Highmark's Medicare Advantage Plans Receive High Quality Ratings from CMS

Highmark's Medicare Advantage plans in Pennsylvania, Delaware, and New York achieved a 4.0 or higher quality rating from the Centers for Medicare and Medicaid Services (CMS). Highmark's HMO and PPO plans in Pennsylvania and New York achieved a 4.5 quality rating, and its Medicare Advantage PPO plans in West Virginia achieved a 3.5 quality rating. Highmark ranks #2 among the top ten largest Medicare Advantage carriers by enrollment, with 95% of members enrolled in a plan 4 Stars or higher.

Clover Health Investments Corp. (Nasdaq: CLOV) has announced its 2026 Medicare Advantage portfolio, reinforcing its leadership in affordable, high-choice PPO plans. The company's offerings come as the Annual Enrollment Period opens from October 15 to December 7, 2025. Clover's plans will be accessible to 5.2 million Medicare-eligible beneficiaries across 203 counties in 5 states, with a focus on maintaining and enhancing benefits for all members, according to Clover Health’s 2026 plans.

Clover Health's 2026 Medicare Advantage offerings include $0 to low monthly premiums for both MAPD PPOs and MA only plans with a Part B Giveback. The company has ensured that 100% of its members will have stable or improved benefits for 2026, emphasizing continuity and predictability for seniors. This commitment is driven by the AI-powered Clover Assistant platform, which supports clinical decision-making and improves health outcomes through early identification and management of chronic diseases.

The Clover Assistant platform has demonstrated significant benefits, such as doctors starting diabetes oral medications three years earlier on average and diagnosing chronic kidney disease over 1.5 years earlier. These earlier interventions have been associated with reduced reliance on insulin and lower incidence of hypoglycemia, as well as decelerating the decline of kidney function for CKD patients.

Clover Health's focus on PPO plans stands out amidst the industry's shift toward narrower HMO networks. The company's approach has contributed to a 32% year-over-year growth in MA members, reflecting the value and impact of its data-driven technology platform.

Meanwhile, Highmark's Medicare Advantage plans in Pennsylvania, Delaware, and New York achieved a 4.0 or higher quality rating from the Centers for Medicare and Medicaid Services (CMS). Highmark's HMO and PPO plans in Pennsylvania and New York achieved a 4.5 quality rating, while its Medicare Advantage PPO plans in West Virginia achieved a 3.5 quality rating. Highmark ranks #2 among the top ten largest Medicare Advantage carriers by enrollment, with 95% of members enrolled in a plan 4 Stars or higher .