On Friday, October 9, the American insurance company Humana revealed that 95% of its Medicare Advantage members are now part of contracts that have achieved a rating of four stars or higher for 2027. These ratings are based on evaluations by the Centers for Medicare & Medicaid Services (CMS).
The company also disclosed that 42% of its Medicare Advantage enrollees are in plans rated at 4.5 stars. These updated scores, released by CMS on Thursday, October 8, arrive just in time before the Medicare Open Enrollment period, which kicks off on October 15.
Humana's Significant Leap in High-Star Contracts
According to Humana's initial announcement, the number of Medicare Advantage contracts achieving at least four stars has jumped to 18 for 2027. This includes six contracts with a 4.5-star rating and twelve with a four-star rating, marking an increase from seven to eleven contracts compared to the previous year.
In addition, Humana's standalone prescription drug plan, known as Part D or PDP, also received a 4.5-star rating for 2027. The company credits this improvement to its proactive healthcare initiatives and diligent member follow-ups. Humana reported that 534,000 more individuals completed an annual preventive visit, and 663,000 additional care opportunities were addressed compared to the prior period.
Comparing Humana's Performance with Other Insurers
In the official 2027 ratings report, CMS noted that roughly 71% of members in Medicare Advantage with drug coverage (MA-PD) contracts are currently in plans that will receive four stars or more in the upcoming year. However, only 37% of the MA-PD contracts available in 2027, totaling 188 contracts, reached that level. The variance in percentages arises due to differing member counts across contracts.
Humana's 95% figure pertains to its Medicare Advantage population, whereas the 71% national figure from CMS specifically relates to MA-PD contracts. Thus, while they serve as performance benchmarks, they do not represent identical populations.
Spotlight on Florida's High-Rated Contracts
Florida is among the states highlighted in Humana's top-rated contracts. Humana Medical Plan, Inc., identified by contract H1036, earned 4.5 stars, whereas CarePlus Health Plans, Inc., contract H1019, secured four stars for 2027, according to the company's report.
This is particularly significant for beneficiaries in South Florida, including Miami-Dade and Broward counties. However, it does not imply that all Humana options in these areas come with the same conditions. Ratings are assigned to contracts, which may encompass various plans. The availability of enrollment, along with premiums, copays, covered medications, and physician networks, depends on the location and specifics of each product.
Understanding Medicare's Star Ratings
Medicare evaluates insurer contracts on a scale from one to five stars based on factors such as quality of care, customer service, and patient experience. For 2027, contracts combining Medicare Advantage and drug coverage were assessed using up to 43 quality and performance measures.
These scores allow for comparisons among insurers, but a high rating doesn't necessarily ensure a lower premium, comprehensive drug coverage, or the retention of a beneficiary's usual doctors. The star ratings also carry financial implications for insurers. CMS stated that the 2027 ratings will influence Medicare Advantage quality incentive payments for 2028, not 2027.
How to Evaluate Your Plan Before 2027 Enrollment
Current Humana members or those considering joining can check ratings and available options on the official Medicare Plan Compare tool. Entering a ZIP code reveals the plans offered in each area.
In addition to star ratings, it's important to review monthly premiums, deductibles, out-of-pocket limits, covered medications, and whether the usual doctors, hospitals, and pharmacies are within the plan's network. Current enrollees should examine the Annual Notice of Change, which outlines any anticipated modifications for the upcoming year.
In a previous guide, CiberCuba explained how to compare Medicare coverages for 2027 before the period for making changes begins.
The Medicare Open Enrollment period runs from October 15 to December 7, 2026. Changes made during this time will take effect on January 1, 2027. Beneficiaries seeking official assistance can contact 1-800-MEDICARE (1-800-633-4227).
Frequently Asked Questions about Medicare Advantage Star Ratings
What are the implications of Humana's star ratings for 2027?
Humana's high star ratings for 2027 indicate improved service and quality in their Medicare Advantage plans. This could lead to increased customer satisfaction and potentially influence the financial incentives they receive.
How does Medicare determine the star ratings for insurance contracts?
Medicare uses a range of up to 43 quality and performance measures to evaluate contracts, including quality of care, patient experience, and customer service, to score them from one to five stars.
Can a higher star rating guarantee lower premiums or better coverage?
No, a higher star rating does not guarantee lower premiums or comprehensive coverage. It reflects the quality and performance of the plan but does not assure specific cost or coverage benefits.