Medicare’s annual enrollment window is open now and closes December 7. What you can change, and when.
This article is for general educational purposes only and is not insurance or medical advice. We are not affiliated with the U.S. government, Medicare, or any insurer named here. For official information, visit Medicare.gov or call 1-800-MEDICARE. See our Medical & Financial Disclaimer for details.
Ask anyone over sixty-five to name a Medicare Advantage insurer and you will get the same four or five answers. Those are the companies that buy the television advertising, so those are the names that end up on the shortlist.
We wanted to know whether that shortlist is any good. So we took every Medicare Advantage plan on sale for 2027 — all 5,522 of them, straight from the CMS plan file — grouped them by the company that actually owns them, not the brand printed on the card, and matched each one to the 2027 star ratings CMS published on October 8, 2026. There are 162 of those companies.
We did the same exercise a year earlier, on the 2026 plans and ratings. Putting the two side by side turned out to be more useful than either list on its own, because the biggest finding is not who is on top. It is how little of last year’s ranking survived.
The Five Names Everyone Knows, Then and Now
The giants genuinely are giants. Humana, UnitedHealth, Aetna, Anthem and WellCare sell 52.2% of all the plans in the country between them for 2027, and the ten biggest companies sell 74.9%. At the other end, 113 of the 162 companies offer ten plans or fewer, and all 113 together account for 8.2% of the market.
| Counted from the CMS plan file | 2027 plans (rated) | 2027 mean stars | 2027 rated plans at 4+ | 2026 rated plans at 4+ | 2027 median out-of-pocket limit | 2027 counties |
|---|---|---|---|---|---|---|
| Humana | 861 (842) | 4.16 | 93.6% | 35.5% | $6,750 | 2,600 |
| UnitedHealth Group | 852 (829) | 3.84 | 62.1% | 79.5% | $7,150 | 2,791 |
| Devoted Health | 740 (504) | 4.10 | 77.4% | 69.4% | $7,150 | 1,341 |
| CVS Health (Aetna) | 654 (643) | 3.67 | 48.2% | 72.0% | $7,150 | 2,072 |
| Elevance Health (Anthem) | 308 (289) | 3.64 | 31.8% | 45.5% | $5,900 | 1,590 |
| Centene (WellCare) | 210 (199) | 3.26 | 10.6% | 18.2% | $9,250 | 1,692 |
| All plans | 5,522 (4,992) | 3.86 | 61.2% | 60.5% | $7,100 | 3,131 |
Read the two percentage columns against each other and the ranking turns upside down. A year ago Humana was the weakest of the big three, with barely a third of its plans at four stars. For 2027 it is the best-rated large insurer in the country by a wide margin, with more than nine plans in ten at four stars or better. UnitedHealth and Aetna, last year’s leaders, both fell — Aetna from 72.0% to below half.
The market as a whole barely moved. So this is not CMS grading harder or softer across the board. It is individual companies’ contracts moving a long way in both directions in a single year.
The Third-Largest Catalog Belongs to a Company You Have Not Heard Of
Look at the row we slipped into the middle of that table. Devoted Health now has the third-largest Medicare Advantage catalog in the United States — 740 plans, ahead of Aetna, sold across 1,341 counties in 34 states. It has grown by more than 300 plans in a year, and more than three quarters of its rated plans reach four stars.
One thing did change. For 2026 Devoted owned 123 of the country’s 227 five-star plans. For 2027 it owns none: the five-star tier shrank to 108 plans across nine companies, and the largest single holder is now UnitedHealth, with 28. Devoted’s plans sit mostly at four and 4.5 stars instead. And 236 of its plans are still too new to carry any rating at all, so a large share of what it sells has no track record yet.
Last Year Eight Companies Never Dropped Below Four Stars. This Year, Four
We wanted a test that could not be gamed by a company with three plans and a lucky year. So we took every company with at least twenty rated plans — twenty-six cleared that bar for 2027 — and asked one blunt question: how many have no plan rated below four stars?
