Oscar Health Announces Financial Results for Third Quarter 2026 and Raises Full Year 2026 Outlook
Oscar Health, Inc. (OSCR) filed an SEC Form 8-K — Results of Operations and Financial Condition. Oscar Health, Inc. ir.oscarhealth.com News Release Oscar Health Announces Financial Results for Third Quarter 2026 and Raises Full Year 2026 Outlook New York, NY, November 5, 2026 – Oscar Health, Inc. (“Oscar Health” or the “Company”) (NYSE: OSCR) announced today its financial re
How this was made
The 30-second read
Why it matters
The Q3 results and raised full‑year outlook provide fresh data for valuation models and may trigger re‑rating by analysts.
Market read
The earnings beat and raised guidance are likely to drive short‑term upside in OSCR and influence sentiment in the health‑insurance sector.
What to watch
Potential regulatory changes to ACA could affect future growth despite current guidance.
Oscar Health Announces Financial Results for Third Quarter 2026 and Raises Full Year 2026 Outlook
Third-quarter revenue, underwriting ratios, operating income, net income, and Adjusted EBITDA all improved materially from the prior-year quarter, while the company raised each of its full-year operating outlook ranges.
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total revenue, three months ended September 30GAAP | $5.14B | – | – |
| Premium revenue, three months ended September 30GAAP | $5.04B | – | – |
| Investment income, three months ended September 30GAAP | $91.02M | – | – |
| Other revenues, three months ended September 30GAAP | $6.29M | – | – |
| Medical expenses, three months ended September 30GAAP | $4.23B | – | – |
| Medical loss ratio, three months ended September 30other | 84.0 % | – | – |
| Selling, general, and administrative expense, three months ended September 30GAAP | $721.9M | – | – |
| SG&A expense ratio, three months ended September 30other | 14.0% | – | – |
| Depreciation and amortization, three months ended September 30GAAP | $6.54M | – | – |
| Total operating expenses, three months ended September 30GAAP | $4.96B | – | – |
| Earnings (loss) from operations, three months ended September 30GAAP | $178.0M | – | – |
| Interest expense, three months ended September 30GAAP | $4.73M | – | – |
| Other expenses (income), three months ended September 30GAAP | −$2.09M | – | – |
| Earnings (loss) before income taxes, three months ended September 30GAAP | $175.4M | – | – |
| Income tax expense (benefit), three months ended September 30GAAP | $8.08M | – | – |
| Net income (loss), three months ended September 30GAAP | $167.3M | – | – |
| Net income (loss) attributable to Oscar Health, Inc., three months ended September 30GAAP | $167.3M | – | – |
| Basic earnings (loss) per share, three months ended September 30GAAP | $ 0.54 | – | – |
| Diluted earnings (loss) per share, three months ended September 30GAAP | $ 0.49 | – | – |
| Adjusted EBITDA, three months ended September 30non-GAAP | $206.9M | – | – |
| Total revenue, nine months ended September 30GAAP | $14.67B | – | – |
| Medical loss ratio, nine months ended September 30other | 78.1 % | – | – |
| SG&A expense ratio, nine months ended September 30other | 14.4% | – | – |
| Earnings (loss) from operations, nine months ended September 30GAAP | $1.27B | – | – |
| Net income (loss) attributable to Oscar Health, Inc., nine months ended September 30GAAP | $1.21B | – | – |
| Diluted earnings (loss) per share, nine months ended September 30GAAP | $ 3.59 | – | – |
| Adjusted EBITDA, nine months ended September 30non-GAAP | $1.35B | – | – |
| Individual and Small Group effectuated membership as of September 30other | 2,691,885 | – | – |
| Cigna+Oscar effectuated membership as of September 30other | — | – | – |
| Total effectuated members as of September 30other | 2,691,885 | – | – |
| Net cash provided by operating activities, nine months ended September 30GAAP | $3.51B | – | – |
| Net cash used in investing activities, nine months ended September 30GAAP | −$1.85B | – | – |
| Net cash provided by financing activities, nine months ended September 30GAAP | $20.55M | – | – |
| Increase in cash, cash equivalents and restricted cash equivalents, nine months ended September 30GAAP | $1.69B | – | – |
| Cash and cash equivalents as of September 30, 2026GAAP | $4.47B | – | – |
| Short-term investments as of September 30, 2026GAAP | 3,021,732 | – | – |
| Long-term investments as of September 30, 2026GAAP | 1,441,909 | – | – |
| Long-term debt as of September 30, 2026GAAP | 432,410 | – | – |
| Total assets as of September 30, 2026GAAP | $10.01B | – | – |
| Total liabilities as of September 30, 2026GAAP | 7,783,186 | – | – |
| Total stockholders' equity as of September 30, 2026GAAP | 2,225,794 | – | – |
Amounts quoted below without a unit are in thousands, as in the filing’s tables. Per-share figures are as printed.
Updated Full Year 2026 Outlook outlook
- Revenue$19.0 billion to $19.3 billion
- NoteMedical loss ratio: 80.5% to 81.5%
- NoteSG&A expense ratio: 15.1% to 15.6%
- NoteEarnings from operations: $850 million to $950 million
What drove it
- The increase in third-quarter total revenue was driven by rate increases and higher membership.
- Revenue for the third quarter of 2026 included a $250 million benefit from updated risk adjustment estimates, driven by favorable development in the Company’s risk scores relative to the market and modestly favorable market morbidity relative to expectations.
- The decrease in MLR was primarily driven by the Company’s disciplined pricing strategy.
- The decrease in the SG&A expense ratio was primarily due to lower risk adjustment as a percentage of premium, greater fixed cost leverage, and disciplined expense management.
