Elevance Health Q3 2026 Earnings: Forecast Raised to $29, but 2027 Growth Starts Lower

By Stock Titan Editorial Team Published October 21, 2026, 06:27 AM EDT

How much has Elevance raised its 2026 earnings guidance?

Elevance set its first 2026 outlook on January 28, at least $25.50 of adjusted diluted earnings per share, in its fourth quarter 2025 release. That was well under the $30.29 it earned on the same basis in 2025.

The company then repeated or changed the figure seven times in all. Between results it reaffirmed the number in Regulation FD filings ahead of investor meetings, on February 26, March 10, June 10 and September 10. The raises came with results, to $26.75 in April, to $27.00 in July and to $29.00 today.

Show the data

Category	2026 adjusted EPS forecast floor	Note
Jan 28	$25.50
Feb 26	$25.50
Mar 10	$25.50	Reaffirmed after the Feb 27 CMS notice
Apr 22	$26.75	Raised to $26.75
Jun 10	$26.75
Jul 15	$27.00	Raised to $27.00
Sep 10	$27.00
Oct 21	$29.00	Raised to $29.00

The GAAP forecast took a different road. It fell in April, when Elevance booked a $935 million accrual for the Medicare Advantage risk adjustment matter that CMS raised in a February 27 notice. At $22.00 today it is still a little below where it started in January.

What is Elevance's 2026 earnings baseline for 2027 growth?

Chief executive Gail Boudreaux put it this way in the October 21 release: "We are raising our 2026 earnings outlook and remain confident in delivering at least 12% growth in adjusted diluted earnings per share in 2027 from our higher earnings baseline of at least $26.75." A footnote says the baseline "excludes non-recurring net investment income and other non-operating items, as well as targeted one-time investments."

The figure is new to a release, though the idea is not. On the January 28 call the company spoke only of growth "off our ending 2026 earnings baseline", with no number. On the April 22 call, management put it at $25.75 and said the roughly $1 of non-recurring investment income in the first quarter "should clearly be excluded from the 2026 earnings baseline." On the July 15 call, the company said it now viewed "at least $26 as the appropriate earnings baseline for modeling purposes."

Show the data

Item	April 2026	October 2026	Change
2026 forecast	$26.75	$29.00	+$2.25
2027 starting point	$25.75	$26.75	+$1.00

Put the two lines side by side and the forecast has outrun the base. From April to today the forecast went up $2.25 and the baseline went up $1.00. In our reading, the $0.75 rise in the baseline since July matters more than the headline $2.00. On our reading, it is the part of the raise that the company's own baseline carries into 2027.

What makes up the $2.25 between Elevance's forecast and its baseline?

Each of this year's three quarterly releases named an item outside normal operations. The first quarter carried "~$1 per share of non-recurring investment income". The second quarter had "an approximately $0.80 per share net below-the-line benefit", which the chief financial officer said on the July call was "primarily related to valuation adjustments within net investment income". Today's release names "a net non-operating benefit of $1.85 per share" in the third quarter.

Spending pulls the other way. In July, Elevance said it planned to put the $0.80 into "one-time accelerated investments in the second half", and the third quarter's adjusted operating expense ratio rose to 11.3% from 10.4%, a move the release says "principally reflected targeted, one-time investments". The baseline also leaves out those one-time costs, so in our reading the gap is a net figure. On the same call the company said about $0.75 of targeted spending already in its outlook was part of the ongoing run rate of the business, separate from the one-time money.

Show the data

Category	Change
Investment income, 9 months	+$805M
Adjusted operating gain, 9 months	-$728M
Investment income, Q3	+$412M
Adjusted operating gain, Q3	-$7M

The income statement shows the same pattern from another side. Net investment income for the first nine months was $2,506 million, already above the $1,875 million the January outlook expected for the whole year. Over the same nine months, adjusted operating gain from the business segments was $728 million lower than a year earlier. Adjusted net income fell 2.5%, and adjusted EPS still rose 0.7% because the diluted share count was 3.1% lower.

The release does not split the $2.25. It leaves open how much income is set aside, how much one-time spending is added back and how much of that spending is still planned for the fourth quarter. Those are the numbers to look for in the call transcript.

How did Elevance's Q3 2026 earnings compare with its July outlook?

Adjusted diluted EPS was $6.99, against $6.03 a year earlier, and GAAP EPS was $6.27. Operating revenue rose 0.7% to $50.4 billion, the release shows.

On the July call the company said it expected third quarter adjusted EPS to be "approximately 17% of our revised full-year guidance". On $27.00 that comes to about $4.59. The quarter beat that by $2.40, and with the $1.85 named benefit taken out it would still have been $5.14.

The medical side improved. The benefit expense ratio, the share of premiums paid out in medical costs, was 90.6% against 91.3% a year earlier, which the release ties to Medicare Advantage and Individual ACA. Health Benefits operating gain still fell to $436 million from $601 million, which the release attributes to targeted investments, while Carelon's rose 17% to about $0.9 billion.

Elevance also raised its full-year operating cash flow forecast to at least $6.5 billion. In the quarter it bought back 0.8 million shares for $330 million, and it declared a fourth quarter dividend of $1.72 a share.

What 12% growth in 2027 would mean for Elevance earnings per share

The company gives a growth rate and a base, never a dollar target for 2027, so $29.96 is our arithmetic on its two figures and a floor at that. It sits about 3% above the $29.00 forecast for 2026 and about $0.33 below the $30.29 of adjusted EPS Elevance reported for 2025 in its January release. That 2025 figure included about $3.75 a share of favorable non-recurring items, the company said on the January 28 call.

Show the data

Category	Value
2025 actual	$30.29
2026 forecast	$29.00
2026 base	$26.75
2027 at 12%	$29.96

The fourth quarter looks light on the same numbers. The company reported $27.06 of adjusted EPS for the first nine months. A $29.00 floor then implies roughly $1.94 for the last quarter if the share count stays about the same, against $3.33 a year earlier. The release does not explain the gap; the call this morning may.

How Elevance's 2026 earnings guidance raises compare with UnitedHealth's

UnitedHealth Group started 2026 at an adjusted forecast of more than $17.75 in its January release and moved it to at least $20.50 on October 13, a rise of 15.5% on the stated floors by our calculation. Elevance's move from $25.50 to $29.00 is 13.7% on the same basis. Both are changes in forecasts, and neither measures how the two businesses performed against each other. We looked at how UnitedHealth got there in our UnitedHealth earnings article.

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