UnitedHealth Group (NYSE:UNH), long regarded as a stable investment, shocked Wall Street by missing earnings estimates for the first time since 2008. Shares of the largest U.S. health insurer tumbled over 22% Thursday, wiping out nearly $120 billion in market value—its worst single-day drop in more than 25 years.
The company reported Q1 revenue of $109.6 billion, falling about $2 billion short of analyst expectations. Earnings also missed forecasts, primarily due to rising medical costs in its Medicare Advantage plans and unexpected disruptions within Optum, its health services and pharmacy benefits division once seen as a key growth engine.
While executives offered some transparency during the earnings call, analysts were left with unanswered questions. “We do not believe the earnings call answered all investors’ questions,” said Mizuho’s Ann Hynes, noting UnitedHealth’s typically conservative and upward-trending guidance history.
Initially, investors feared a broader industry issue, triggering sell-offs across health insurers. However, the panic eased after Elevance Health (NYSE:ELV) reaffirmed its quarterly guidance, helping its stock rebound from an early 5.8% drop to end down just 2.3%. UnitedHealth, however, saw no such recovery.
The earnings disappointment adds to a turbulent year for UnitedHealth, which included a cyberattack impacting 200 million Americans and the high-profile murder of insurance unit head Brian Thompson. Additionally, the Department of Justice is reportedly investigating its Medicare billing practices, though the company denies knowledge of an active probe.
Concerns also mounted over Optum’s declining performance, especially following changes in 2025 Medicare reimbursements. “Optum was always the silver lining,” said Bahl & Gaynor’s Kevin Gade, expressing surprise at its underperformance.
Investors now await updates from rivals like Humana (NYSE:HUM), whose shares also dropped 7%, to assess the broader implications for the Medicare Advantage market.


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