| 2027: no plan below four stars | Plans (rated) | Mean star rating | Median out-of-pocket limit | Plans with no monthly premium | Where it sells |
|---|---|---|---|---|---|
| Kaiser Permanente | 117 (115) | 4.47 | $6,400 | 52.7% | 10 states |
| Blue Cross Blue Shield of Michigan (incl. Blue Care Network, WyoBlue Advantage) | 43 (40) | 4.50 | $4,800 | 7.3% | Michigan, Wyoming |
| Capital Blue Cross | 35 (35) | 4.00 | $7,100 | 40.0% | Pennsylvania |
| Medica (incl. Dean Advantage) | 29 (29) | 4.00 | $7,150 | 7.4% | Minnesota, Nebraska, North Dakota, South Dakota, Wisconsin |
Only Kaiser Permanente and Capital Blue Cross were also on last year’s list. Here is what happened to the other six, on the same test:
| On last year’s list | 2026 rated plans at 4+ | 2027 rated plans at 4+ | 2027 plans below four stars |
|---|---|---|---|
| MHH Healthcare (GlobalHealth, MCS Classicare) | 100% | 75.0% | 7 |
| SCAN Health Plan | 100% | 84.2% | 12 |
| Universal Health Services (Prominence Health Plan) | 100% | 63.3% | 11 |
| Alignment Health | 100% | 50.7% | 35 |
| Trinity Health (MediGold, Saint Alphonsus) | 100% | 0% | 19 |
| Athena Healthcare (Solis Health Plans) | 100% | 100% | 0, but only 19 rated plans now |
Trinity Health went from every plan at four stars or better to none. Medica went the other way: for 2026 none of its 23 rated plans reached four stars, and for 2027 all 29 do. Those are not small companies having a lucky or unlucky draw on three plans. They are whole catalogs moving together, because CMS rates contracts and a company’s plans tend to share a handful of them.
What a One-Year Swing Like This Tells You
It tells you that a company’s reputation for quality, good or bad, is at most one year old. The rating you see in the Plan Finder this fall is the one that applies to the plan you are joining for 2027. What a friend’s plan scored two years ago, or what an insurer was known for last time you looked, does not carry over.
It also tells you something about lists like this one. Last year’s eight were genuinely excellent on last year’s numbers, and half of them would have been the wrong advice this year. So we are not going to tell you to buy from the four above. We are going to tell you to read the rating of the specific plan, this year.
Does a Better Rating Come With Better Coverage?
A star rating measures how well a plan is run: screenings, medication management, complaints, members leaving. It does not measure how much the plan charges you when you use it. So we set the 2027 ratings of the five largest names next to three things that decide what a plan costs a member, counting only the ordinary plans open to anyone (no special needs or employer plans).
| Ordinary plans, 2027 | Rated plans at 4+ stars | Median out-of-pocket limit | Median drug deductible | Plans with an OTC allowance |
|---|---|---|---|---|
| Kaiser Permanente | 100% | $5,700 | $0 | 73.6% |
| Humana | 92.7% | $6,350 | $700 | 39.0% |
| Devoted Health | 73.4% | $7,050 | $650 | 73.2% |
| UnitedHealthcare | 70.6% | $7,025 | $685 | 53.5% |
| Aetna (CVS Health) | 57.0% | $7,150 | $700 | 61.9% |
| All ordinary plans | 66.2% | $6,600 | $650 | 58.3% |
Our own count. Ratings: 2027 Star Ratings Data Tables, matched by contract. Out-of-pocket limits and drug deductibles: CY2027 Landscape file (drug deductible over plans with drug coverage). Over-the-counter allowance: PBP Benefits 2027 file. Plan counts differ slightly between the CMS files because they group companies by parent organization and by marketing name respectively.
Only one company is ahead on everything: Kaiser, which is also the one most people can’t buy, because it sells in so few counties. Among the national insurers the picture splits. Humana, now the best rated of the large companies, also has a lower typical out-of-pocket limit than the market, but its typical plan charges the full $700 drug deductible and it cut its over-the-counter card sharply for 2027, from 52.8% of its ordinary plans to 39.0%. Aetna sits at the bottom of the ratings column and at the top of the out-of-pocket column, the wrong end of both. Devoted, the newest of the five, combines ratings above the market with an over-the-counter card on almost three plans in four.
The lesson is the same one the rest of this page points to. A rating is worth checking, but it is one column of several, and the company that wins it does not automatically win the others. Once you have narrowed your choice to well-rated plans, the out-of-pocket limit and the drug deductible of each specific plan are what separate a cheap year from an expensive one. Our step-by-step guide to the Plan Finder shows where to find all three on each plan’s card.
The Catch Has Not Changed
Put the four together and they sell in 417 of the country’s 3,131 counties, 13.3%, across 18 states. Two are confined to a single state or two. So for most people reading this, the table above is not a shopping list. If you live in Pennsylvania, Michigan, Minnesota or a Kaiser region, one of them may well sell at your address. Elsewhere, none does.
