AEP 2027 scorecard: more members in 4-star plans, fewer counties for some big insurers

Medicare’s annual enrollment period runs Oct 15 to Dec 7. Here is where the Medicare Advantage (MA) market stands in the public data, with dates. Which insurers actually gain members won’t be known until CMS publishes early-2027 enrollment counts.

Star Ratings moved toward 4 stars

CMS’s Oct 8 fact sheet puts the average 2027 star rating for MA prescription drug (MA-PD) contracts at 3.99, against 4.01 for 2026. About 37% of MA-PD contracts offered in 2027, or 188, earned 4 stars or more.

Weighted by enrollment, about 71% of MA-PD members are in contracts with 4 or more stars for 2027. CMS’s table for 2026 adds up to about 67%. The share of members in 4.5-star contracts fell from about 39% to 33%, while the 4-star share rose from about 26% to 36%. Members in contracts at 3 stars or below rose from about 7% to 10%. For standalone drug plans, 22% of enrollees are in 4-star or better contracts, up from 2% in 2026. These ratings set 2028 quality bonus payments.

Plans and counties

CMS projects about 5,532 MA plans for 2027, against 5,553 in 2026, and says about eight in 10 MA members can stay in their current plan at the same or a lower premium.

The footprint changes are uneven. KFF’s county analysis of CMS data shows Devoted Health entering 342 counties and leaving none. CVS Health enters 63 counties and leaves 186. UnitedHealth Group leaves 228 and enters 9. Humana leaves 62 and enters 4. Health Care Service Corporation leaves 498 and enters none, and Centene leaves 359 and enters 15. Molina and Group 1001 (Clear Spring Health) are leaving the MA-PD market, though Molina still offers special needs plans in many counties. KFF counts 193 counties, home to about 638,000 people with Medicare, with no MA-PD plan for general enrollment, up from 123 counties.

Actuary Jared Strock, whose public LinkedIn posts led us to this story, counts about 3.1 million MA members in a plan that is ending or leaving their county for 2027, by his reading of the CMS plan crosswalk. We have not recomputed that figure from the CMS files.

Earnings

UnitedHealth Group, one of the two largest MA insurers per KFF, reported 7.605 million MA members on Sept 30, 2026, against 8.445 million at the end of 2025. It said at least 69% of its members are in 4-star or better plans for 2027 and raised its 2026 adjusted earnings outlook to at least $20.50 a share.

Why it matters

With most members now just above the 4-star line and several big insurers shrinking their maps, this AEP rewards whoever wins the members who are forced to choose a new plan.