The latest medicare advantage star ratings 2026 news shows a year of stability but also tighter scoring, fewer perfect-rated contracts, and growing pressure on insurers to maintain quality.
If you’re enrolled in medicare advantage marketing rule judge decision or planning to review options during Open Enrollment these 2026 ratings matter more than ever. Star ratings influence plan bonuses, extra benefits, and long-term value.
Here’s everything you need to know.
Quick Overview of 2026 Medicare Advantage Star Ratings
Here are the most important updates for 2026:
- ⭐ Enrollment-weighted average rating: 3.98
- ⭐ Average MA-PD contract rating: 3.66
- ⭐ Around 40% of contracts earned 4 stars or higher
- ⭐ Approximately 64% of members are in 4+ star plans
- ⭐ 18 Medicare Advantage contracts earned 5 stars
- ⭐ Patient experience measures now carry less weight than in prior years
- ⭐ 2026 ratings impact 2027 bonus payments
Although the overall average improved slightly, ratings remain below pre-2023 highs.
What Are Medicare Advantage Star Ratings?
Each year, Medicare Advantage plans are graded on a scale of 1 to 5 stars based on quality and performance.
Plans are evaluated on:
- Preventive screenings
- Chronic disease management
- Medication adherence
- Customer service
- Member complaints
- Appeals handling
- Health outcome improvements
⭐ 5 Stars = Excellent
⭐ 4 Stars = Above Average
⭐ 3 Stars = Average
⭐ Below 3 Stars = Performance concerns
These ratings are visible to consumers and directly tied to bonus payments that help fund plan benefits.
Did Medicare Advantage Ratings Improve in 2026?
Yes but only slightly.
The enrollment-weighted average increased from 3.95 in 2025 to 3.98 in 2026. However, fewer contracts reached the 5-star level compared to peak years.
More contracts are now clustered in the 3.5-star range. That means competition is tighter, and earning 4+ stars is becoming harder.
5-Star Medicare Advantage Plans in 2026
- 18 Medicare Advantage Prescription Drug (MA-PD) contracts earned 5 stars.
- 2 standalone prescription drug plans reached 5 stars.
- Only a handful repeated 5-star status from the previous year.
Several well-known parent organizations operate high-performing contracts in certain states, including:
- UnitedHealth Group
- Elevance Health
- Humana
- Aetna
However, ratings vary by contract and location. One insurer may have a 4.5-star plan in one county and a 3.5-star plan in another.
Always check your exact plan not just the brand name.
Major Changes Behind the 2026 Ratings
Several technical adjustments shaped this year’s results.
Patient Experience Weight Reduced
Survey-based patient experience measures now count less toward overall scores. This change shifts more emphasis toward clinical outcomes and medication performance.
New Chronic Care Measures
A kidney health evaluation measure for diabetes patients was introduced. Chronic condition management remains central to quality scoring.
Returning Physical & Mental Health Measures
Measures evaluating improvements in physical and mental health returned after technical updates. Their scoring weight will increase further next year.
Stricter Cut Points
Each year, scoring thresholds are recalculated. As top plans improve, it becomes harder for others to reach 4 or 5 stars.
Nonprofit vs For-Profit Performance in 2026
An interesting trend in the medicare advantage star ratings 2026 news is the performance gap between nonprofit and for-profit organizations.
- Around 50% of nonprofit MA-PD contracts earned 4+ stars
- About 36% of for-profit contracts reached 4+ stars
While this doesn’t apply uniformly in every region, nonprofit plans showed stronger overall performance distribution.
Standalone Part D Plan Ratings
Prescription drug-only plans saw more pressure this year.
- Enrollment-weighted average dropped to 3.01
- Only about 23% of contracts earned 4+ stars
- Very few enrollees are currently in high-rated standalone drug plans
Medication adherence remains one of the most difficult measures across the industry.
Why 4-Star Ratings Matter So Much
Plans that earn 4 stars or higher qualify for 5% quality bonus payments.
These bonus payments often fund:
- Dental allowances
- Vision coverage
- Hearing benefits
- Over-the-counter (OTC) cards
- Reduced premiums
- Transportation services
If a plan drops below 4 stars, it may lose bonus eligibility which can impact benefits in the following year.
That’s why 2026 ratings are especially important for 2027 coverage.
Where Plans Struggled in 2026
Some measure-level trends showed pressure:
- Breast cancer screening scores declined.
- Diabetes blood sugar control ratings slipped slightly.
- Some readmission measures fluctuated.
- Medication adherence remains inconsistent.
At the same time, improvements were seen in:
- Post-discharge medication reconciliation
- Care management for needs plans
- Drug pricing accuracy
These mixed results show ongoing industry adjustment after pandemic-related disruptions.
What This Means for American Old Peoples
Many beneficiaries are concerned about:
- Rising out-of-pocket costs
- Reduced supplemental benefits
- Narrowing provider networks
- Plan exits in certain counties
- Confusing benefit structures
Star ratings don’t tell the whole story but they provide a strong quality signal.
If your plan’s rating declined:
- Review your 2027 benefits carefully.
- Compare options during Open Enrollment.
- Check provider network updates.
- Review prescription drug coverage.
Even if your rating stayed the same, plan details can change year to year.
Should You Switch Medicare Advantage Plans?
Not necessarily.
Instead:
- Compare total costs (premium + copays + max out-of-pocket).
- Confirm your doctors remain in-network.
- Review your medication formulary.
- Check whether your plan maintained 4+ star status.
- Look at additional benefits, not just ratings.
Star ratings are one decision tool but they shouldn’t be the only factor.
FAQs
Q:What are Medicare Advantage star ratings?
Ans:Medicare Advantage star ratings are annual quality scores from 1 to 5 stars that evaluate plan performance based on clinical care, customer service, preventive screenings, medication adherence, and member satisfaction.
Q:Did Medicare Advantage ratings improve in 2026?
Ans:Slightly. The enrollment-weighted average increased from 3.95 in 2025 to 3.98 in 2026. However, fewer contracts reached 5-star status compared to earlier years.
Q:How many 5-star Medicare Advantage plans are there in 2026?
Ans:In 2026, 18 Medicare Advantage contracts and 2 standalone drug plans earned 5-star ratings.
Q:Why are fewer plans earning 5 stars?
Ans:Scoring thresholds were recalculated, patient experience weighting changed, and new quality measures were introduced. These adjustments make earning top-tier ratings more competitive.
Q:Do star ratings affect my benefits?
Ans:Yes. Plans with 4 or more stars qualify for bonus payments, which often help fund additional benefits like dental, vision, and OTC allowances.
Q”Can I switch to a 5-star plan anytime?
Ans:Yes. There is a special enrollment opportunity that allows eligible beneficiaries to switch to a 5-star plan once per year if available in their area.
Q:Should I leave a 3.5-star plan?
Ans:Not automatically. Review your total costs, provider access, and coverage details before making a decision. Ratings are important, but plan value varies by individual needs.
Final Thoughts on Medicare Advantage Star Ratings 2026 News
The medicare advantage star ratings 2026 news reflects a stabilizing but increasingly competitive market. While overall averages improved slightly, fewer contracts reached elite status, and performance gaps between plans remain significant.
For Old People, the key takeaway is simple:
Review your plan every year
Compare benefits beyond premiums
Use star ratings as a quality guide
Don’t assume last year’s plan is still your best option
Healthcare decisions become more important each year. Staying informed can protect both your coverage and your wallet.
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