Centene reported $1.5 billion in net earnings in the first quarter of 2026, the company shared in its April 28 earnings report, with adjusted diluted earnings per share of $3.37 coming in approximately $0.50 above expectations.
Total revenues for Q1 were $49.9 billion, up from $46.6 billion in the first quarter of 2025. Centene raised its full-year 2026 adjusted diluted EPS guidance floor to greater than $3.40, up from its prior outlook, and increased its premium and service revenues guidance range by $1 billion to between $171 billion and $175 billion.
ACA marketplace membership fell sharply year-over-year, dropping to 3.6 million from 5.6 million in the first quarter of 2025. The insurer noted the decline weighed on consolidated member mix and contributed to a commercial medical loss ratio of 75.3%.
The company’s overall MLR was 87.3% for the quarter, a slight improvement from 87.5% in the same period last year. The company’s Medicaid MLR improved 50 basis points year over year to 93.1%, which Centene attributed to rate and revenue increases and progress in managing medical costs. Its Medicare MLR improved from 86.3% to 84.9%, reflecting outperformance in both Medicare Advantage and the prescription drug plan business.
Centene’s total membership stood at approximately 26.3 million at the end of Q1. Medicaid membership was 12.4 million, down from 13 million a year earlier. Medicare membership was roughly 1 million, and Medicare PDP membership grew to 8.8 million from 7.9 million year-over-year.
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