Elevance Health Inc. reported fourth-quarter and full-year 2025 financial results that met company expectations but signaled challenges ahead, according to a company statement.
The Indianapolis-based health insurer posted fourth-quarter operating revenue of $49.3 billion, a 10% increase compared with the same period in 2024. Full-year operating revenue reached $197.6 billion, up 13% year on year.
However, the company reported diluted earnings per share (EPS) of $2.47 for the fourth quarter, compared with adjusted diluted EPS of $3.33. For the full year, diluted EPS came in at $25.21, with adjusted diluted EPS of $30.29.
Looking ahead, Elevance Health projected 2026 GAAP diluted EPS of at least $22.30 and adjusted diluted EPS of at least $25.50, down from 2025 levels.
“Elevance Health delivered fourth-quarter results in line with our outlook, reflecting disciplined execution in a dynamic environment,” president and chief executive officer Gail K. Boudreaux said. “Through pricing discipline and targeted investments, we are strengthening the earnings power of our diversified platform and remain confident in our ability to return to at least 12% adjusted EPS growth in 2027.”
The company’s benefit expense ratio rose 110 basis points to 93.5% in the fourth quarter compared with the prior year. The increase reflected higher medical cost trends, primarily in Affordable Care Act health plans, and heightened Medicare Part D seasonality driven by Inflation Reduction Act changes.
Medical membership totaled approximately 45.2 million as of 31 December 2025, a 1% decline year on year, driven by attrition in the Medicaid business.
Elevance Health’s Health Benefits segment reported an adjusted operating loss of $0.2 billion in the fourth quarter and an adjusted operating gain of $4.2 billion for the full year. The Carelon segment posted an adjusted operating gain of $0.6 billion in the fourth quarter and $3.4 billion for the full year, up 10% annually.
The company returned $4.1 billion of capital to shareholders in 2025 through share repurchases and dividends. During the fourth quarter, Elevance Health repurchased 1.4 million shares for $471 million at a weighted average price of $335.64.
Operating cash flow totaled $4.3 billion in 2025, approximately 0.8 times GAAP net income.
