In the fourth quarter of 2025, Elevance Health reported operating revenue of $49.3 billion, up 10 percent year-over-year. Health Benefits segment revenue rose 11 percent to $41.8 billion, driven by higher premium yields and growth in Medicare Advantage membership, which added approximately 1.2 million lives during the year. Carelon’s revenue surged 27 percent to $18.7 billion, fueled by expansion of CarelonRx product lines and increased adoption of risk-based solutions in Carelon Services, including the acquisition of CareBridge, which contributed $0.8 billion of revenue in the quarter.

Benefit expense ratio for the quarter climbed to 93.5 percent, a 110-basis-point increase from the prior year, reflecting elevated medical cost trends in Affordable Care Act plans and higher Medicare Part D seasonality from Inflation Reduction Act provisions. As a result, adjusted operating margin contracted to 0.8 percent for the enterprise and to negative 0.5 percent in the Health Benefits segment. Carelon’s adjusted operating margin declined to 3.3 percent, a five-year low, as investments in capabilities and integration costs weighed on profitability.

Elevance generated $4.3 billion of operating cash flow in 2025, representing 0.8 times GAAP net income, and ended the year with $2.6 billion in parent-company cash and investments. During the fourth quarter, the company repurchased 1.4 million shares at an average of $335.64, deploying $471 million, and declared a first-quarter dividend of $1.72 per share for a $377 million distribution. For fiscal 2026, Elevance forecast profit below consensus estimates, citing persistent medical cost pressures and a benefit expense ratio expected to remain near current elevated levels, while maintaining a target of returning to at least 12 percent adjusted EPS growth by 2027.