Intelligence Feed event · Policy · 2026-10-09

    Clover Health Medicare Advantage PPO Awarded CMS 5-Star Rating

    Question

    Clover Health Medicare Advantage PPO Awarded CMS 5-Star Rating

    Direct answer

    Clover Health received a 5-Star quality rating from CMS for its 2027 PPO Medicare Advantage plans, while its HMO plans received 4.5 Stars. The company also confirmed year-over-year membership growth of approximately 48%, surpassing 157,000 enrolled members. A 5-Star rating provides material regulatory advantages, including federal quality bonus payments from CMS and marketing authority to enroll beneficiaries year-round outside the standard annual enrollment period.

    Original publisher
    Market Ontology
    Evidence through
    2026-10-09
    Published
    2026-10-20
    Revision
    1 · 2026-10-20

    Cite as: Market Ontology, “Clover Health Medicare Advantage PPO Awarded CMS 5-Star Rating”, revision 1, evidence through 2026-10-09. https://marketontology.com/market-events/2026-10-09/clover-health-medicare-advantage-ppo-awarded-cms-5-star-rating-51ca67

    POLICY
    Clover Health Medicare Advantage PPO Awarded CMS 5-Star Rating
    Clover Health received a 5-Star quality rating from CMS for its 2027 PPO Medicare Advantage plans, while its HMO plans received 4.5 Stars. The company also confirmed year-over-year membership growth of approximately 48%, surpassing 157,000 enrolled members. A 5-Star rating provides material regulatory advantages, including federal quality bonus payments from CMS and marketing authority to enroll beneficiaries year-round outside the standard annual enrollment period.
    CLOV
    Impact
    72
    OCT 9
    SIG
    88%
    CLOV
    Clover Health Medicare Advantage PPO Awarded CMS 5-Star Rating
    Clover Health received a 5-Star quality rating from CMS for its 2027 PPO Medicare Advantage plans, while its HMO plans received 4.5 Stars. The company also confirmed year-over-year membership growth of approximately 48%, surpassing 157,000 enrolled members. A 5-Star rating provides material regulatory advantages, including federal quality bonus payments from CMS and marketing authority to enroll beneficiaries year-round outside the standard annual enrollment period.
    → Higher CMS star ratings trigger quality bonus payment percentages and allow year-round enrollment, expanding Clover's per-member revenue margin.
    Impact
    Clover Health received a 5-Star quality rating from CMS for its 2027 PPO Medicare Advantage plans, while its HMO plans received 4.5 Stars. The company also confirmed year-over-year membership growth of approximately 48%, surpassing 157,000 enrolled members. A 5-Star rating provides material regulatory advantages, including federal quality bonus payments from CMS and marketing authority to enroll beneficiaries year-round outside the standard annual enrollment period.
    Affected
    CLOV
    Transmission
    Higher CMS star ratings trigger quality bonus payment percentages and allow year-round enrollment, expanding Clover's per-member revenue margin.

    How this development reaches the affected companies

    AssetExposure and channelDirectionEvidence
    CLOVCMS quality bonus payment realization and continuous enrollment eligibilityUp1-4wCMS awarded PPO plans 5-Star rating and HMO plans 4.5-Star rating for 2027.

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    What happened next

    Price follow-up pending — no stored daily closes for these assets yet.

    Closing prices from stored daily bars; returns measured from the last close on or before the event date. Not a recommendation.

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