UnitedHealth Group Inc. (NYSE: UNH) on October 13, 2026, raised its full year 2026 earnings outlook and now expects adjusted net earnings of at least $20.50 per share. The company said the forecast incorporates its experience through the third quarter 2026.
On a GAAP basis, UnitedHealth now expects full year earnings of at least $19.50 per share. GAAP refers to standard US accounting rules, while the adjusted figure excludes items such as the amortization of acquired intangible assets and gains or losses tied to business sales.
The updated outlook follows third quarter adjusted earnings of $4.69 per share, compared with $2.92 in the third quarter 2025. GAAP diluted earnings were $4.56 per share, up from $2.59 a year earlier.
The release lists the Department of Justice's legal actions concerning UnitedHealth's participation in the Medicare program among the factors that could cause results to differ from expectations. It also cites changes in Medicare, the CMS star ratings program and risk adjustment data validation audits, which review the diagnosis data used to set government payments.
#UnitedHealth Medical Care Ratio Falls to 88.4% in Third Quarter
UnitedHealth's medical care ratio, the share of premium revenue spent on patient care, was 88.4% in the third quarter, compared with 89.9% a year earlier. The company attributed the decline to medical cost management, benefit design changes and pricing.
The ratio included $610 million of net favorable prior period reserve development related to 2026 dates of service. This means UnitedHealth's earlier estimates of claims owed for care delivered this year proved higher than the amounts now expected.
Earnings from operations were $6.6 billion, compared with $4.3 billion in the third quarter 2025. The company said the increase was driven by execution across both its UnitedHealthcare insurance unit and its Optum health services unit.
Consolidated revenue was $112.7 billion, compared with $113.2 billion a year earlier. Revenue in the second quarter 2026 was $112 billion.
The operating cost ratio, which measures administrative costs against revenue, was 12.8%, compared with 13.5% in the third quarter 2025. The company said efficiency gains were partly offset by increased spending on technology, processes and staff.
"Our third quarter results reflect the discipline and execution our teams are bringing to every part of our business," Stephen Hemsley, Chief Executive Officer, UnitedHealth Group, said in the earnings release.
#Optum Health Posts $735 Million Operating Profit as Revenue Falls 10%
UnitedHealthcare earned $2.8 billion from operations in the quarter, up from $1.8 billion a year earlier, on revenue of $86.3 billion. The unit served 48.3 million people, compared with about 50.1 million at the end of the third quarter 2025.
The number of seniors served through Medicare Advantage, including programs for complex populations also covered by Medicaid, has contracted by 935,000 since year-end 2025, according to the release.
Optum Health revenue fell 10% to $22.9 billion. The company said it served fewer patients under value-based care, arrangements in which providers are paid based on patient outcomes and costs, in markets where it lacked enough presence to sustain its clinicians.
Optum Health earnings from operations rose to $735 million from $41 million a year earlier. The company attributed the change to operational discipline and medical cost management in its value-based care markets.
Optum Rx, the company's pharmacy benefits business, reported earnings from operations of $1.7 billion, compared with $1.5 billion a year earlier. Adjusted scripts fell to 393 million from 414 million, which the company linked to membership declines at UnitedHealthcare and other customers.
Optum Insight, the data and technology unit, reported revenue of $5.5 billion, up 3% from a year earlier. Its earnings from operations rose to $1.3 billion from $920 million.
A sharper way to see the markets in just 5 minutes.
Same news, different lens. We cut through the noise and hand you the overlooked ideas and the deeper read the crowd misses. Join 38,000+ investors seeing the markets differently.
#UnitedHealth Flags Commercial Costs and Medicaid Funding as Pressures
On the earnings call, Tim Noel, who leads UnitedHealthcare, said commercial medical cost trends are running above the company's initial expectation of 11%. He cited costs tied to the No Surprises Act dispute process, greater cost intensity from clinicians and high-cost specialty drugs.
The No Surprises Act is a federal law intended to protect patients from unexpected medical bills. Noel said arbitration awards under its dispute process can approach nearly 6% of total medical spending in some regions.
Noel said UnitedHealth continues to view 2026 as a trough year for core Medicaid margins, which it now expects to be moderately better than negative 1%. He said the main variable remains the timing and adequacy of state funding.
UnitedHealth's debt-to-capital ratio was 41.7% as of September 30, 2026, compared with 41.2% at the end of the second quarter. The company said it continues to target approximately 40% by year-end.
The company repurchased $5 billion of its stock and paid $6.2 billion in dividends through the first nine months of 2026. Chief Financial Officer Wayne DeVeydt said the company expects dividends to exceed $8 billion by year-end.
Management said it views the lower end of its 13% to 16% long-term growth target as a more reasonable starting point for 2027 and plans a fuller update in December, though elevated medical cost trends, government program funding and the Department of Justice's legal actions remain key risks to that outlook.