Oscar Health Raises 2026 Operating Earnings Outlook After Q3 Profit

Oscar Health raised its 2026 operating earnings forecast to $850 million-$950 million after posting third-quarter net income attributable to the company of $167.3 million. That compared with a $137.5 million loss in the same quarter a year earlier.

Revenue for the quarter ended Sept. 30 reached $5.139 billion, up 72.1% from $2.986 billion a year earlier. Oscar had 2,691,885 effectuated members at quarter-end, about 27.2% more than a year earlier.

Quarterly revenue included a $250 million benefit from updated risk-adjustment estimates. The adjustment reflected favorable development in Oscar’s risk scores relative to the market and market morbidity that was modestly more favorable than expected. Higher rates and membership also contributed to premium-revenue growth. Earnings from operations were $178 million, compared with an operating loss of $129.3 million a year earlier. Diluted earnings per share were $0.49, versus a loss of $0.53.

The medical loss ratio, a measure of medical costs against net premiums before ceded quota-share reinsurance, improved to 84% from 88.5%. The improvement was primarily driven by pricing strategy. The selling, general and administrative expense ratio fell to 14% from 17.5%, even as those expenses rose 38% to $721.9 million. The ratio declined as Oscar managed expenses and spread fixed costs across a larger membership base, while risk adjustment represented a smaller share of premium; dollar costs rose with enrollment, volume-related expenses and exchange user fees.

Oscar also raised its 2026 revenue forecast to $19 billion-$19.3 billion from $18.7 billion-$19 billion. It lowered its projected medical loss ratio range to 80.5%-81.5% from 81%-82%, and its selling, general and administrative expense ratio range to 15.1%-15.6% from 15.6%-16.1%.

Oscar released results at 6 a.m. ET (11:00 UTC) on Nov. 5. Shares had gained 8.58% to $35.19 at the Nov. 4 close, before the release. They reached $38.50 during Nov. 5 trading and closed at $33.18, down 5.71%, at 4 p.m. ET (21:00 UTC).