UnitedHealth Raises 2026 Outlook After Profit Recovery
The healthcare company now expects full-year 2026 earnings of at least $19.50 a share and adjusted earnings of at least $20.50 a share.
UnitedHealth Group (UNH) raised its full-year 2026 earnings outlook after third-quarter operating profit recovered from a year-earlier trough, even as revenue stayed essentially unchanged and membership continued to shrink across UnitedHealthcare.
The company now expects full-year 2026 earnings of at least $19.50 a share and adjusted earnings of at least $20.50 a share, incorporating experience through the third quarter. That floor sits above the second-quarter range of $18.45 to $18.95 a share and $19.50 to $20.00 a share, respectively.
Consolidated revenues were $112.7 billion in the three months ended September 30, 2026, compared with $113.2 billion a year earlier. Earnings from operations were $6.6 billion, versus $4.3 billion in the year-ago quarter, for a net margin of 3.6%. The year-over-year increase was driven by disciplined execution across both UnitedHealthcare and Optum.
The medical cost ratio was 88.4%, down from 89.9% a year earlier. The decrease reflected medical cost management, benefit design changes and pricing discipline, as well as care delivery enhancements. Net medical reserve development was $610 million related to 2026 dates of service. The operating cost ratio was 12.8%, versus 13.5% a year earlier.
UnitedHealthcare served 48.3 million people. Revenues were $86.3 billion, compared with $87.1 billion a year earlier. Earnings from operations were $2.8 billion and the operating margin was 3.3%, versus $1.8 billion and 2.1% a year earlier. The year-over-year increase was driven by benefit changes and pricing discipline, combined with medical and operating cost management.
Employer & Individual revenues were $20.2 billion, up from $19.9 billion a year earlier. People served in that book contracted by 165,000 in the quarter due to employer attrition. Medicare & Retirement revenues were $42.4 billion, down from $43.4 billion a year earlier due to changes in membership and product mix. Seniors served through Medicare Advantage, including complex-population Medicaid programs, had contracted by 935,000 since year-end 2025. Community & State revenues were $23.7 billion, down from $23.8 billion a year earlier. People served there contracted by 85,000 in the quarter due to ongoing Medicaid eligibility changes.
Optum cared for more than 120 million patients and consumers. Revenues were $66.9 billion, down from $69.2 billion a year earlier. Earnings from operations were $3.7 billion and the operating margin was 5.6%, versus $2.5 billion and 3.6% a year earlier.
Optum Health revenues were $22.9 billion, down 10% year-over-year as a result of fewer value-based care patients served in markets where Optum lacked sufficient value-based care presence to sustain its clinicians. Earnings from operations were $735 million and the operating margin was 3.2%, versus $41 million and 0.2% a year earlier. The year-over-year increase was driven by strengthened operational discipline and medical cost management across those markets. Optum Insight revenues were $5.5 billion, up 3% year-over-year. Earnings from operations were $1.3 billion, versus $920 million a year earlier. Optum Rx revenues were $39.9 billion, up from $39.7 billion a year earlier. Earnings from operations were $1.7 billion, versus $1.5 billion a year earlier. Adjusted scripts were 393 million, down from 414 million a year earlier due to membership declines within UnitedHealthcare and other customers.
Cash flows from operations were $5.1 billion, or 1.2 times net income. The debt-to-capital ratio was 41.7% as of September 30, 2026. The company continues to target a long-term debt-to-capital ratio of approximately 40.0% by year-end. Year-to-date, it repurchased $5.0 billion of common stock and paid $6.2 billion in dividends.
The company committed $1 billion to the United Health Foundation and is voluntarily eliminating and rebating profits from individual Affordable Care Act coverage offerings in 2026, returning money to approximately 1 million ACA members. It is also eliminating 30% of current prior approval volume by the end of 2026 and nearly two-thirds of prior approval requirements for pediatric care.
Stephen Hemsley, chief executive officer, said third-quarter results reflect discipline and execution as the company continues evolving UnitedHealth Group to deliver a simpler, more supportive experience for patients and clinicians.