What Your Own County Probably Looks Like
Since the national list will not help most readers, and there is no single best plan anyone can point you to, here is the more useful version of the same data: what a typical American county offers for 2027.
- The median county has six different parent companies selling Medicare Advantage in it, and 42 plans on offer.
- More than a third of counties — 1,159 of them — have five companies or fewer. About one in seven has ten or more.
- In the median county, 56.8% of the rated plans on sale score four stars or better, up from 47.3% for 2026. In most places, more than half your local options are well rated.
What This Actually Changes for You
Open the plan list for your own address before you form an opinion about any company. Whatever names come up in your county are your real choices. Our state-by-state analysis shows how many insurers compete where you live.
Read the 2027 rating of the specific plan, not the company and not last year. A company averaging 3.6 still sells good plans; a company with 93% of its plans at four stars still sells some that are not. Our guide to how star ratings are built explains what goes into the score.
Compare the out-of-pocket maximum before anything else. It decides your worst year. Across 2027 plans it runs from under $2,000 to $9,850, and a better star rating buys surprisingly little of that difference — we checked, in our analysis of whether better-rated plans cost more.
Two Fair Objections
Isn’t it easier to score 100% with thirty plans than with eight hundred? Yes, which is why we set a floor of twenty rated plans. But Kaiser holds the line across 115 rated plans in ten states, for the second year running, and Humana gets 93.6% across 842. Size is not the obstacle it looks like.
Why do your figures differ from the ones CMS quotes? Because CMS weights its averages by how many people are enrolled in each contract, and we count each plan once. Ours answers “what is on the shelf”, which is the question you face when you shop. Theirs answers “where did people end up”.
The Bottom Line
For 2027 the best-rated large insurer is Humana, the company that was the weakest of the big three a year ago, and only two of last year’s eight spotless companies are still spotless. That is the real lesson of this list. In Medicare Advantage, a company’s name tells you how much it spends on advertising, and its reputation tells you how it did a year or two ago. The plan’s own 2027 rating and its own out-of-pocket limit tell you what you are buying, and both are on the plan’s summary, in your county, for free.
How We Counted This
Every figure here is our own count from the CY2027 and CY2026 Landscape files that CMS published in September 2026, grouped by the parent organization named in the file rather than by the brand on the card. The 2027 star figures come from matching each plan’s contract to its overall rating in CMS’s 2027 Star Ratings data tables; the 2026 figures use the ratings carried in the 2026 file.
That gives 162 parent organizations across 5,522 distinct plans in 3,131 counties for 2027. Where a table shows two plan counts, the second is the number carrying a star rating: every star figure is worked out over that smaller number, and so is every premium share. Percentages are shares of plans, not of enrollment. The full method is on our editorial methodology page.
Sources
- CY2027 and CY2026 Medicare Advantage and Part D Landscape files — Centers for Medicare & Medicaid Services, September 2026 versions. Source for the parent organizations, plan counts, market shares, out-of-pocket limits, premium shares, county and state coverage, and the 2026 star figures. All calculations are our own.
- 2027 Star Ratings Data Tables — Centers for Medicare & Medicaid Services, published October 8, 2026. Source for every 2027 star figure, matched contract by contract, and for ratings being assigned to contracts rather than companies. See also the 2027 Star Ratings fact sheet.
- PBP Benefits – 2027 — Centers for Medicare & Medicaid Services. Source for the over-the-counter allowance column in the ratings-against-costs table (our own count of each company’s ordinary plans, by the marketing name in the filing).
The rating figures on this page were counted from the CMS files on October 12, 2026; the table of ratings against costs and extras was added on October 18, 2026, from the same files and the CMS PBP Benefits 2027 file. Plan availability changes; confirm what is sold at your own address on Medicare.gov before enrolling.
Disclaimer: Plan figures reflect 2027 and 2026 data from the Centers for Medicare & Medicaid Services (CMS) and vary by state, county and plan. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.
Unai Sampedro founded and edits Medicare Plan Compass. He is not a licensed insurance agent or broker and takes no commission from any insurer; the site is funded by advertising. Articles are written from CMS and Medicare.gov documents and reviewed each year when new figures are published. Nothing here is personalized advice: the goal is to explain the rules in plain language so readers can ask better questions before they speak to someone who can advise them.