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Will Declining Medical Membership Affect Humana's Q4 Earnings?


Humana Inc. HUM is set to report fourth-quarter 2025 results on Feb. 11, 2026, before the opening bell. For the to-be-reported quarter, the Zacks Consensus Estimate projects a loss of $4.01 per share on revenues of $31.9 billion.

The consensus estimate for the fourth-quarter loss has widened by a penny over the past 60 days. However, the bottom-line projection indicates a year-over-year decrease of 85.7%. The Zacks Consensus Estimate for quarterly revenues implies year-over-year growth of 9.2%.

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Image Source: Zacks Investment Research

For full-year 2025, the Zacks Consensus Estimate for Humana’s revenues is pegged at $128.9 billion, implying a rise of 10% year over year. Also, the consensus mark for the current year EPS is pegged at $17.07, implying a gain of around 5.3% on a year-over-year basis.

HUM’s earnings beat the consensus estimate in three of the trailing four quarters and missed once, with the average surprise being 7.5%.

Humana Inc. Price and EPS Surprise

Humana Inc. Price and EPS Surprise

Humana Inc. price-eps-surprise | Humana Inc. Quote

Q4 Earnings Whispers for HUM

Our proven model does not conclusively predict an earnings beat for the company this time around. The combination of a positive Earnings ESP and a Zacks Rank #1 (Strong Buy), 2 (Buy) or 3 (Hold) increases the odds of an earnings beat. However, that’s not the case here.

Humana currently has an Earnings ESP of 0.00% and a Zacks Rank #4 (Sell). You can uncover the best stocks to buy or sell before they’re reported with our Earnings ESP Filter.

You can see the complete list of today’s Zacks #1 Rank stocks here.

What’s Shaping HUM’s Q4 Results?

The Zacks Consensus Estimate for HUM’s fourth-quarter premiums indicates an 8.9% increase from the prior-year quarter’s reported figure, whereas our model predicts 7.4% growth. Similarly, the consensus mark for service revenues signals a 22.2% increase from a year ago.

The Zacks Consensus Estimate for operating income from the CenterWell unit indicates 6.4% growth from a year ago. The Zacks Consensus Estimate for specialty membership is expected to witness nearly 2.1% growth in the quarter under review.
However, the Zacks Consensus Estimate for operating income from the Insurance unit predicts a 9.7% decrease from the year-ago level.

Furthermore, the consensus estimate indicates that Humana’s investment income will see an 8.2% drop from the year-ago level. We expect total operating costs to increase 7% in the fourth quarter, pushing the figure above $31.8 billion. This is likely to have led to a year-over-year decline in the bottom line.

The consensus mark for the overall benefits expense ratio is pegged at 93.26% for the to-be-reported quarter, deteriorating from 91.5% a year ago. Also, the Zacks Consensus Estimate for medical membership suggests a 7.6% year-over-year decline.

How Did Peers Perform?

Several healthcare companies, including The Cigna Group CI, UnitedHealth Group Incorporated UNH and Elevance Health, Inc. ELV, have already reported their financial results for the December quarter of 2025. Here’s how they had performed:

Cigna reported fourth-quarter 2025 adjusted earnings per share of $8.08, which beat the Zacks Consensus Estimate by 2.7%. The bottom line advanced 22% year over year. The results benefited on the back of strong results from its Evernorth Health Services segment, driven by new business and client relationship expansion, Pharmacy Benefit Services’ strength and improved specialty volumes. However, the upside was partly offset by a decline in Cigna’s medical customers following divestitures to Health Care Services Corporation and an elevated expense level.

UnitedHealth reported fourth-quarter 2025 adjusted EPS of $2.11, which beat the Zacks Consensus Estimate of $2.09. However, the bottom line fell 69% from the year-ago period. The earnings were aided by growth in commercial fee-based membership and the strength witnessed in Optum Rx. However, UnitedHealth’s elevated medical costs and declining risk-based membership partially offset the positives.

Elevance reported fourth-quarter 2025 adjusted EPS of $3.33, which surpassed the Zacks Consensus Estimate by 7.3%. The bottom line rose 3.1% year over year. The earnings benefited on the back of strong growth in premiums. Segment-wise, the Carelon division posted a robust revenue surge, aided by buyout and scaling risk-based services, while Health Benefits saw increased premium yields and Medicare Advantage membership growth. However, the upside was partly offset by a decline in Elevance’s overall medical membership and an elevated expense level.

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UnitedHealth Group Incorporated (UNH): Free Stock Analysis Report
 
Humana Inc. (HUM): Free Stock Analysis Report
 
Cigna Group (CI): Free Stock Analysis Report
 
Elevance Health, Inc. (ELV): Free Stock Analysis Report

This article originally published on Zacks Investment Research (zacks.com).

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At Zacks, we are dedicated to independent investment research, helping investors succeed through tools like our Zacks Rank stock-rating system, which has averaged +23.89% annual returns since 1988. Founded on the discovery that earnings estimate revisions drive stock prices, we offer purely mathematical, unbiased ratings, along with additional innovations like the Price Response Indicator, Earnings ESP, and specialized rankings for mutual funds and ETFs.
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