
HUM$431.87▲ 11.6%Humana estimates its ratings money tops five rivals'. It will plan as if near its goal
Humana said on Oct. 9 that 95% of its Medicare Advantage members are in plans rated four stars or more for 2027. Its filing estimates its ratings revenue at $160 a member a month, above the goal it had set.
KeyVex News··6 min readFact-checked against 8 public records
KeyVex News··6 min readFact-checked against 8 public records
HUM$431.87▲ 11.6%Close, Oct. 9. Prices from Tiingo.The short versionTap to readTap to close
- Medicare pays private insurers a bonus for plans rated four stars or more. For 2024, 94% of Humana's members were in such plans. For 2025 the share fell to 25%, and Humana sued.
- It lost in court and has appealed. For 2027, J.P. Morgan analysts expected 60% to 70%, Reuters reported. Humana says it reached 95%.
- Humana's Oct. 9 filing estimates its new ratings are worth $160 a member each month in extra Medicare money, on assumptions it applies to every insurer, above every rival it charts and its $115 goal.
- As it has said before, Humana will design its plans and benefits as if its results were close to that goal. It expects some of the extra only once, for one-time investments and shareholders.
- The new ratings pay in 2028. Humana holds an investor update on Dec. 10, and says it will size the one-time benefit by the time it gives 2028 guidance.
The ratings: In October 2024, Humana said only a quarter of its Medicare Advantage members would be in plans rated four stars or more, the level that earns Medicare's quality bonus, down from 94%.8-KKFF On Oct. 9, Humana said 95% of its members are in such plans for 2027.Release That is up from 20% for 2026, Reuters noted.Reuters8-K Medicare had posted the new ratings the day before.CMS
The filing: Its Oct. 9 securities filing, using the same assumptions for every insurer, estimates its new ratings are worth $160 a member a month in what it calls Stars revenue, the extra Medicare money a higher rating brings. Its goal was $115. All five rivals in its chart come in lower, the highest at $135.8-KData
Why it matters: Star ratings decide which plans get Medicare's quality bonus, a program KFF, the health policy research group, estimates at $13.4 billion or more in 2026.KFF Humana's filing repeats that it will design its plans and benefits as if its results were close to its goal, and says some of the gain "will be one time in nature."8-K
The stock: Humana filed before the market opened on Oct. 9. The stock closed up 11.6% that day, at $431.87, its highest close since Jan. 17, 2024.8-KChart data
Humana's stock and the story's key datesDaily close, Sept. 3, 2024 to Oct. 9, 2026 ▲ 18.8%Show chartHide chart
How Humana fell
Medicare Advantage is the private-plan version of Medicare. CMS, the agency that runs Medicare, gives each contract one to five stars. A contract can cover many plans.KFF One with drug coverage is scored on up to 43 measures of care and service. CMS says year-to-year changes are "normal and expected," and recalculates the cut points that set each measure's stars every year.CMS
For the 2025 ratings, a Humana contract known as H5216 slipped from 4.5 stars to 3.5. It held about 45% of Humana's Medicare Advantage members. The share in four-star plans fell to 25%, based on preliminary CMS data, Humana said.8-K Humana said there "may be potential errors" in CMS's math. On Oct. 18, 2024, it sued.8-K10-Q
It lost. On Oct. 14, 2025, the court in Fort Worth, Texas, rejected Humana's challenge. Humana appealed to the Fifth Circuit, where the case is pending, its quarterly report for the period ended June 30, 2026, says.10-Q By then the 2026 ratings were out: about 1.2 million members, 20%, were in four-star plans, again based on preliminary data, Humana said.8-K For 2027, H5216 is rated four stars, up from 3.5, and 42% of Humana's Medicare Advantage members are in plans rated 4.5 stars, its Oct. 9 release says.ReleaseData
Sources: Humana Forms 8-K of Oct. 2, 2024 (2024 and 2025) and Oct. 2, 2025 (2026); Humana press release, Oct. 9, 2026 (2027). The 2025 and 2026 figures were based on preliminary CMS data.
