HUM · 10-Q · 2026Q3 · Full report

Medical Cost Trends

HUMANA INC · 2026-11-06 · Importance 71 · Surprise 48 · In source text

Consolidated benefits expense increased 29.8% to $36.3 billion in the 2026 quarter and 28.4% to $105.4 billion in the first nine months. The consolidated benefit ratio rose 280 basis points to 93.9% in the quarter and 220 basis points to 91.5% for the nine months. The increases primarily reflected the 2026 Star Ratings revenue headwind, higher benefit ratios among new individual MA members, and lower favorable prior-period claims reserve development; 2026 individual MA pricing, clinical efforts, and group MA recontracting partially offset those pressures. Favorable prior-period claims reserve development was $67 million in the quarter and $509 million in the nine-month period, versus $275 million and $913 million, respectively, in 2025.

Key facts

• Consolidated benefits expense increased 29.8% to $36.3 billion in the 2026 quarter from $28.0 billion in the 2025 quarter and increased 28.4% to $105.4 billion in the 2026 period from $82.1 billion in the 2025 period. source
• Favorable prior-period medical claims reserve development was $509 million in the 2026 nine-month period and $913 million in the 2025 nine-month period. source
• Favorable prior-period medical claims reserve development was $67 million in the 2026 quarter and $275 million in the 2025 quarter. source
• The consolidated benefit ratio rose to 93.9% from 91.1% in the quarter and to 91.5% from 89.3% in the nine-month period, increases of 280 and 220 basis points, respectively. source
• The higher consolidated benefit ratio primarily reflected the BY 2026 Star Ratings revenue headwind, higher average benefit ratios for new individual MA members, and lower favorable prior-period claims reserve development; pricing, clinical efforts, and group MA recontracting partly offset those factors. source

Impact estimates