Centene lost nearly 500,000 Medicaid members in 2025, but posted 26% enrollment growth in its marketplace segment, according to the company’s fourth quarter and full year earnings report published Feb. 6.
Total revenues in the fourth quarter were $49.7 billion, up 21.9% year over year. Total revenues in 2025 were $194.8 billion, up 19.4%.
In the fourth quarter, net loss was $1.1 billion, compared to net income of $283 million during the same period in 2024. Full year net loss was $6.7 billion, compared to net income of $3.3 billion in 2024. The loss was driven primarily by a $6.7 billion non-cash goodwill impairment recorded in the third quarter, triggered by the One Big Beautiful Bill Act and a decline in the company’s stock price. Centene also recorded $513 million in impairment charges tied to the divestiture of its remaining Magellan Health businesses. On an adjusted basis, full year diluted earnings per share were $2.08.
The company’s medical loss ratio was 94.3% in the fourth quarter, compared to 89.6% during the same period last year. In 2025, the company’s MLR was 91.9%, up from 88.3% in 2024, driven by higher marketplace medical costs, Medicaid cost pressures in behavioral health and home health, and program changes in the Medicare prescription drug plan business.
As of Dec. 31, Centene had 27.6 million total at-risk members. There are 12.5 million Medicaid members, 5.5 million marketplace members, and a combined 1 million Medicare Advantage and supplement plan members. The company’s Medicare PDP membership grew to 8.1 million from 6.9 million.
Centene expects full year 2026 adjusted diluted earnings per share of more than $3.00, with total revenues in a range of $186.5 billion to $190.5 billion and an MLR between 90.9% and 91.7%.
