharmacy update needed
•       Follow-up after October 1
•       Final Star Rating reviewed
•       Plan comparison completed
•       SOA completed
•       AEP appointment
•       Enrollment submitted

Automations can help organize reminders and follow-up.

They do not determine whether plan information is final, approved, or compliant for beneficiary use.

The agent must still verify the information.

What Should Agents Avoid?

Avoid these common mistakes:

Quoting Preliminary Information as Final

If the carrier, FMO, or quoting system labels something preliminary, treat it as preliminary.

Using Draft Star Ratings With Clients

Wait for the final published rating.

Assuming Provider Directories Are Perfect

The new attestation requirements improve accountability but do not eliminate potential errors.

Marketing Before the Permitted Date

Do not market prospective upcoming-year plan offerings before October 1.

Confusing October 1 With AEP

October 1 is not the first day a beneficiary can make an AEP election.

AEP begins October 15.

Treating Star Ratings as the Whole Comparison

Doctors, prescriptions, costs, benefits, networks, and individual circumstances also matter.

Where TMS Insurance Brokerage Fits

TMS Insurance Brokerage helps independent Medicare agents build repeatable annual-review and AEP workflows.

Agent resources include:

•       OmniReach CRM
•       Dedicated Agent Success Manager support
•       Medicare-focused training
•       Carrier contracting support
•       Medicare Agent IQ education
•       Qualifying Brokerage Bucks marketing support

For the September-to-October transition, OmniReach can help agents identify which clients have completed ANOC reviews, which need provider or prescription verification, and which need follow-up once finalized next-year information becomes available.

The system organizes the process.

The agent remains responsible for verifying current CMS and carrier information before making representations to beneficiaries.

Keep the Dates Straight

The simplest framework is:

September: Review, organize, and prepare.

Beginning in October: Verify finalized next-year Medicare plan information as it becomes officially available.

October 1: Prospective upcoming-year marketing may begin, subject to applicable rules.

October 15: Medicare Open Enrollment begins.

December 7: Medicare Open Enrollment ends.

Clients do not need every technical detail behind CMS data releases.

They need an agent who knows the difference between preliminary and final information, verifies providers and medications, and uses the correct Medicare calendar.

That is the workflow that reduces surprises once AEP begins.