Contract
H8145

Humana · 2027 Star Ratings

HUMANA INSURANCE COMPANY · PFFS

Parent: Humana Inc.

Summary ratings

Overall
4.0
2026: 3.5+0.5
Part C · health plan
3.5
2026: 3.5±0
Part D · drug plan
4.0
2026: 3.0+1.0

2027 footprint

Members, Sep 2026
27K
2027 plans
7
Open to all ($0 premium)
7 (3)
Counties
542
Special needs plans
None
Drug coverage
Yes
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Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines4.03.0+1.0
HD2Managing Chronic (Long Term) Conditions3.03.0±0
HD3Member Experience with Health Plan4.05.0−1.0
HD4Member Complaints and Changes in the Health Plan's Performance3.03.0±0
HD5Health Plan Customer Service4.05.0−1.0
DD1Drug Plan Customer Service5.05.0±0
DD2Member Complaints and Changes in the Drug Plan's Performance3.03.0±0
DD3Member Experience with the Drug Plan5.03.0+2.0
DD4Drug Safety and Accuracy of Drug Pricing3.03.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening75%3.0+1
C02Colorectal Cancer Screening78%4.0new spec
C03Annual Flu Vaccine75%5.0+1
C04Improving or Maintaining Physical Health71%3.0±0
C05Improving or Maintaining Mental Health89%5.0±0
C06Monitoring Physical Activity49%2.0±0
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a Fracture37%2.0±0
C11Diabetes Care – Eye Exam78%3.0±0
C12Diabetes Care – Blood Sugar Controlled86%3.0±0
C13Kidney Health Evaluation for Patients with Diabetes66%3.0±0
C14Controlling High Blood Pressure79%3.0±0
C15Reducing the Risk of Falling63%3.0+1
C16Improving Bladder Control38%2.0±0
C17Plan All-Cause Readmissions10%4.0+1
C18Statin Therapy for Patients with Cardiovascular Disease87%3.0±0
C19Transitions of Care75%4.0±0
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions61%2.0±0
C21Getting Needed Care855.0±0
C22Getting Appointments and Care Quickly864.0−1
C23Customer ServiceNot enough data available—
C24Rating of Health Care Quality874.0−1
C25Rating of Health Plan863.0−1
C26Care Coordination904.0−1
C27Complaints about the Health Plan0.254.0±0
C28Members Choosing to Leave the Plan33%2.0−2
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic3.0+1
C30Plan Makes Timely Decisions about Appeals99%4.0−1
C31Reviewing Appeals Decisions99%4.0±0
C32Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0
D02Complaints about the Drug Plan0.254.0±0
D03Members Choosing to Leave the Plan33%2.0−2
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0+3
D05Rating of Drug Plan884.0+2
D06Getting Needed Prescription Drugs935.0+1
D07MPF Price Accuracy941.0±0
D08Medication Adherence for Diabetes Medications89%3.0±0
D09Medication Adherence for Hypertension (RAS antagonists)90%4.0+1
D10Medication Adherence for Cholesterol (Statins)90%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)85%2.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)12%4.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)5%5.0—

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