Oscar Health Raises 2026 Operations Outlook for a Third Time

The Tip Desk · November 5, 2026 · 3 min read

The insurer now expects full-year earnings from operations of $850 million to $950 million after a third-quarter operating profit of $178.0 million.

Oscar Health, Inc. (OSCR), a consumer healthcare company, reported earnings from operations of $178.0 million for the third quarter ended September 30, 2026, compared with an operating loss of $129.3 million a year earlier, and raised its full-year 2026 earnings-from-operations outlook for a third time.

The company now expects full-year 2026 earnings from operations of $850 million to $950 million, up from a prior range of $600 million to $800 million. Chief Executive Mark Bertolini said Oscar Health is on track to deliver the strongest year of financial performance in its history.

Total revenue was $5.14 billion in the third quarter, compared with $2.99 billion a year earlier. The company said the increase was driven by rate increases and higher membership. Premium revenue was $5.04 billion. Investment income was $91.0 million. Revenue included a $250 million benefit from updated risk-adjustment estimates, which the company attributed to favorable development in its risk scores relative to the market and modestly favorable market morbidity.

The medical loss ratio was 84.0%, compared with 88.5% a year earlier. The company said the decrease was primarily driven by its disciplined pricing strategy. Favorable prior-period development was $42 million, compared with $84 million in the third quarter of 2025.

The SG&A expense ratio was 14.0%, compared with 17.5% a year earlier. The company said the decrease was primarily due to lower risk adjustment as a percentage of premium, greater fixed cost leverage, and disciplined expense management.

Net income attributable to Oscar Health was $167.3 million, or $0.49 of diluted earnings per share, compared with a net loss of $137.5 million, or $(0.53) of diluted loss per share, a year earlier. Adjusted EBITDA, a non-GAAP measure, was $206.9 million, compared with an adjusted EBITDA loss of $101.5 million a year earlier.

Effectuated membership was 2,691,885 as of September 30, 2026, compared with 2,116,904 a year earlier. The company no longer offers small group plans, effective December 15, 2024, and did not renew the Cigna+Oscar Small Group arrangement after its initial term ended December 31, 2024.

Cash and cash equivalents were $4.47 billion as of September 30, 2026, compared with $2.77 billion at December 31, 2025. Short-term investments were $3.02 billion. Total assets were $10.01 billion.

The company also raised its full-year 2026 total-revenue outlook to $19.0 billion to $19.3 billion from $18.7 billion to $19.0 billion. It tightened the full-year medical loss ratio outlook to 80.5% to 81.5% from 81.0% to 82.0%, and the SG&A expense-ratio outlook to 15.1% to 15.6% from 15.6% to 16.1%.

Bertolini said the ACA is the foundation of a rapidly developing individual market and that Oscar Health is built to lead it. He said disciplined pricing, consumer-led products, and a technology-powered approach are driving stronger economics and position the company to grow market share and expand margin in 2027.