Key Highlights

  • Earnings from operations were $178.0 million, compared with a loss of $129.3 million a year earlier.
  • The medical loss ratio fell to 84.0% from 88.5%.
  • Adjusted EBITDA reached $206.9 million, compared with a loss of $101.5 million.
  • The company raised its Earnings from operations outlook for a third time in 2026.

Oscar Health (NYSE:OSCR), an insurer focused on the individual market under the Affordable Care Act, reported third-quarter 2026 financial results for the period ended September 30, 2026. The company posted earnings from operations of $178.0 million, a sharp Reversal from the loss recorded a year earlier. It also raised its full-year 2026 outlook for earnings from operations, the third upward revision this year.

For an insurer, the medical loss ratio is the single most watched operating measure, because it determines how much of each premium dollar remains to cover administrative costs and profit. A drop of 4.5 percentage points in one year is a large move, and it explains much of the turn from operating loss to operating profit in the quarter.

Medical Loss Ratio and Cost Trends

The medical loss ratio, which measures medical claims as a share of premium revenue, was 84.0% in the third quarter, compared with 88.5% a year earlier. A lower ratio means the company paid out less of each premium dollar in medical costs, which is the most direct driver of the swing to profit in the period.

The selling, general and administrative expense ratio also declined, falling to 14.0% from 17.5%. Together, the two ratios explain much of the improvement in operating results, and the release presents both to show how medical costs and overhead changed.

The company's nine-month figures show that the third-quarter improvement was part of a broader change across the year. The nine-month medical loss ratio of 78.1% compared with 84.8% a year earlier, and the nine-month SG&A ratio of 14.4% compared with 17.3%, together produced an operating result that moved from a loss to a profit of $1.27 billion.

Earnings From Operations and Net Income

Earnings from operations reached $178.0 million, compared with a loss of $129.3 million in the prior-year quarter. Net Income attributable to Oscar Health was $167.3 million, compared with a net loss of $137.5 million a year earlier. The gap between operating earnings and net income reflects items below the operating line, such as interest and taxes.

For the nine months ended September 30, 2026, the company reported earnings from operations of $1.27 billion, compared with a loss of $62.6 million in the prior-year period. Nine-month net income attributable to Oscar Health was $1.21 billion, against a loss of $90.5 million, which shows that the profit improvement extends across the year to date.

The gap between nine-month and third-quarter adjusted EBITDA shows that the first half of the year contributed a substantial share of the year-to-date total. Investors comparing the quarterly and year-to-date figures can see how the company's performance has developed over time, and whether the third quarter continued a pattern established earlier in the year.

Adjusted EBITDA and Year-to-Date Results

Adjusted EBITDA for the third quarter was $206.9 million, compared with a loss of $101.5 million a year earlier. The release defines adjusted EBITDA as a non-GAAP measure that excludes certain items, and its reconciliation shows how the figure is derived from net income.

For the nine months, adjusted EBITDA reached $1.35 billion, compared with $28.0 million a year earlier. The year-to-date figure is substantially above the prior-year level, and it is the more complete view of the company's earnings trajectory because it smooths out quarterly variation.

Management attributed its outlook raises to disciplined pricing, product design and technology. Those factors bear on the company's ability to set premiums that reflect expected claims costs, and the release positions them as the basis for expanding margins in 2027, a year the company has not yet reported.

Raised Outlook and Management Commentary

Oscar Health raised its full-year 2026 earnings from operations outlook for a third time. Chief executive Mark Bertolini said the company is on track for its best year of financial performance in its history, and he tied the company's disciplined pricing, consumer-led products and technology-powered approach to its ability to grow Market Share and expand Margin in 2027.

The third raise in the outlook indicates that results have repeatedly exceeded the company's earlier expectations during 2026. The release presents the revised figures, which investors can compare against the earlier ranges to measure how much the outlook has changed.

The company's expectations for 2027 margins are the most forward-looking statement in the release. Subsequent reports will show whether the pricing and product approach the company describes translates into the margin expansion it expects for next year.

Outlook

Oscar Health's third-quarter report combines a sharp move from loss to profit, a lower medical loss ratio, higher adjusted EBITDA and a third upward revision to its full-year operating outlook. Subsequent quarters will show whether the medical cost improvements hold as the company moves toward its 2027 margin goals.