Oscar Health (OSCR) Q4 2025 earnings summary

Executive summary

• Reported total revenue of $11.7 billion for 2025, up 28% year-over-year, with membership reaching 3.4 million by year-end, driven by new affordable products and AI features.

• 2025 marked a reset year with decisive actions taken to return to profitability in 2026, including efficiency gains and technology integration.

• Loss from operations was $396 million in 2025, primarily due to higher market morbidity and risk adjustment payable, but a return to profitability is expected in 2026 with a projected $750 million year-over-year improvement in operating earnings.

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

Financial highlights

• Total revenue for 2025 was $11.7 billion, up from $9.2 billion in 2024, primarily due to higher membership.

• Net loss attributable to the company was $443 million in 2025, with adjusted EBITDA loss of $280 million, both impacted by higher risk adjustment and market morbidity.

• Medical Loss Ratio (MLR) increased 570 basis points year-over-year to 87.4% for 2025; Q4 MLR was 95.4%, up 730 basis points year-over-year.

• SG&A expense ratio improved to 17.5% in 2025 from 19.1% in 2024, benefiting from cost discipline and technology integration.

• Loss from operations was $396.4 million in 2025, compared to operating earnings of $57.3 million in 2024.

Outlook and guidance

• 2026 revenue guidance is $18.7–$19 billion, a 61% increase year-over-year at the midpoint, driven by above-market growth, retention, and rate increases.

• 2026 operating earnings expected between $250–$450 million, with an operating margin of 1.9% at the midpoint; adjusted EBITDA projected to be $115 million higher than operating earnings.

• 2026 MLR expected to improve to 82.4%–83.4%, a 450 basis point year-over-year improvement at the midpoint.

• SG&A expense ratio for 2026 expected to further improve to 15.8%–16.3%.