EP18 Why Medicare Advantage Star Ratings Fell for 2026

📝 Episode DescriptionMedicare Advantage contracts earning 4 or more Stars fell from 261 to 207 for 2026, while enrollment in bonus-qualifying plans dropped to 68 percent. Because CMS resets rating cut points annually, a plan can perform similarly and still receive a lower score.That matters because 4-Star bonuses help support dental, vision, givebacks, and low-premium benefits. Total bonus spending rose to $13.4 billion but is now concentrated across fewer contracts.The Veteran and The Closer explain the client impact, recent legal challenges involving Clover Health and Elevance, and how agents can review affected business before open enrollment. 🔑 Key Topics CoveredWhy Star ratings can fallAnnual CMS cut-point changesBonus dollars and plan benefitsClover and Elevance legal challenges 🎯 What This Means for AgentsLower ratings do not always mean worse performanceBonus changes may affect future benefitsClients need clear, compliant explanationsEarly outreach can protect retention 🔗 SourcesQuality Bonus Program funding Medicare Will Spend More Than $13 Billion on the MA Quality Bonus Program in 2026 (KFF, via Medicare Report, July 1, 2026)Star ratings shift and strategy Medicare Advantage Star Ratings Are Changing: Is Your Strategy Ready? (mPulse, July 8, 2026)Elevance lawsuit over star ratings Elevance Sues CMS Over Star Ratings (MedCity News, Marissa Plescia, July 7, 2026) 📌 GO-DO: Audit Ten ClientsPull your Medicare Advantage book and flag clients whose plan or contract changed Star ratings for 2026. Schedule ten-minute annual reviews with the first ten clients, using the episode script. Use PSM’s outreach materials and submit your message to Compliance before sending.Tags: Medicare, Medicare Advantage, star ratings, insurance agents, PSM Brokerage, CMS, enrollment, compliance, quality bonus, retentionInfographic: https://www.psmbrokerage.com/hubfs/The%20Insurance%20Producers%20Guild/IPG_EP18_Infographic.pngSlides: https://www.psmbrokerage.com/hubfs/The%20Insurance%20Producers%20Guild/IPG_EP18_Slides.pdfThe Insurance Producers Guild Podcast delivers intelligence for insurance agents looking to stay ahead of industry trends.Follow the show and connect with PSM Brokerage to access tools, training, and support designed to help you grow your business.Learn more: https://www.psmbrokerage.com