Clover Health announced its 2026 Medicare Advantage Star Rating for its primary PPO plan has been upgraded to 4.5 Stars from the previously assigned 3.5 Stars. This change, which impacts the 2027 payment year, follows a federal court ruling in favor of the company that ordered the Centers for Medicare & Medicaid Services (CMS) to recalculate the rating.
Key Details
- New Rating: The 2026 Star Rating for PPO plan (Contract H5141) was increased from 3.5 Stars to 4.5 Stars, impacting the 2027 payment year.
- Affected Membership: The upgraded rating applies to the plan covering over 97% of Clover's members.
- Background: The upgrade resulted from a U.S. District Court order issued on May 29, 2026, with CMS confirming the new rating on June 9, 2026. Clover's HMO plan rating remains unchanged at 4.0 Stars.