2027 Medicare Advantage star ratings: Humana returns to 95% of members in 4-star plans as Alignment's main contract falls to 3.5 stars, October 8, 2026

Humana now has about 95% of its Medicare Advantage members in plans rated four stars or higher, up from about 20% a year earlier, after the Centers for Medicare & Medicaid Services published its 2027 star ratings on Thursday, October 8, 2026. Alignment Healthcare moved the other way: its California HMO contract, which serves about 75% of its health plan members, fell to 3.5 stars from 4.0.

Both stocks moved after the regular session had ended. Humana closed Thursday at $387.12, down 2.37%, and Alignment closed at $8.71, up 1.87%. Once the ratings were out, Investing.com reported Humana 16.5% higher and Alignment 21.4% lower in after-hours trading.

The 2027 ratings by insurer

Why half a star moves these stocks

Four stars is the threshold for Medicare's quality bonus payments, and the money follows the ratings with a lag: ratings published in October 2026 set the bonuses paid in 2028. Alignment said the downgrade does not change its revenue for 2026 or 2027 and does reduce its quality bonus payments for 2028. Investing.com described Humana's largest contract, back at four stars from 3.5, as restoring the insurer's eligibility for those payments. Where a large contract lands relative to four stars decides the bonus on that contract's members two years later.

Humana's round trip

In the 2024 ratings 94% of Humana's members were in four-star plans. For 2025 that fell to about 25%, roughly 1.6 million members, after contract H5216, which held about 45% of Humana's Medicare Advantage members and more than 90% of its employer group members, dropped to 3.5 stars from 4.5. The 2026 ratings left Humana at about 20%. The 2027 ratings return it to about 95%, close to the 94% of the 2024 ratings. Aetna's share fell over the same years, to more than 69% for 2027 from more than 81% for 2026 and 88% for 2025.

Alignment's press release and its membership

Alignment's announcement led with six of seven eligible contracts rated four stars or higher, three of them at 4.5 stars. The seventh is H3815, the California HMO, and the company's filing with the SEC put its membership at about 75% of the total. By membership, three quarters of Alignment's business is now in a plan below the bonus threshold. The company said it is expanding care-gap and quality programs to bring H3815 back to at least four stars in later rating years.

The program as a whole

CMS rated 508 Medicare Advantage prescription drug contracts for 2027. About 37% of them earned four stars or more, against about 40% for 2026, yet the share of enrollees in four-star contracts rose to about 71% from about 64%. Fewer contracts cleared the threshold, and the ones that did hold more members; Humana's largest contract is one of them.