Elevance Health beats estimates on earnings, gives underwhelming guidance

Elevance Health, already battered after the Trump administration proposed keeping payments to private Medicare plans flat in 2027, reported earnings results on Wednesday that beat Wall Street estimates, but gave a disappointing full-year outlook.

For the last three months of 2025, Elevance Health reported:

• $3.33 adjusted earnings per share, compared to the $3.10 analysts polled by FactSet were expecting.

• $49.3 billion in revenue, compared to the $49.8 billion the Street was penciling in.

• A medical cost ratio of 93.5%, right in line with estimates.

For full-year 2026, the company expects to report:

• Annual adjusted earnings per share of at least $25.50, short of the $29.99 analysts are currently penciling in.

CEO Gail Boudreaux told analysts Wednesday morning that the company sees 2026 as a “trough” year. “The outlook we provided today reflects prudent, achievable assumptions, grounded in pricing discipline, operational rigor, and targeted investments,” she said.

The earnings report comes after the Trump administration said Tuesday it would seek roughly no change in rates for Medicare insurers, sending Elevance and a host of other major Medicare Advantage providers lower. The proposal complicates the turnaround story insurers like Elevance had been telling investors after taking a major hit in 2025 amid higher-than-expected medical costs.

Boudreaux said the company expects Medicare Advantage membership to “decline in the high teens percentage range in 2026.”