The U.S. Centers for Medicare & Medicaid Services (CMS) has released its 2026 quality ratings for Medicare Advantage (Part C) and Medicare Part D prescription drug plans. The ratings are designed to help Medicare beneficiaries make informed decisions and to reward insurers that deliver high-quality healthcare.
CMS evaluates plans based on 40 quality measures, covering customer satisfaction, chronic disease management, access to care, preventive care, and medication management. Plans achieving 4 stars or higher qualify for quality bonus payments, which insurers can reinvest to enhance benefits, improve services, or reduce premiums.
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Key Highlights of the 2026 Ratings
The average star rating for Medicare Advantage plans dropped to 3.65 in 2026, down from 3.92 in 2025. This decline is attributed to stricter evaluation criteria and higher performance thresholds set by CMS.
Despite the overall decrease, the number of top-performing plans increased. Thirty-four Medicare Advantage plans earned the highest 5-star rating in 2026, compared with seven in 2025. Among these top performers are five Kaiser plans, one Risant Health plan offered by Geisinger, and four plans from Longevity.
High Enrollment in 4+ Star Plans
Several major insurers have a large percentage of members enrolled in high-rated plans. These insurers are:
| Insurer | Percentage of Members in 4+ Star Plans | Notes |
|---|---|---|
| Aetna (CVS Health) | 81% | More than 63% of members in 4.5-star plans |
| UnitedHealth Group | 78% | Large coverage in top-rated plans |
| Elevance Health | 55% | Significant improvement from prior year |
| Humana | 20% | Decrease from 25% in 2025; 14% now in 4.5-star plans |
For Aetna, the majority of members are enrolled in plans rated 4 or higher, with a strong share in 4.5-star plans. UnitedHealth Group maintains nearly 80% of its members in 4+ star plans, while Elevance Health saw significant improvements over the previous year. Humana, despite a lower overall percentage in 4+ star plans, saw a substantial increase in members in 4.5-star plans, rising from 3% in 2025 to 14% in 2026.
Why These Ratings Matter
CMS star ratings directly impact insurer payments. High-rated plans receive quality bonus payments that can be used to reduce premiums or expand benefits, while low-rated plans risk increased oversight or potential contract termination. Beneficiaries enrolled in highly rated plans generally experience better care, improved services, and more preventive health support.
Guidance for Beneficiaries
Medicare beneficiaries are encouraged to review the 2026 Star Ratings when choosing or renewing their plans. Higher-rated plans are generally associated with better access to care, higher patient satisfaction, and additional benefits. Beneficiaries can use the Medicare Plan Finder tool at Medicare.gov to compare ratings, costs, and benefits for different plans in their area.
Frequently Asked Questions (FAQ)
Q: What are Medicare Star Ratings?
A: Star Ratings are evaluations by CMS of Medicare Advantage and Part D plans based on performance in areas such as care quality, member experience, and access to services.
Q: How do star ratings affect beneficiaries?
A: Higher-rated plans often offer better care and additional benefits. They also receive government bonus payments that can reduce premiums.
Q: How can I find a high-rated plan?
A: Use the Medicare Plan Finder tool at Medicare.gov to compare plans by star rating, cost, and coverage.
Q: Have average star ratings changed in 2026?
A: Yes, the average Medicare Advantage rating dropped to 3.65 due to stricter CMS evaluation criteria.