UnitedHealth says 2025 earnings will be worse than expected as high medical costs dog insurers

• UnitedHealth gave 2025 earnings guidance that fell well short of Wall Street's expectations.
• The company and the broader insurance industry are grappling with higher medical costs in Medicare Advantage plans.
• The report adds to a growing string of setbacks for the company, which owns the nation's largest and most powerful insurer and is often viewed as the industry's bellwether.

UnitedHealth Group on Tuesday issued a 2025 outlook that fell short of Wall Street's expectations, as the company's insurance unit continues to grapple with higher medical costs.

Shares of UnitedHealth Group fell more than 3% in premarket trading on Tuesday.

The company anticipates it will post 2025 adjusted earnings of at least $16 per share, with revenue of $445.5 billion to $448 billion. Wall Street analysts had expected 2025 adjusted profit of $20.91 per share, and full-year revenue of $449.16 billion, according to consensus estimates from LSEG.

The stock tumbled in May after the company suspended that 2025 guidance due to elevated medical costs and announced the abrupt departure of former CEO Andrew Witty. The report Tuesday adds to a growing string of setbacks for the company, which owns the nation's largest and most powerful insurer, UnitedHealthcare, and is often viewed as the industry's bellwether.

“While we face challenges across our lines of business, we believe we can resolve these issues and recapture our earnings growth potential while ensuring people have access to high-quality, affordable health care,” UnitedHealthcare CEO Tim Noel said in a release.

The company expects its insurance unit's 2025 medical care ratio — a measure of total medical expenses paid relative to premiums collected — to come in between 89% and 89.5%. A lower ratio typically indicates that a company collected more in premiums than it paid out in benefits, resulting in higher profitability.

For the second quarter, that ratio increased to 89.4% from 85.1% during the year-earlier period, primarily due to medical costs.

UnitedHealth Group's report signals that elevated medical costs in Medicare Advantage plans may not ease anytime soon for the broader health insurance industry. UnitedHealthcare, the insurance arm of UnitedHealth Group, is the nation's largest provider of those privately run Medicare plans.

Higher expenses in Medicare Advantage plans have dogged insurers over the past year as more seniors return to hospitals to undergo procedures they had delayed during the Covid-19 pandemic, such as joint and hip replacements.

Here's what UnitedHealth Group reported for the second quarter compared with what Wall Street was expecting, based on a survey of analysts by LSEG:

• Earnings per share: $4.08 adjusted vs. $4.48 expected
• Revenue: $111.62 billion vs. $111.52 billion expected

Notably, the report comes just days after UnitedHealth revealed it is complying with Department of Justice investigations into its Medicare billing practices.

It marks UnitedHealth's first earnings report under new CEO, Stephen Hemsley, who is tasked with restoring investor confidence and turning around a struggling company that has continued to draw heavy public scrutiny in recent months. Shares of UnitedHealth Group are down more than 44% for the year, fueled in part by the DOJ's investigations and its suspended outlook.

The company's 2024 wasn't any better. It grappled with the murder of UnitedHealthcare's CEO, Brian Thompson, the torrent of public blowback that followed and a historic cyberattack that affected millions of Americans.