Centene Raises 2026 EPS Guidance as Medicare Strength Offsets Membership Decline

CNC reported third-quarter 2026 adjusted diluted EPS of $0.58, up from $0.50 a year earlier, and raised its full-year 2026 adjusted EPS guidance by $0.40 to above $5.20. On a GAAP basis the company posted a diluted loss of $0.14 per share. Total revenues were $50.65 billion, up 1.9%, and the company said its consolidated health benefits ratio of 92.7% was better than expectations, driven by the Medicare segment.

The mix beneath the headline numbers is uneven. Medicare premium and service revenue rose about 19.9% to $11,263 million and Medicaid grew about 4%, while commercial premium and service revenue fell 21% to $8,700 million, which is why total revenue grew only 1.9%. Total at-risk membership fell 8.1% to 25.7 million, with the largest drop in commercial plans (down roughly 38%) and a smaller decline in Medicaid. Medicare membership rose roughly 10% when Part D prescription drug plans are included, but Medicare Advantage enrollment itself slipped.

Margins and costs did the work. The Medicare health benefits ratio improved to 93.8% from 94.3%, the consolidated ratio held at 92.7%, and the adjusted SG&A ratio dropped to 6.5% from 7.0%, which management attributed to strong cost management. Guidance now calls for a 2026 health benefits ratio of 90.4% to 91.1% and total revenues of $196.5 billion to $200.5 billion. Reuters and the Wall Street Journal both framed the update as a guidance raise.

Investors may watch whether the commercial membership decline stabilizes, whether Medicare margins hold as more of the book shifts toward prescription drug plans, and how management frames 2027. The company has not issued formal 2027 guidance, though Reuters headlined that Centene sees earnings growth continuing into 2027, and the CEO said the company is focused on "building on this progress in 2027".