UnitedHealth Q3 2026 earnings: adjusted EPS jumps to $4.69 as medical cost ratio eases to 88.4%; outlook raised

UnitedHealth Group's earnings rose sharply in the third quarter as the health insurer spent a smaller share of premiums on medical care. The company reported adjusted earnings of $4.69 per share on Tuesday, up from $2.92 a year earlier, and raised its full-year outlook.

On a GAAP basis, diluted EPS was $4.56, compared with $2.59 in the third quarter of 2025. Earnings from operations climbed to $6.6 billion from $4.3 billion.

UnitedHealth now expects 2026 earnings of at least $19.50 per share, and adjusted earnings of at least $20.50 per share, "incorporating experience through the third quarter," according to the release.

The cost ratio did the heavy lifting

The medical care ratio, the share of premiums paid out for care, fell to 88.4% from 89.9% a year ago. The company credited medical cost management, benefit design changes, pricing discipline and care delivery changes. The quarter included $610 million of net favorable reserve development tied to 2026 dates of service.

The operating cost ratio also improved, to 12.8% from 13.5%, which UnitedHealth tied to investments to modernize operations and streamline administration.

Revenue slipped to $112.7 billion from $113.2 billion. Cash flows from operations were $5.1 billion, or 1.2 times net income.

"Our third quarter results reflect the discipline and execution our teams are bringing to every part of our business," CEO Stephen Hemsley said.

Optum Health's margin rebuild

UnitedHealthcare, the insurance arm, served 48.3 million consumers and earned $2.8 billion on $86.3 billion of revenue. Optum earned $3.7 billion on $66.9 billion of revenue.

Inside Optum, the value-based care unit Optum Health earned $735 million from operations, a 3.2% margin, versus $41 million and a 0.2% margin a year earlier. Its revenue fell 10% to $22.9 billion, which the company attributed to serving fewer value-based care patients in markets where it lacked enough presence to sustain its clinicians.

The release also highlighted a $1 billion commitment to the United Health Foundation and a pledge to eliminate and rebate profits from its 2026 individual Affordable Care Act offerings to roughly 1 million members.

By the numbers

• Adjusted EPS: $4.69 (vs. $2.92)
• GAAP diluted EPS: $4.56 (vs. $2.59)
• Revenue: $112.7 billion (vs. $113.2 billion)
• Medical care ratio: 88.4% (vs. 89.9%)
• 2026 outlook: at least $19.50 GAAP EPS; at least $20.50 adjusted
• Debt-to-capital: 41.7% at Sept. 30

Sources

1. UnitedHealth Group Incorporated, Form 8-K, Exhibit 99.1, "UnitedHealth Group Reports Third Quarter 2026 Results," filed Oct. 13, 2026 (accession 0000731766-26-000255)

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