Oscar Health (OSCR) Q4 2025 earnings summary

Executive summary

• Reported total revenue of $11.7 billion for 2025, up 28% year-over-year, driven by strong membership growth and disciplined pricing.

• Achieved record membership of approximately 3.4 million by year-end 2025, with expected paid membership of 3 million by Q2 2026, a 58% year-over-year increase.

• 2025 marked a reset year with decisive actions taken to return to profitability in 2026.

• Positioned for a return to profitability in 2026, with projected earnings from operations improving by nearly $750 million year-over-year.

• Full-year 2026 revenue outlook set at $18.7–$19.0 billion, with significant margin improvement expected.

Financial highlights

• Fourth quarter medical loss ratio (MLR) was 95.4%, up 730 basis points year-over-year; full year MLR was 87.4%, up 570 basis points.

• Net loss for 2025 was $443 million, with adjusted EBITDA loss of $280 million.

• SG&A expense ratio improved to 17.5% in 2025 from 19.1% in 2024, benefiting from cost discipline and AI-driven management.

• Loss from operations was $396 million in 2025, primarily due to higher market morbidity and risk adjustment payable.

• Risk adjustment as a percentage of direct premiums rose to 18.5% in 2025, a 390 basis point increase.

Outlook and guidance

• 2026 revenue guidance is $18.7–$19.0 billion, a 61% increase at the midpoint, driven by above-market growth and rate increases.

• Expected 2026 MLR of 82.4%–83.4%, a 450 basis point improvement year-over-year.

• Earnings from operations projected at $250–$450 million, implying a 1.9% operating margin at the midpoint.

• SG&A expense ratio projected at 15.8%–16.3% for 2026.

• Adjusted EBITDA expected to be $115 million above earnings from operations.