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The Trump administration has released the 2026 quality ratings for Medicare health and prescription drug plans, showing that several leading players in the market slipped under stricter evaluation standards.
The Centers for Medicare and Medicaid Services (CMS) published the new ratings on Oct. 9, assessing Medicare Advantage (MA) and Part D plans based on criteria such as customer satisfaction, access to care, cancer screenings, and management of chronic conditions.
Plans that earn higher “star” ratings receive larger federal bonus payments, which can amount to hundreds of millions or billions of dollars.
According to an analysis by research platform Oppenheimer, 64 percent of MA enrollees are in plans that will have four or more stars in 2026, roughly in line with 2025’s level of 62 percent. The firm said the results largely met expectations and mirrored early disclosures from several major insurers.
UnitedHealthcare Holds Steady; Humana and Aetna Slip
UnitedHealthcare and Humana, the two largest MA carriers with 10.3 million and 5.8 million members respectively, had already previewed their fiscal 2026 results.
UnitedHealthcare disclosed in a filing with the Securities and Exchange Commission (SEC) that about 78 percent of its members will be in plans rated four stars or higher next year, largely unchanged from 2025.
Humana, meanwhile, told the SEC that about 20 percent of its members will be enrolled in plans rated at least four stars for 2026, a drop from 25 percent in 2025.
CVS-owned Aetna, the third largest MA insurer with 4.2 million members, also saw a decline. The company announced on Oct. 9 that 81 percent of its members will be in plans rated four stars or above, compared to 88 percent this year. Still, Aetna noted that more than 63 percent of its members are in plans rated 4.5 stars or higher.
“I am proud of the way our teams show up every day to support our members,” Aetna President Steve Nelson said.
Aetna also highlighted strong performances among some of its top-rated contracts, including its H5521 plan, which covers 1.1 million members across 33 states and earned 4.5 stars for the second consecutive year.
Bright Spots for Elevance and Centene
Elevance Health posted some notable improvements, with 53 percent of its 2.2 million MA members in plans rated at least four stars for 2026, up from about 40 percent this year. Elevance was among the largest gainers in quality ratings, according to Oppenheimer.
Centene also made significant gains, hiking the percentage of its members in the highly rated plans from 1 percent this year to more than 18 percent next year.
Michael Carson, president and CEO of Wellcare, Centene’s Medicare business, said he was “pleased with the continued progress reflected in this year’s star ratings.”
“We’re focused on building on this momentum—ensuring our members receive high-quality, affordable care and continuing to improve health outcomes in the communities we serve,” he said.
