Humana said Friday that 95% of its Medicare Advantage members are enrolled in contracts earning at least four stars in the federal government’s 2027 quality ratings, a rebound that strengthens its outlook for bonus payments in 2028 and gives seniors new information ahead of enrollment season.
The Louisville, Kentucky-based insurer said 42% of its Medicare Advantage members are in contracts rated 4.5 stars. Its results include six Medicare Advantage contracts at 4.5 stars and 12 at four stars, with 11 more contracts reaching the four-star threshold than a year earlier. Its standalone prescription drug contract also earned 4.5 stars.
For Humana, the improvement matters financially. Medicare’s ratings help determine quality bonus payments, making the difference between 3.5 and four stars consequential for an insurer’s revenue. For members, the scores provide a comparison of care quality and service as they assess coverage for the coming year.
The timing is important. The 2027 ratings are available for this fall’s enrollment decisions, but their effect on Medicare Advantage quality bonus payments comes in 2028. Higher scores therefore do not establish that a member’s premium will fall or benefits will expand in January.
Humana’s recovery follows a period when weaker ratings threatened its government bonus revenue. The company lost a lawsuit challenging the calculation of its 2025 scores in October 2025, according to Reuters.
Investors welcomed the new results, with Humana shares rising sharply Friday. Evercore ISI analyst Elizabeth Anderson estimated the improved ratings could produce $4.8 billion in 2028 bonus payments. That is an analyst estimate, not a payment already awarded. Baird analysts cautioned that the benefit to profits would depend partly on spending on member benefits and arrangements with healthcare providers.
Humana pointed to increased preventive care as one contributor to its improvement. The company reported that 534,000 additional members completed annual preventive visits compared with the previous year. It also said overdue mammograms completed by 28,000 members identified 600 previously undetected breast cancers.
Those screening figures are company-reported results. They illustrate the care activities behind the ratings, but they do not independently establish that every member will have the same experience.
“We’re extremely proud of these Star Ratings,” Chief Executive Jim Rechtin said in the announcement.
The broader industry results show why enrollment percentages and contract counts should be read separately. The Centers for Medicare & Medicaid Services said approximately 71% of current Medicare Advantage prescription drug plan enrollees are in contracts receiving at least four stars for 2027.
Yet only about 37% of those contracts achieved that rating. Both figures can be true because larger contracts account for more members. CMS evaluates contracts, which can encompass multiple individual plan offerings; the score is not a separate assessment of every local doctor network.
Humana’s stronger scores also arrive alongside a reduction in its plan footprint. In its July 29 earnings call, management said planned 2027 exits were expected to affect approximately 600,000 members, while the company would seek to retain a significant portion in other plans.
That estimate does not mean 600,000 people will leave Humana. It does mean affected members face a coverage decision, even as the insurer’s overall ratings improve. Management linked its approach to prioritizing higher-performing plans and improving profitability.
For seniors comparing options, the star rating is one part of the decision. Medicare advises checking prescription coverage, doctors and pharmacies, monthly premiums, deductibles and estimated annual drug costs. Someone spending part of the year in another state should also check coverage there.
Network rules differ by plan type. HMOs generally require members to use participating providers for routine care, while PPOs allow more out-of-network access, often at a higher cost. Medicare Advantage plans also typically require prior authorization for certain services or supplies.
The next deadline is close. Medicare’s annual enrollment period runs October 15 through December 7, 2026, with coverage changes generally taking effect January 1, 2027. Members whose plans are ending should review their notices and available replacements. Free, independent counseling is available through State Health Insurance Assistance Programs.
For Humana, enrollment will help determine how much of the ratings recovery translates into future revenue. For members, the immediate task is choosing coverage that fits their prescriptions, providers and budget.
JBizNews Desk | Louisville, Ky.
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