What a star is worth
Plans rated four stars or more get higher Medicare payments, under a quality bonus program set up by the Affordable Care Act.KFF Humana has about 20% of Medicare Advantage enrollment, KFF estimates. It will get about 11% of 2026 bonus spending, $1.5 billion. UnitedHealth Group gets the most, $3.9 billion.KFF
Humana's quarterly report lists the "BY 2026 Star Ratings revenue headwind" first among the reasons its medical costs took a bigger share of its premiums in the first half of 2026. BY stands for bonus year.10-Q The 2027 ratings set the bonuses paid in 2028.CMS
How far past the goal
Humana's goal was "Top Quartile" results, which it defines as Stars revenue per member per month 10% above the median of its peers: Centene, CVS, Elevance, HCSC and United.8-K The filing's chart does not say which rival is which bar.8-K
Humana's estimate of Stars revenue per member per month, 2027 ratingsShow chartHide chart
View the data
| 2027 ratings (paid in 2028) | Stars revenue per member per month | Note |
|---|---|---|
| Humana (Humana's estimate) | $160 | $160 a member a month, rounded to the nearest $5 |
| Highest peer bar (Filing does not name it) | $135 | $135; the filing lists the peer group as Centene, CVS, Elevance, HCSC and United, without matching names to bars |
| Top quartile (Humana's goal) (Peer median plus 10%) | $115 | $115, the line Humana defines as its goal |
| Peer median (As the filing draws it) | $105 | $105 |
| Lowest peer bar (Filing does not name it) | $40 | $40 |
Source: Humana Form 8-K, Oct. 9, 2026. The middle three of the filing's five rival bars ($130, $105 and $65) are left out here. Humana computed every bar with the same benchmark, risk score and rebate for each insurer, and says actual 2028 figures will differ.
The figures are Humana's own estimates, using the same assumptions for every insurer, and it says actual 2028 figures "will be different."8-K
How others read it
Across the industry, about 71% of members in Medicare Advantage drug plans are in contracts rated four stars or more for 2027, CMS says.CMS J.P. Morgan analysts estimate UnitedHealth's share falls to about 67%, from 81%, Reuters reported. They put CVS Health's at about 70%, from 84%, Reuters reported.Reuters
Evercore ISI analyst Elizabeth Anderson said Humana improved on drug-plan quality, health-plan quality and readmissions, according to Reuters.Reuters
Not everyone reads the ratings as a measure of quality. MedPAC, the commission that advises Congress on Medicare, and others have suggested the ratings "may not be a useful indicator of quality" because they are reported for a whole contract, not each plan, KFF writes. They have also said the ratings use too many measures and don't adequately account for social risk factors.KFF
What Humana says it will do with it
As a reminder, the Company intends to manage its product and benefit structure assuming performance that approximates Top Quartile results. Further, the Company anticipates some of the outperformance in BY28 relative to Top Quartile will be one time in nature, and it will manage its expenses as such.
Humana says it expects "a benefit for 2028" that will go to "one-time investments and return to shareholders."8-K
It gives no figure. It says it will share the size and use of that benefit once it knows more about 2028: competition, rates, regulation, and its members and contracts.8-K It will hold a virtual investor update on Dec. 10, and says it will size the benefit before or when it gives detailed 2028 guidance, on its fourth-quarter 2027 earnings call.8-K
Also in the filings
These items are not tied to the ratings. Humana affirmed its 2026 forecast of at least $9.00 a share in adjusted earnings, a measure it defines itself.8-K Unlike its Sept. 1 filing, which paired that with at least $6.52 a share under standard accounting, the Oct. 9 filing gives no standard-accounting figure. It says it can't reconcile the two measures without unreasonable effort while it closes its third-quarter books, and expects possible changes to the standard-accounting forecast, tied to its value creation and other strategic initiatives. Its Sept. 1 filing had also said it expected possible changes to that forecast.8-K8-K
What to watch
Medicare open enrollment, when the 2027 ratings show on Medicare Plan Finder, CMS says.
Humana's virtual investor update, against the framework from its 2025 Investor Day.
Humana's detailed 2028 guidance; it says it will size the one-time benefit by then.
