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Ahead of the expected release of the Medicare Advantage and Part D star ratings on or around Oct. 9, and after the Centers for Medicare and Medicaid Services mistakenly released MA stars data on Wednesday, Humana has reaffirmed its financial outlook.
Consistent with expectations, roughly 20% of Humana's Medicare Advantage members in 2026 will be enrolled in plans rated four stars and above.
The company has an average MA Star rating of 3.61 for next year, which is in line with last year's rating, according to Seeking Alpha. Plans with 4.5 stars are expected to cover 14% of its members next year, up from 3% in 2025.
"While the company is not satisfied with its 2026 Star Ratings, it is pleased with the tactical operational improvements made during the final months of the 2026 measurement period," Humana said in a regulatory filing, according to the Seeking Alpha report.
WHY THIS MATTERS
Humana, with UnitedHealthcare and CVS Health’s Aetna, are the three largest Medicare Advantage insurers.
In Q2 earnings calls, the insurers announced MA financial headwinds that could cause them to cut back on the number of plans.
Humana's overall strong financial performance was driven by CenterWell Pharmacy, the company said.
Humana said Wednesday that in 2026 it will have Medicare Advantage plan offerings in 46 states and Washington, D.C., covering 85% of U.S. counties. New plan types will be available in four states and 177 counties, broadening geographical access to coverage, the company said.
Humana is expanding its Special Needs Plans (SNP) to new states, it said, including D-SNPs (Dual Eligible) in Illinois and C-SNPs (Chronic Condition) in Idaho, Maine and New Jersey.
Medicare open enrollment runs from Oct. 15-Dec. 7.
More than 80% of Humana Medicare Advantage members will be in plans with stable benefits, the company said. This includes preventive and diagnostic screenings for breast cancer, colon cancer and bone density at no additional cost to members.
All Humana Medicare Advantage plans include dental, vision and hearing coverage, and in many cases, prescription drug coverage.
Approximately 83% of Humana prescription drug plans will have a premium decrease and the maximum out-of-pocket for covered prescriptions, set by the CMS, will be $2,100 for the year.
In 2026, Humana said it would introduce benefits to support members with end-stage renal disease or chronic kidney condition on certain nonspecial needs Medicare Advantage plans in Oklahoma, Texas, North Carolina and Virginia.
The company is currently contesting its 2025 star ratings results, which showed a drop. CMS rewards plans with four or more stars with annual bonus payments, which can be a key factor in an insurer's financial performance. Humana's loss is estimated to be in the billions.
THE LARGER TREND
Releasing its own information, CMS has said average premiums, benefits and plan choices for Medicare Advantage and the Medicare Part D prescription drug program are expected to remain stable in 2026.
Over 99% of Medicare beneficiaries have access to a plan and 97% of Medicare beneficiaries will have access to 10 or more MA plan choices, CMS said.
The total number of available MA plans nationally will decrease slightly from 5,633 in 2025 to approximately 5,600 in 2026.
Average premiums are projected to decline in both the MA and Part D programs from 2025 to 2026, CMS said.
The average monthly plan premium across all MA plans, which includes MA plans that provide prescription drug coverage and MA Special Needs Plans, is estimated by CMS to decrease from $16.40 in 2025 to $14 in 2026. Benefit options will remain stable, including MA supplemental benefit offerings, such as hearing, dental and vision.
Based on plans' projections, enrollment in MA is forecast to be 34 million in 2026, a decrease from 34.9 million in 2025, with MA enrollment representing approximately 48% of all people enrolled in Medicare, compared with 50% in 2025.
CMS said it anticipates that enrollment in MA in 2026 will be more robust than the plans' projections and that enrollment will be stable.
The average standalone Part D plan total premium is projected to decrease from $38.31 in 2025 to $34.50 in 2026. After the application of MA rebates, which reflects what people in MA plans with prescription drug coverage will pay, the average Part D total premium for MA plans with prescription drug coverage is projected to decrease from $13.32 in 2025 to $11.50 in 2026.
Email the writer: SMorse@himss.org