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The U.S. government has released its 2026 Medicare Advantage and prescription drug plan quality ratings, offering insight into how major health insurers performed in providing care to seniors. These annual ratings, issued by the Centers for Medicare & Medicaid Services (CMS), play a key role in determining bonus payments to insurers—worth hundreds of millions or even billions of dollars—and influence plan revenues in 2027.
According to CMS data, CVS Health’s Aetna stands out with over 81% of members enrolled in top-rated plans, while UnitedHealth Group follows closely with 78%. Elevance Health improved significantly, reaching 55% of members in 4-star or higher plans, compared to 40% last year. In contrast, Humana saw only about 20%, or 1.2 million members, in highly rated plans.
Overall, 64% of all Medicare Advantage members with prescription drug coverage are enrolled in plans rated four stars or higher, according to Oppenheimer analysts. These ratings assess factors such as customer satisfaction, access to care, chronic disease management, and preventive health screenings, ensuring seniors can make informed choices when selecting coverage.
CVS Health said more than 63% of its Aetna Medicare Advantage members are in 4.5-star plans for next year. Meanwhile, UnitedHealth reported that 40% of its members are enrolled in 4.5-star or higher plans, consistent with its earlier projections. Analysts described this year’s results as largely expected, following recent company updates.
Centene’s Wellcare, led by CEO Michael Carson, also reported continued improvement, emphasizing the company’s focus on delivering high-quality, affordable healthcare and enhancing health outcomes nationwide.
As competition intensifies, star ratings continue to shape the landscape of the Medicare Advantage market, rewarding insurers that excel in quality and member satisfaction while motivating others to raise their standards.
