Clover Health's Medicare Advantage PPO Plans Earn 5-Star Rating for 2027

Clover Health Investments, Corp. announced its 2027 Star Ratings from the Centers for Medicare & Medicaid Services (CMS). The company's Preferred Provider Organization (PPO) Medicare Advantage (MA) plans were awarded a 5-Star rating, while its Health Maintenance Organization (HMO) plan received a 4.5-Star rating. These ratings impact the 2028 payment year, and the 5-Star rating allows Clover's PPO plans to enroll new beneficiaries year-round.

Key Details

• PPO Plan Rating: Awarded 5 out of 5 Stars for 2027.
• HMO Plan Rating: Awarded 4.5 out of 5 Stars for 2027.
• Rating Calculation: The PPO plans' 5-Star rating was calculated by CMS excluding 20 measures following a court decision. Including these measures would have resulted in a 4.5-Star rating.
• Business Impact: The 2027 Star Ratings determine reimbursement levels for the 2028 payment year. A 5-Star rating also provides a marketing advantage and the ability for continuous enrollment.