Medicare Advantage
The star ratings behind $13 billion in bonuses
Medicare will pay Advantage plans at least $13.4 billion in quality bonuses this year, a new KFF analysis finds. The stars you shop by are the same stars that set those payments.
By the Goodsurance editorial teamJuly 3, 2026
On July 1, 2026, the health policy group KFF published its annual look at the Medicare Advantage quality bonus program, and the headline number is large: Medicare will spend at least $13.4 billion on the program in 2026, up from $12.7 billion in 2025 and more than four times the $3.0 billion it spent in 2015. Here is how the program works. Every Medicare Advantage contract gets a star rating from one to five, built from roughly 40 measures such as cancer screenings, flu shots, care for chronic conditions, member complaints, and customer service. Contracts that earn four stars or more qualify for higher payments: the benchmark that caps what Medicare pays the plan rises by five percentage points, or ten in certain counties. Plans can use that extra money to fund the things that make them attractive, such as dental and vision coverage, lower cost sharing, or a lower premium, though they are not required to. Two findings in this year's analysis matter for shoppers. First, fewer plans made the cut: 68 percent of Advantage enrollees, about 24 million people, are in plans that qualify for bonuses in 2026, down from 75 percent last year and the lowest share since 2018, largely because the scoring thresholds moved and only 209 contracts earned at least four stars, compared with 261 the year before. Second, the money lands very unevenly. UnitedHealth Group, with about a quarter of all Advantage enrollees, will receive the largest total increase, $3.9 billion. Kaiser Foundation Health Plans receives the most per person, $577, because virtually all of its enrollees are in four-star-plus plans. Humana, the second largest insurer by enrollment, gets a disproportionately small 11 percent of bonus dollars after a star drop it fought in court and lost. Centene sits at the bottom at $23 per enrollee. The program has real critics: MedPAC, Congress's Medicare advisory body, has recommended replacing it, arguing the ratings mix too many measures and are reported at the contract level, where one rating can cover many different plans with different networks, costs, and service areas. The Congressional Budget Office estimated back in 2018 that ending the program would save roughly $100 billion over ten years, and enrollment has grown far past what that estimate assumed. Supporters counter that the ratings give plans a financial reason to improve care and give shoppers a usable quality signal. The practical takeaway is narrower and more useful: the star next to a plan's name on Medicare Plan Finder is a screening tool, not a verdict. It reflects the whole contract, not necessarily your plan, your doctors, or your county. Read it as one input alongside the network, the drug list, and the total cost picture.
In plain words
Medicare Advantage plans get star ratings, from one star to five. The ratings are meant to help you compare plans. But they do something else too. Plans with four stars or more get paid extra by Medicare. A new report from KFF says those extra payments will add up to at least $13.4 billion this year. That money can pay for extras like dental or vision coverage, but plans do not have to use it that way. This year, fewer plans earned four stars. About 68 out of every 100 people in Medicare Advantage are in a plan that gets bonus money, down from 75 last year. Here is what it means for you. A star rating covers a whole group of plans, not just yours. A four-star label does not promise your doctors are in the network or your drugs are covered. So use the stars as a first check, then look at the details that touch your life: the doctors, the drug list, and what you would pay in a bad year.
Understand the basics first
Source: KFF
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