Aetna achieves over 81% of Medicare Advantage members in 4-Star plans and over 63% in 4.5-Star plans for 2026
Rhea-AI Summary
Aetna (NYSE: CVS) reported that for 2026 over 81% of its Medicare Advantage members are in plans rated 4 stars or higher by CMS, and over 63% are in 4.5-star plans. Key MA contracts and enrollments cited include H5522 (1.3M employer-group members; 4.5 stars, 14-year 4+ streak), H5521 (1.1M individual members; 4.5 stars), H3959 (210k; 4 stars), H2293 (134k; 4 stars), H1609 (132k; 4.5 stars, +0.5 star YoY), and H2663 (128k; 4 stars, 14-year 4+ streak). Ratings are based on CMS data published October 9, 2025; enrollment as of September 2025.
Positive
- Over 81% of Medicare Advantage members in 4+ star plans for 2026
- Over 63% of Medicare Advantage members in 4.5-star plans for 2026
- H5522 contract: 1.3M employer-group members with 4.5 stars and 14-year 4+ streak
- H5521 contract: 1.1M individual members with 4.5 stars
- H1609 contract: 132k members improved by 0.5 star year-over-year
Negative
- None.
Insights
Aetna reports strong 2026 CMS Star Ratings, placing a large share of MA members in high‑quality plans.
Aetna places over
These outcomes depend on CMS methodology, year‑over‑year measure stability, and whether the reported enrollment figures (as of September 2025) persist through the Annual Enrollment Period. Risks include possible changes in ratings methodology, variances in contract‑level performance across states, and the short window between rating publication (
Watch retention and net enrollment trends over the Annual Enrollment Period and any CMS technical updates to rating calculations; contract‑level star maintenance or movement at the next reporting cycle will confirm persistence. Monitor enrollment figures for the highlighted contracts and CMS publications in the coming quarter for concrete confirmation of impact.
HARTFORD, Conn., Oct. 9, 2025 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), announced today that over 81 percent of its Medicare Advantage (MA) members are in 2026 Medicare Advantage Prescription Drug (MAPD) plans that are rated 4 stars or higher (out of 5 stars) by the Centers for Medicare & Medicaid Services (CMS). Additionally, over 63 percent of Aetna Medicare Advantage members are in a 4.5-star plan for 2026.
"This year's Star Ratings reflect Aetna's strong fundamentals and unwavering commitment to delivering exceptional care experiences and better health outcomes for our Medicare Advantage members," said Aetna president Steve Nelson. "I am proud of the way our teams show up every day to support our members, enabling Aetna to serve as their trusted, reliable health care partner."
Aetna continues to be an industry leader in providing high-quality Medicare solutions, consistently ranking among the top tier of large publicly traded companies in CMS Star Ratings.
Our Star Ratings success includes high-quality performance for many of our largest MA contracts:
- Our Aetna Life Insurance Company's H5522 contract, the primary contract serving over 1.3 million Employer Group Medicare Advantage members across the country, as well as serving 110 thousand Individual Medicare Advantage members in
Pennsylvania , achieved 4.5 stars, extending its streak to 14 years with 4+ star performance. - Our Aetna Life Insurance Company's H5521 contract, serving 1.1 million Individual Medicare Advantage members in 33 states, once again achieved 4.5 stars repeating its performance from the prior year.
- Our Aetna Health Inc. (PA)'s H3959 contract, with 210 thousand Individual Medicare Advantage members primarily in the states of
Pennsylvania andDelaware , earned 4 stars. - Our SilverScript Insurance Company's H2293 contract, with 134 thousand Individual Medicare Advantage members in the states of
Georgia andTexas , repeated a 4-star performance from its inaugural year. - Our Aetna Health Inc. (FL)'s H1609 contract, with 132 thousand Individual Medicare Advantage members in the states of
Florida andIowa , earned 4.5 stars, improving half a star year over year. - Our Coventry Health Care of
Missouri , Inc.'s H2663 contract, with 128 thousand Individual Medicare Advantage members in the states ofMissouri ,Kansas, Illinois ,Arkansas , andOklahoma earned 4 stars, extending its streak to 14 years with 4+ star performance.
Every year, Medicare evaluates plans based on a 5-star rating system. The Star Ratings are posted at Medicare.gov. Visit AetnaMedicare.com to learn more about the 2026 Aetna Medicare plans. Or call 1-844-588-0041 (TTY: 711), 7 days a week, 8 AM to 8 PM. The Medicare Annual Enrollment Period runs from October 15 through December 7, 2025. A licensed agent may answer your call.
NOTE: Information in this release is based on 2026 Star Ratings data published by CMS on October 9, 2025, and MA and MAPD enrollment as of September 2025.
About CVS Health
CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of June 30, 2025, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 87 million plan members. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.
About Aetna
Aetna, a CVS Health business, serves more than 37 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com.
Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.
To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.
©2025 Aetna Inc.
Media contact
Phil Blando
Phillip.blando@cvshealth.com
Investor contact
Larry McGrath
800-201-0938
Investorinfo@cvshealth.com
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SOURCE CVS Health
FAQ
What percent of Aetna Medicare Advantage members are in 4+ star plans for 2026 (CVS)?
How many Aetna MA members are in 4.5-star plans for 2026 under CVS?
Which Aetna MA contract serves 1.3M members and what is its 2026 CMS rating?
When were the 2026 Star Ratings published and what enrollment date was used in Aetna's announcement?
What is the Medicare Annual Enrollment Period timeframe mentioned by Aetna (CVS)?
Where can consumers find Aetna 2026 Medicare plan ratings and enrollment information?
