7/104 sources · 3 publishersUpdated Oct 9, 10:42 UTC
Clover Health’s Medicare Advantage PPO plans receive 5‑Star rating for 2027
The Centers for Medicare & Medicaid Services awarded Clover Health’s Medicare Advantage PPO plans a 5‑Star rating and its HMO plan a 4.5‑Star rating for the 2027 performance year. The rating will determine payment adjustments for the 2028 year. Clover reported that its Medicare Advantage membership grew about 48 % year‑over‑year to more than 157,000 members, with roughly 98 % enrolled in the PPO product.
Why it matters
The 5‑Star rating increases the Medicare Advantage payment rate Clover will receive in 2028, enhancing its revenue outlook (the company’s filing states the rating “will affect payment year 2028”).
Key facts
- 1CMS awarded Clover’s PPO Medicare Advantage plans a 5‑Star rating and its HMO plan a 4.5‑Star rating for 2027, which will affect payments in 2028. globenewswire.com
- 2Through the first half of 2026, Clover Health’s Medicare Advantage membership grew ~48 % year‑over‑year to more than 157,000 members. globenewswire.com
- 3Approximately 98 % of the members are enrolled in Clover’s wide‑network PPO plans. globenewswire.com
- 4Clover’s HEDIS score remained at 4.82 out of 5 stars, ranking #1 among non‑SNP PPO plans with over 2,000 members. globenewswire.com
- 5The 5‑Star rating was calculated after CMS removed 20 measures from the evaluation due to a court decision (Clover Insurance Co. v. HHS, Civ. A. No. 25‑142, May 27 2026). globenewswire.com
Summary written by AlphAI AI Desk from 4 of 4 sources. Not investment advice. Figures are as stated by the linked sources.