UnitedHealth's Profit Jumps as 935,000 Medicare Advantage Members Leave: What Seniors Should Check Before Open Enrollment

The nation's largest health insurer is making more money by spending less on care, and that strategy shows up in the plans seniors will choose from this fall.

UnitedHealth Group, the parent company of UnitedHealthcare and the largest Medicare Advantage insurer in the country, reported a big jump in third-quarter profit on Tuesday, Oct. 13, and raised its forecast for the year.

The company earned $4.1 billion, or $4.56 a share, in the July-to-September quarter, up from $2.3 billion, or $2.59 a share, a year earlier. It now expects adjusted earnings of at least $20.50 a share for 2026, up from its earlier forecast of $19.50 to $20, according to Reuters. Shares rose about 4.5% in premarket trading.

But the details matter more for families than the headline profit. The company is covering fewer people, especially in Medicare Advantage, and it credited its improved results in part to "benefit design changes." With Medicare's annual open enrollment starting Oct. 15, here's what the numbers say and what to look for in your own coverage.

What UnitedHealth reported

UnitedHealth's revenue slipped slightly to $112.7 billion from $113.2 billion a year earlier, but its operating earnings jumped to $6.6 billion from $4.3 billion.

The key number for health insurers is the medical care ratio, the share of premium dollars an insurer spends on members' actual medical care. A lower ratio means the company keeps more of each premium dollar. UnitedHealth's ratio fell to 88.4% from 89.9% a year earlier. The company said that included $610 million in favorable "reserve development," meaning some medical costs it had set money aside for came in lower than expected.

In its earnings release, UnitedHealth credited the improvement to medical cost management, benefit design changes, pricing discipline and changes in how it delivers care. "Our third quarter results reflect the discipline and execution our teams are bringing to every part of our business," CEO Stephen Hemsley said.

Fewer people covered, especially seniors

At the same time, UnitedHealthcare is serving fewer people. It covered about 48.3 million people with medical insurance at the end of September, down from about 50.1 million a year earlier.

The drop is sharpest in Medicare Advantage, the private-insurer alternative to Original Medicare. UnitedHealthcare had about 7.6 million Medicare Advantage members, down from about 8.4 million at the end of 2025. Counting programs for seniors with complex needs that are reported under Medicaid, 935,000 Medicare Advantage seniors have left since the end of last year, the company said.

That was largely by design. A year ago, the company said it would drop plans covering more than 600,000 people for 2026 and expected others to leave after it raised prices and trimmed benefits, the Minnesota Star Tribune reported at the time.

The company also lost 165,000 members from employer plans in the quarter, and 85,000 from Medicaid because of changes in who qualifies.

For 2027, UnitedHealthcare plans to offer Medicare Advantage in 2,791 counties across 47 states and Washington, D.C., slightly more than this year, but will exit Wyoming, according to Forbes. The company said at least 69% of its Medicare Advantage members are in plans rated four stars or higher for 2027, in line with its expectations.

What this means for your wallet

If you're on Medicare, or turning 65 soon, this is a good reminder that insurers' plans change every year, and the changes aren't always in your favor.

Medicare's open enrollment period runs from Oct. 15 to Dec. 7. During that window, you can switch Medicare Advantage plans, move between Medicare Advantage and Original Medicare, or change your Part D drug plan. Changes take effect Jan. 1.

When an insurer focuses on cutting costs, the changes can show up in several places: a higher monthly premium, a bigger deductible or copays, a smaller network of doctors and hospitals, new prior-authorization rules, or trimmed extras like dental, vision or over-the-counter allowances. Your plan should have mailed you an Annual Notice of Change describing what's different for next year. It's worth reading closely, even if you liked your plan this year.

Here are a few practical steps to consider. First, make a list of your doctors, hospitals and prescriptions, and check each one against the 2027 plan details, not just this year's. Second, compare your estimated total yearly cost, including premiums, copays and drug costs, not only the monthly premium. Medicare's online Plan Finder can help with that comparison. Third, if you live in an area where your insurer is leaving, watch for a notice explaining your options, so you aren't left without coverage.

Free, unbiased help is available through your State Health Insurance Assistance Program (SHIP), which offers one-on-one Medicare counseling. Be wary of unsolicited calls promising "free" benefits or asking for your Medicare number, which are common during enrollment season.

The bigger picture

UnitedHealth's results show a company choosing healthier profit margins over adding members, after a stretch of rising medical costs squeezed insurers. That may help its bottom line, but it can mean fewer generous plans for seniors to choose from. Other insurers have also trimmed Medicare Advantage offerings, and the number of plan choices in some areas has fallen.

For investors, the turnaround is good news: UnitedHealth's profit forecast beat analysts' expectations. For seniors, the lesson is simpler: don't assume next year's plan is the same as this year's. A little homework during open enrollment could save hundreds of dollars, or keep your favorite doctor in network.

This article is for education only and is not financial advice. Everyone's situation is different.