UnitedHealth raises 2026 profit outlook after medical costs ease and Optum earnings rebound

UnitedHealth Group raised its 2026 adjusted earnings outlook to at least $20.50 a share on Tuesday after third-quarter adjusted profit of $4.69 a share and a medical care ratio of 88.4%, even as revenue slipped slightly from a year earlier.

Stronger third-quarter earnings and a higher full-year target

UnitedHealth Group raised its 2026 profit outlook on Tuesday after third-quarter results showed stronger earnings and an improved medical care ratio. Adjusted earnings were $4.69 a share, and the company now expects full-year adjusted earnings of at least $20.50 a share.

On a GAAP basis, diluted earnings were $4.56 a share. Consolidated revenue was $112.7 billion, slightly below the year-ago $113.2 billion. Earnings from operations were $6.6 billion, up from $4.3 billion in the third quarter of 2025.

The company scheduled an 8:00 a.m. investor call for Tuesday morning.

Medical care ratio falls to 88.4% from 89.9%

UnitedHealth's medical care ratio — medical costs as a share of premiums — was 88.4% in the quarter, down from 89.9% a year earlier. The company said the ratio reflected medical-cost management, pricing discipline, benefit design changes and care-delivery work, and that it included $610 million of net favorable prior-period reserve development tied to 2026 dates of service.

The operating cost ratio fell to 12.8% from 13.5% a year earlier. Cash flow from operations was $5.1 billion, or 1.2 times net income. The debt-to-capital ratio was 41.7% at Sept. 30. Year to date, UnitedHealth repurchased $5.0 billion of stock and paid $6.2 billion in dividends.

UnitedHealthcare: higher earnings, fewer members in places

UnitedHealthcare, the insurance arm, posted $86.3 billion of revenue and $2.8 billion of operating earnings, with a 3.3% operating margin, up from $1.8 billion and 2.1% a year earlier. It served 48.3 million consumers.

Membership still shrank in several books. Employer and Individual people served fell by 165,000 in the quarter on employer attrition. Seniors in Medicare Advantage, including complex populations counted with Medicaid, are down 935,000 since year-end 2025. Community and State people served fell by 85,000 in the quarter amid Medicaid eligibility changes. Medicare and Retirement revenue was $42.4 billion, down from $43.4 billion a year earlier on membership and product mix. The company said its 2027 Medicare Advantage Stars results, at least 69% of members in 4+ Star plans, were in line with expectations.

Optum: Health margin rebound, Insight and Rx steady

Optum reported $66.9 billion of revenue and $3.7 billion of operating earnings, caring for more than 120 million patients and consumers. Operating margin was 5.6%, up from 3.6% a year earlier.

Optum Health revenue fell 10% to $22.9 billion as the company served fewer value-based care patients in markets where it said it lacked enough presence to sustain clinicians. Earnings from operations nonetheless jumped to $735 million, or a 3.2% margin, from $41 million and 0.2% a year earlier. Optum Insight revenue rose 3% to $5.5 billion, with operating earnings of $1.3 billion against $920 million. Optum Rx revenue was $39.9 billion, with earnings of $1.7 billion against $1.5 billion; adjusted scripts fell to 393 million from 414 million on membership declines at UnitedHealthcare and other customers.

What the new outlook does and does not settle

The lift to at least $20.50 of adjusted earnings per share for 2026 is the clearest signal that management is willing to mark up the year after three quarters of reported results. The company also guided GAAP diluted earnings to at least $19.50 a share. Chief executive Stephen Hemsley said the quarter reflected "discipline and execution" as UnitedHealth tries to deliver a simpler experience for patients and clinicians.

Open questions remain for the fourth quarter and 2027: how durable the medical-cost improvement is once the $610 million reserve development is set aside, how far Medicare Advantage membership and Stars economics move, and how the company's broader legal and regulatory overhangs resolve. The investor call is the next checkpoint.