The paper trail
Humana's star-ratings disclosures and the filings cited here, with the time EDGAR accepted each 8-K (Eastern).
| Filed (ET) | Form | Filer | What it shows |
|---|---|---|---|
| Oct. 2, 2024, 6:35 a.m. | 8-K | Humana | 2025 ratings: about 1.6 million members, 25%, in 4-star plans, down from 94%; H5216 falls to 3.5 stars. |
| Oct. 2, 2025, 12:00 p.m. | 8-K | Humana | 2026 ratings: about 1.2 million members, 20%; Humana expects to return to top-quartile results for 2027. |
| July 29, 2026 | 10-Q | Humana | The 2025 ratings lawsuit: rejected Oct. 14, 2025; appeal pending at the Fifth Circuit. The bonus-year 2026 headwind, from the 2025 ratings. |
| Sept. 1, 2026 | 8-K | Humana | 2026 forecast: at least $6.52 a share GAAP, at least $9.00 adjusted; no comment on 2027 ratings until CMS releases them. |
| Oct. 9, 2026, 6:01 a.m. | 8-K | Humana | 2027 ratings: beat its top-quartile goal; $160 a member a month against $115; some outperformance "one time in nature." |
Sources
12 sources, 8 of them public records
Public records
- Humana Inc., Form 8-K, Item 7.01: 2027 Medicare Advantage Star RatingsSEC EDGAR · Oct. 9, 2026
- Humana Inc., Form 8-K filing index (acceptance time)SEC EDGAR · Oct. 9, 2026
- Humana Inc., Form 8-K, Item 7.01: 2026 Medicare Advantage Star RatingsSEC EDGAR · Oct. 2, 2025
- Humana Inc., Form 8-K, Item 7.01: 2025 Medicare Advantage Star RatingsSEC EDGAR · Oct. 2, 2024
- Humana Inc., Form 10-Q for the quarter ended June 30, 2026SEC EDGAR · July 29, 2026
- Humana Inc., Form 8-K, Item 7.01: 2026 guidanceSEC EDGAR · Sept. 1, 2026
- 2027 Medicare Advantage and Part D Star Ratings, fact sheetCenters for Medicare & Medicaid Services · Oct. 8, 2026
- Humana press release: "Humana Announces Improved CMS Star Ratings with 95 Percent of Medicare Advantage Members in 4-Star or Above Plans for 2027"Humana · Oct. 9, 2026
Rules and references
- "Medicare Will Spend More Than $13 Billion on the Medicare Advantage Quality Bonus Program in 2026"KFF · updated Aug. 12, 2026
Reporting
- "Humana surges after emerging as top beneficiary of 2027 Medicare star ratings"Reuters, via Yahoo Finance · Oct. 9, 2026
Data
- End-of-day prices for HUM, and for SPY and QQQ on the chart (Tiingo)KeyVex · through Oct. 9, 2026
- The chart's Filings layer: KeyVex's Congress trade, insider trade, Form 144, 8-K and lobbying records for HUMKeyVex · through Oct. 9, 2026
How we got these numbers
- Prices are end-of-day closes as traded, not adjusted for dividends. The S&P 500 and Nasdaq 100 lines follow SPY and QQQ, also as traded, rebased to Humana's close at the start of the range shown. The Oct. 9, 2026 close of $431.87 is up 11.56% from $387.12 on Oct. 8. "Highest close since Jan. 17, 2024" compares it with every as-traded close from Oct. 10, 2016; the last close at or above it was $447.76 on Jan. 17, 2024. The Oct. 2, 2024 move is $246.49 against $279.45 the day before. The Filings switch shows the filing markers from KeyVex's Humana stock page, a selection of congressional trades, insider trades, Form 144 notices, 8-Ks and lobbying filings: not every filing, and not only those tied to this story.
- Stars revenue per member per month is Humana's own measure, as its Oct. 9 filing defines it: the extra revenue from a 3.5, 4 or 4.5 star rating, including the extra rebate retained and the quality bonus for 4 stars, with a 50% rebate retention treated as the baseline. Humana computed it for itself and its peers with the same $1,370 benchmark, 1.15 risk score and $222 rebate, and September 2026 membership. The filing's chart rounds to the nearest $5 and does not say which peer is which bar.
- The 95% and 42% figures for 2027 are from Humana's Oct. 9, 2026 press release (also reported by Reuters); its Oct. 9 Form 8-K does not state them. The 94%, 25% and 20% figures come from Humana's Forms 8-K; the 25% and 20% figures were based on preliminary CMS data. CMS's 71% is weighted by enrollment, for Medicare Advantage contracts that include drug coverage.
- The quality bonus amounts are KFF's estimates for 2026, which KFF calls a lower bound. The J.P. Morgan estimates are as Reuters reported them. Filing times are the "Accepted" times on each filing's EDGAR index page, Eastern time.




