While medical cost trend remains a pressure point for health insurers, leading companies cited some positive trends, too, heading into the final months of 2026.
UnitedHealth Group was once again the most profitable company among payers in the quarter, bringing in $4.1 billion in profit for Q3. That's up from a $2.3 billion haul in the prior-year quarter.
Through the first nine months of the year, profits were $15.9 billion at UHG, rising from $12 billion a year ago.
The healthcare giant has been in the midst of a critical financial turnaround since mid-2025, and in the most recent quarter, it highlighted some of the progress that it's logged over the past year at one of it's biggest pain centers: Optum Health.
When the company posted an uncharacteristically poor quarter to start 2025, Optum Health was cited as one of the main pressure points. During its most recent call, Optum CEO Patrick Conway, M.D., said the transition centered on a "continued return to value-based care principles" that sit at the core of Optum Health.
UnitedHealth also led the way on revenue in Q3, posting $112.7 billion. That's down slightly from $113.2 billion the company reported in the third quarter of 2025.
CVS Health had the second-highest profit and revenue in Q3, bringing in $2.2 billion in earnings for the quarter. This marks a significant reversal from the prior-year quarter, when the company posted a nearly $4 billion loss.
CVS' revenue in the quarter was $108.4 billion, increasing from $102.9 billion in the third quarter of 2025.
The company's financial performance wasn't what dominated the headlines in Q3, however, as CVS shocked the industry in announcing plans to split its pharmacy business off and form two companies. The break-up is expected to close in the first half of 2028, and would establish CVS Pharmacy as its own company while Aetna and Caremark would remain together as CVS Health.
CVS CEO David Joyner said that the shift represents "a structure and plan that are built to win and represent the best path to create value over the long term."
The Cigna Group and Elevance Health were on par with one another in Q3 on profits, both earning $1.4 billion. Cigna wins out on revenue, though, with $73.7 billion, while Elevance reported $51.4 billion.
By comparison, Cigna posted $1.9 billion in profit and $69.7 billion in revenue in Q3 2025.
Core to the third quarter conversation was the company's newly-unveiled Lead to One healthcare transformation strategy, which puts an emphasis on building a personalized experience for its members and customers.
Cigna said it plans to lean on all of the segments under its umbrella to drive toward meeting individual member needs.
Elevance Health, meanwhile, increased its profit slightly year over year from $1.2 billion in Q3 2025. Revenues in the prior-year quarter were $50.7 million.
The company was one of several insurers in the quarter that noted positive signs in its Medicaid plans. While its leaders told investors that 2026 remains a "trough year" for its Medicaid business, improvements are likely in the cards for 2027.
That trend is supported by state rate setting that more fully accounts for the rising cost of care and the acuity of people enrolled in Medicaid, executives said. The member mix is only expected to increase in acuity as states roll out work requirements at the beginning of this year.
Similarly, Centene CEO Sarah London said the company sees an opportunity for "long-term growth" in the Medicaid market as part of its Q3 report. She noted similar trends around rate setting from states.
London added that the insurer has made significant progress on focus areas for improvement, such as behavioral health.
Centene posted a $71 million loss in the quarter, slimming its losses significantly from $6.6 billion in the prior-year quarter. That massive loss a year ago was backstopped by a one-time impairment charge of more than $6 billion.
Revenues in Q3 were $50.6 billion, up slightly from $49.7 billion in the third quarter of 2025.
Humana offered color on early signals in the Medicare annual enrollment period, which suggests that the insurer is poised for further growth in Medicare Advantage for next year. CEO Jim Rechtin said sign-ups through the early parts of the window indicate 2027 membership growth.
The insurer has had momentum around new sign-ups and has also done well in recapturing enrollments that were impacted by market exits, Rechtin said.
Humana posted a $162 million profit in the third quarter, down from $195 million a year ago. Revenues were $41.15 billion, growing from $32.6 billion in the prior-year quarter.