H5216 · Humana (HUMANA INSURANCE COMPANY): 2027 Star Rating
H5216 (Humana, HUMANA INSURANCE COMPANY) earned 4.0 stars in the 2027 Medicare Advantage Star Ratings, up from 3.5 in 2026. Parent company: Humana Inc. Plan type: Local CCP · offers special needs plans.
What stands out for H5216
- Most of its members are in Florida (297,568, 10.6% of Medicare Advantage members in CMS county files there). Calc
- Of the 36 rated contracts with members in Florida, 13 have a higher 2027 rating and 12 have the same rating. Calc
- Largest other contract in Florida: H1036 · Humana, 4.5 stars, 541,186 members. Calc
- At 4.0 stars it is at or above the 4-star line that sets 2028 quality bonus payments. CMS rule
- 8 of its 45 rated measures are at 5 stars; 6 are at 1 or 2 stars. Calc
Weakest high-weight measures
Measures with weight 2 or more and the lowest stars. These move the overall rating most.
- Improving or Maintaining Physical Health (C04, weight ×3): 2 stars, score 67
- Medication Adherence for Diabetes Medications (D08, weight ×3): 3 stars, score 89
- Getting Needed Care (C21, weight ×2): 3 stars, score 82
- Getting Appointments and Care Quickly (C22, weight ×2): 3 stars, score 83
- Rating of Health Plan (C25, weight ×2): 3 stars, score 86
All 2027 measure scores Sourced: CMS
| Measure | Weight | Score | Stars |
|---|---|---|---|
| Breast Cancer Screening (C01) | ×1 | 77 | 4 |
| Colorectal Cancer Screening (C02) | ×1 | 77 | 4 |
| Annual Flu Vaccine (C03) | ×1 | 63 | 2 |
| Improving or Maintaining Physical Health (C04) | ×3 | 67 | 2 |
| Improving or Maintaining Mental Health (C05) | ×3 | 87 | 5 |
| Monitoring Physical Activity (C06) | ×1 | 53 | 3 |
| Special Needs Plan (SNP) Care Management (C07) | ×1 | 81 | 4 |
| Care for Older Adults - Medication Review (C08) | ×1 | 99 | 5 |
| Care for Older Adults - Functional Status Assessment (C09) | ×1 | 96 | 5 |
| Osteoporosis Management in Women who had a Fracture (C10) | ×1 | 44 | 3 |
| Diabetes Care - Eye Exam (C11) | ×1 | 78 | 3 |
| Diabetes Care - Blood Sugar Controlled (C12) | ×3 | 93 | 5 |
| Kidney Health Evaluation for Patients with Diabetes (C13) | ×1 | 71 | 3 |
| Controlling High Blood Pressure (C14) | ×3 | 86 | 4 |
| Reducing the Risk of Falling (C15) | ×1 | 59 | 3 |
| Improving Bladder Control (C16) | ×1 | 42 | 2 |
| Plan All-Cause Readmissions (C17) | ×3 | 10 | 4 |
| Statin Therapy for Patients with Cardiovascular Disease (C18) | ×1 | 89 | 4 |
| Transitions of Care (C19) | ×1 | 74 | 4 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (C20) | ×1 | 63 | 2 |
| Getting Needed Care (C21) | ×2 | 82 | 3 |
| Getting Appointments and Care Quickly (C22) | ×2 | 83 | 3 |
| Customer Service (C23) | ×2 | 91 | 4 |
| Rating of Health Care Quality (C24) | ×2 | 87 | 4 |
| Rating of Health Plan (C25) | ×2 | 86 | 3 |
| Care Coordination (C26) | ×2 | 88 | 4 |
| Complaints about the Health Plan (C27) | ×2 | 0.21 | 4 |
| Members Choosing to Leave the Plan (C28) | ×2 | 21 | 3 |
| Health Plan Quality Improvement (C29) | ×5 | – | 4 |
| Plan Makes Timely Decisions about Appeals (C30) | ×2 | 100 | 5 |
| Reviewing Appeals Decisions (C31) | ×2 | 99 | 4 |
| Call Center - Foreign Language Interpreter and TTY Availability (C32) | ×2 | 100 | 5 |
| Call Center - Foreign Language Interpreter and TTY Availability (D01) | ×2 | 100 | 5 |
| Complaints about the Drug Plan (D02) | ×2 | 0.21 | 4 |
| Members Choosing to Leave the Plan (D03) | ×2 | 21 | 3 |
| Drug Plan Quality Improvement (D04) | ×5 | – | 4 |
| Rating of Drug Plan (D05) | ×2 | 87 | 4 |
| Getting Needed Prescription Drugs (D06) | ×2 | 90 | 4 |
| MPF Price Accuracy (D07) | ×1 | 94 | 1 |
| Medication Adherence for Diabetes Medications (D08) | ×3 | 89 | 3 |
| Medication Adherence for Hypertension (RAS antagonists) (D09) | ×3 | 90 | 4 |
| Medication Adherence for Cholesterol (Statins) (D10) | ×3 | 90 | 4 |
| Statin Use in Persons with Diabetes (SUPD) (D11) | ×1 | 86 | 2 |
| Concurrent Use of Opioids and Benzodiazepines (COB) (D12) | ×1 | 11 | 4 |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (D13) | ×1 | 4 | 5 |
Where H5216 has members
Florida (297,568), Texas (177,707), Michigan (141,049), Georgia (134,554), Kentucky (119,123), North Carolina (115,839), Illinois (100,577), West Virginia (84,594), South Carolina (73,304), Ohio (70,740), Virginia (70,207), Alabama (69,245), Mississippi (62,838), Indiana (60,520), Colorado (58,510), Arizona (54,889), Oklahoma (53,187), Wisconsin (52,836), Utah (41,913), Missouri (35,649), New Mexico (32,978), Washington (32,434), Arkansas (31,538), Montana (30,337), Tennessee (29,940), Louisiana (28,227), Iowa (26,026), Kansas (21,688), Maryland (21,349), Nevada (21,260), New Jersey (21,181), New Hampshire (16,734), Hawaii (12,032), Pennsylvania (11,216), Massachusetts (8,978), Nebraska (7,759), Oregon (7,648), Maine (7,340), Connecticut (6,501), Idaho (6,061), Delaware (5,586), Vermont (4,974), District of Columbia (1,556), Wyoming (1,263)
Other Humana Inc. contracts
Sources: CMS 2027 and 2026 Star Ratings data tables (CMS Part C and D performance data); CMS monthly enrollment by contract and county (October 2026). Sourced: CMS marks figures taken from CMS. Calculated marks figures Carelytics added up or compared. Built 2026-10-25.