- The increase in earnings from operations reflected strong operating performance driven primarily by improved underwriting performance.
Concerns
- Third-quarter revenue included a $250 million benefit from updated risk adjustment estimates.
- The Company had $42 million of favorable prior period development in the third quarter of 2026, compared to $84 million in the third quarter of 2025.
- The filing identifies uncertainty around risk adjustment programs, medical-cost and market-morbidity estimates, ACA-related laws and regulations, the expiration of enhanced Advanced Premium Tax Credits, and capital reserve and surplus requirements.
- Cigna+Oscar membership was — as of September 30, 2026, following the decision not to renew the Cigna+Oscar Small Group arrangement after December 31, 2024.
What to watch
- Full-year 2026 execution against updated total revenue guidance of $19.0 billion to $19.3 billion.
- Whether full-year MLR lands within the updated 80.5% to 81.5% range.
- Whether the SG&A expense ratio remains within the updated 15.1% to 15.6% range as membership grows.
- The sustainability of favorable risk adjustment estimates and prior-period development.
- Progress toward the updated full-year earnings from operations range of $850 million to $950 million.
Balance sheet and cash flow
- Cash and cash equivalents were $ 4,466,858 as of September 30, 2026, compared with $ 2,774,151 as of December 31, 2025.
- Short-term investments were 3,021,732 and long-term investments were 1,441,909 as of September 30, 2026.
- Long-term debt was 432,410 as of September 30, 2026, compared with 430,095 as of December 31, 2025.
- Net cash provided by operating activities was $ 3,510,737 for the nine months ended September 30, 2026, compared with $ 422,951 for the nine months ended September 30, 2025.
- Net cash used in investing activities was $ (1,845,926) for the nine months ended September 30, 2026, compared with $ (192,354) for the nine months ended September 30, 2025.
- Net cash provided by financing activities was $ 20,548 for the nine months ended September 30, 2026, compared with $ 391,040 for the nine months ended September 30, 2025.
Analysis
Oscar Health reported a substantially stronger third quarter than the prior-year period. Total revenue was approximately $5.1 billion compared to $3.0 billion, while earnings from operations were $178.0 million compared to a loss from operations of $129.3 million. Net income attributable to Oscar Health, Inc. was $167.3 million, or $0.49 of diluted earnings per share, compared to a net loss of $137.5 million, or $(0.53) of diluted loss per share. Adjusted EBITDA was $206.9 million compared to an adjusted EBITDA loss of $101.5 million.
Revenue expansion reflected rate increases and higher membership, with total effectuated members of 2,691,885 as of September 30, 2026, versus 2,116,904 a year earlier. The reported quarter also included a $250 million benefit from updated risk adjustment estimates. Management attributed that benefit to favorable development in its risk scores relative to the market and modestly favorable market morbidity relative to expectations.
Underwriting and expense ratios improved. MLR was 84.0%, compared with 88.5%, with the company citing disciplined pricing as the primary factor. The SG&A expense ratio was 14.0%, compared with 17.5%, reflecting lower risk adjustment as a percentage of premium, greater fixed-cost leverage, and disciplined expense management. Favorable prior-period development was $42 million in the quarter, compared with $84 million in the prior-year period, making risk adjustment and reserve development key determinants of reported profitability.
Nine-month operating cash flow was $3,510,737, compared with $422,951, and cash and cash equivalents were $4,466,858 as of September 30, 2026. Long-term debt was 432,410. The company raised its full-year 2026 outlook, moving total revenue to $19.0 billion to $19.3 billion, MLR to 80.5% to 81.5%, SG&A expense ratio to 15.1% to 15.6%, and earnings from operations to $850 million to $950 million. The higher outlook places continued pricing discipline, medical-cost management, risk adjustment outcomes, and expense leverage at the center of the remaining full-year execution.
Management, verbatim
Oscar Health is on track to deliver the strongest year of financial performance in our history, and we are raising our earnings from operations outlook for a third time.
Mark Bertolini, CEO of Oscar Health
Not in the filing
stated, not guessed- Gross margin was not reported.
- Free cash flow was not reported.
- No dividends, share repurchases, or other capital-return program was reported.
- A quarterly operating cash flow figure was not reported.
- A reported income tax rate was not provided.
- Segment revenue was not reported.
- Guidance for earnings per share, Adjusted EBITDA, cash flow, or capital returns was not provided.
- No previous-release outlook was provided for comparison in vs_prior_guidance.
- Balance-sheet comparative figures are presented as of December 31, 2025, rather than a prior-year or prior-quarter period supported by the Metric schema.
Written by an AI language model from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure is checked against the filing text, and a metric the filing does not print, or whose value, prior period and change do not add up, is dropped from the metrics. The model can still misread a table, in the metrics or in the text, so check a number in the filing before you rely on it. Consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.
Background
Oscar Health is a publicly traded health‑insurance company (NYSE: OSCR) that recently exited small‑group plans and focuses on individual market growth.
Ticker impact
Oscar Health disclosed Q3 2026 results and updated full-year guidance, raising outlook to $19.0‑$19.3 B revenue and $850‑$950 M earnings from operations.
likely upward pressure as the market prices in the raised guidance
The company reported a swing to $178 M earnings from operations and lifted full‑year earnings guidance, indicating stronger margins and growth.
Market effects
Health‑tech insurers may see increased investor interest as Oscar Health shows margin improvement.
U.S. market may see modest gains in the health‑insurance sector.
Limited, primarily U.S. focused.
Counterpoint
If the guidance is overly optimistic, the stock could face a pull‑back on earnings sustainability concerns.
Key entities
- ExecutiveMark Bertolini
CEO of Oscar Health who announced the results and guidance.
