Medicare Advantage Star Ratings 2026: Winners and Losers

Medicare Advantage star ratings for 2026 are flat, with variation among major insurers. UnitedHealthcare and Elevance improved, while Humana and Aetna declined. Clover Health's largest contract dropped below 4 stars, potentially costing it tens of millions of dollars. The ratings are tied to bonuses and rebates.

The Centers for Medicare & Medicaid Services (CMS) recently released the 2026 Medicare Advantage (MA) Star Ratings, revealing a mixed bag of results for major insurers. While some companies improved their ratings, others experienced declines, potentially impacting their financial performance.

UnitedHealthcare (UNH) and Elevance (ELV) saw improvements in their ratings. UnitedHealthcare's 2026-Star Ratings were in line with its prior announcements, with 78% of its members in top-rated plans CVS Health, Clover update on Medicare Star Ratings for 2026^[1]. Elevance also reported an increase in its Star Ratings, with 55% of its members in top-rated plans CVS Health, Clover update on Medicare Star Ratings for 2026^[1].

However, Humana (HUM) and Aetna, the health insurer operated by CVS Health (NYSE:CVS), experienced declines in their ratings. Humana's 2026-Star Ratings were also in line with its prior announcements, with 20% of its members in top-rated plans CVS Health, Clover update on Medicare Star Ratings for 2026^[1]. Aetna reported that more than 81% of its MA members are in Medicare Advantage Prescription Drug (MAPD) plans rated 4 stars or above, but over 63% of Aetna MA enrollees are in a 4.5-star plan for 2026 CVS Health, Clover update on Medicare Star Ratings for 2026^[1].

Clover Health (NASDAQ:CLOV) received 3.5 Stars for its PPO MA plans and 4.0 Stars for its HMO MA plan, which will impact the 2027 payment year Clover Health Comments on 2026 Medicare Advantage Star Ratings and Trajectory for Increasing Profitability into 2027^[2]. The company has expressed confidence in its ability to drive above-market membership growth and increasing Adjusted EBITDA profitability through 2027, citing AI-driven improvements in its Clover Assistant and increased physician adoption Clover Health Comments on 2026 Medicare Advantage Star Ratings and Trajectory for Increasing Profitability into 2027^[2].

The 2026-Star Ratings are tied to bonuses and rebates, making them a key determinant of insurers' financial performance. The ratings will affect the 2027 payment year, with the next Medicare Open Enrollment period set to get underway from Oct. 15 to Dec. 7 CVS Health, Clover update on Medicare Star Ratings for 2026^[1]. The Star Ratings methodology places disproportionate weight on non-outcomes measures, such as member experience surveys and administrative processes, rather than actual clinical outcomes and health improvements Clover Health Comments on 2026 Medicare Advantage Star Ratings and Trajectory for Increasing Profitability into 2027^[2].

The mixed results of the 2026-Star Ratings underscore the importance of insurers' ability to adapt to changing regulatory environments and maintain high-quality care for their members. As the industry continues to evolve, insurers will need to focus on delivering real clinical outcomes and improving health outcomes for their members to thrive.