Elevance Health reported Q4 net income of $547 million and full-year net income of $5.1 billion, with operating revenue of $49.3 billion in Q4 (up 10% year-over-year) and $197.6 billion for 2025 (up 13%). GAAP operating gain was $0.3 billion in Q4 versus $0.7 billion in the prior year quarter, and $7.2 billion for the full year compared to $7.9 billion in 2024. Adjusted operating gain was $0.4 billion in Q4 and $7.5 billion for the year, with corresponding margins of 0.8% and 3.8%, reflecting pricing discipline and targeted investments.

Health Benefits segment revenue reached $41.8 billion in Q4 (up 11%) and $167.1 billion for 2025 (up 11%), driven by higher premium yields and Medicare Advantage membership growth, partially offset by Medicaid attrition. Adjusted operating loss of $0.2 billion in Q4 contrasts with a $0.2 billion gain in the prior year. Carelon segment revenue rose 27% in Q4 to $18.7 billion and 33% for the year to $71.7 billion, led by CarelonRx and risk-based services, producing an adjusted operating gain of $0.6 billion in Q4 and $3.4 billion for 2025.

The benefit expense ratio increased to 93.5% in Q4 (110 basis points higher) and to 90.0% for the full year (150 basis points higher), reflecting elevated medical trends in ACA plans and Medicare Part D seasonality from Inflation Reduction Act changes. Days in Claims Payable improved to 41.3 days as of December 31, 2025. For 2026, management projects growth below Wall Street expectations due to continued medical cost inflation, targeting at least 12% adjusted EPS growth by 2027.

Operating cash flow totaled $4.3 billion in 2025 (0.8 times GAAP net income), with parent company cash and investments of $2.6 billion at year-end. In Q4, the company repurchased 1.4 million shares for $471 million and paid a quarterly dividend of $1.71 per share, distributing $377 million. Approximately $6.7 billion remains authorized for share repurchases. The Board declared a Q1 2026 dividend of $1.72 per share, payable March 25 to holders of record March 10.