2026 Medicare Advantage Star Ratings: What Changed

Overview

If you’re one of the 33 million Americans enrolled in a Medicare Advantage (MA) plan, the 2026 Star Ratings bring meaningful updates. These scores determine how plans are evaluated by the Centers for Medicare & Medicaid Services (CMS)—affecting bonus payments and, indirectly, the benefits and services available to members.

Access remains strong in 2026: Over 99% of Medicare beneficiaries can choose from at least one MA plan, and 97% have 10 or more options. The total number of available plans will dip slightly—from 5,633 in 2025 to about 5,600—but the overall market remains stable.

This year’s updates reflect CMS’s continued push to refine how plan quality is measured, focusing more on outcomes, equity, and consistent national benchmarks.

Key Terms Explained

Cut-Point Tightening: CMS raised score thresholds, making it harder for plans to achieve top ratings.
Tukey Outlier Rules: Filters extreme results to ensure fairer benchmarks.
Reweighting: Adjusts how much each measure counts; outcomes now weigh more than experience.
New Measures: Adds metrics on maintaining physical and mental health, with lower initial weighting.
EHO4All: Excellent Health Outcomes for All—a revamped equity index rewarding quality across diverse populations.

How Medicare Advantage Plan Ratings Work

Medicare Advantage Star Ratings assess health and drug plans on a 1- to 5-star scale.

★★★★★ — excellent

★★★★ — above average

★★★ — average

★★ — below average

★ — poor

Plan ratings are based on over 40 performance measures covering:

• Clinical outcomes: How well members maintain or improve their health

• Patient experience and access to care

• Customer service and complaint resolution

• Medication adherence and preventive services

Plans earning 4 stars or higher may qualify for CMS quality bonus payments (QBPs), which can help support additional benefits or lower member costs.

How The Top Medicare Advantage Carriers Scored in 2026

Each Medicare Advantage company offers different plans (contracts) in different states. For example, Humana has a Kentucky-specific plan called Humana Insurance Company of Kentucky.

• Centene (Wellcare) — Heavily offers Special Needs Plans (SNPs): 72% SNP (46 of 64). Ratings skew to 3.0–3.5 (35 contracts), with some 4.0.

• BCBS (state plans & affiliates) — Broad mix: strong 4.0/4.5 presence (26 total at ≥4.0). ~40% SNP.

• UnitedHealthcare — Many contracts and generally mid-to-high: solid 4.0/4.5 showing; ~66% SNP.

• Humana — Spread across 3.0–4.5, with a meaningful 4.5 cohort; ~54% SNP.

• Aetna (CVS Health) — Balanced 3.5–4.5, including several 4.5; ~60% SNP.

• Elevance (Anthem/Wellpoint) — Mixed results; several 3.0–3.5 plus some 4.5 outliers; ~73% SNP.

• Cigna — Concentrated 3.0–4.5 with fewer contracts overall; ~71% SNP.

• Kaiser Permanente — Smaller MA footprint in this extract; concentrated 3.5–4.5; minimal SNP availability.

• Molina Healthcare — Mostly 3.0–4.0 in MA, high SNP emphasis.

• SCAN Health Plan — SNP-heavy (~86% SNP) with 4.0–4.5 in established markets and some newer entries.

What Changed in the 2026 Star Ratings

1. Tougher Scoring Across the Board

CMS raised many of the performance thresholds (“cut points”) that determine how plans earn each star level. Roughly 60% of 4-star benchmarks increased, meaning maintaining past performance may not guarantee the same rating.

This continues CMS’s use of Tukey outlier removal—a method that removes unusually high or low data points to create fairer, more stable comparisons.

Takeaway: Ratings now better reflect consistent, high-quality performance rather than outlier results.

2. Rebalanced Measure Weights

The weight of patient experience and access measures decreased from 4 to 2, while outcome measures maintained higher importance. This emphasizes measurable improvements in health outcomes and care management.

Takeaway: Star Ratings now focus more on helping members stay healthy.

3. Introduction of New Quality Measures

CMS introduced new metrics, such as Maintaining Physical and Mental Health, encouraging more holistic care. These measures have lower initial weights while CMS collects and validates data.

Takeaway: Expect growing emphasis on preventive and behavioral health.

4. Focus on Health Equity Through EHO4All

The Health Equity Index evolved into EHO4All (Excellent Health Outcomes for All), rewarding plans that achieve strong outcomes for underserved or at-risk populations.

Takeaway: Equity performance now plays a larger role in assessing quality.

5. Overall Stability Despite Higher Standards

While benchmarks tightened, overall rating distributions stayed steady. CMS reports that the share of enrollees in 4-star or higher plans remained near 2025 levels.

Takeaway: Beneficiaries continue to enjoy strong plan access and quality choices.

Comparison: 2025 vs. 2026 Star Ratings

Sources: CMS.gov; Wakely Consulting; RISE Health, 2025

How These Updates Affect Members

1. Ratings Reflect Stronger Standards

Higher cut-points better differentiate top-performing plans. A lower rating this year doesn’t necessarily mean quality declined—it may reflect tougher benchmarks.

2. Continued Focus on Member Outcomes

Plans are expected to invest more in preventive care, chronic condition management, and engagement programs to improve measurable outcomes.

3. Stable Plan Access and Choice

Despite a slight reduction in plan count, beneficiaries still enjoy broad access: over 99% can choose an MA plan, and 97% have ten or more options.

To see which insurers are offering the strongest overall performance this year, review our list of the best Medicare Advantage companies for 2026.

4. Long-Term Equity Goals

EHO4All reinforces CMS’s long-term goal of reducing care gaps and improving outcomes for all populations.

Understanding 2026 Costs and Coverage

Plan benefits and premiums can shift as quality benchmarks evolve. Reviewing the latest 2026 Medicare plan costs can help you understand how funding and Star Ratings affect what you’ll pay next year.

If you’re deciding between multiple plans, use our 2026 guide to compare Medicare Advantage plans to evaluate networks, drug coverage, and out-of-pocket limits side by side.

How to Use Star Ratings During Enrollment

1. Start early: Check your plan’s 2026 Star Rating on Medicare Plan Finder.

2. Compare carefully: Look at benefits, drug coverage, and provider networks alongside the rating.

3. Stay informed: Understand why a plan’s rating changed before switching—it may reflect stricter scoring.

4. Leverage 5-Star Plans: If available in your area, you can use a Special Enrollment Period to join a 5-star plan.

Quick FAQ

How are Medicare Advantage plans reviewed?
CMS evaluates each plan annually using more than 40 measures related to outcomes, experience, and access to care.

Did ratings go down overall in 2026?
Not necessarily—scores shifted because of higher standards, not widespread declines in performance.

What’s new about equity measures?
The new EHO4All framework rewards plans that deliver strong results for the underserved group.

Conclusion

The 2026 Medicare Advantage Star Ratings reflect CMS’s effort to make quality evaluations more data-driven and outcome-focused. Changes like tighter cut-points, measure reweighting, and EHO4All advance the agency’s goal of improving equity and long-term health outcomes.

For most beneficiaries, plan access remains strong. Use this year’s Medicare Annual Open Enrollment to compare ratings and benefits so you can choose coverage that best fits your health and budget needs.

And if you’re still choosing between plan types, explore our breakdown of Medicare Advantage PPO, HMO, and MSA plans to see which structure best fits your health and budget needs.

For regional insights, visit our Medicare by state resource to compare plan availability and benefits in your area.