“Clover Health reported Q4 2025 total revenues of approximately $488 million, marking a roughly 45% year-over-year increase and surpassing analyst expectations. The company posted a GAAP net loss but achieved full-year Adjusted EBITDA profitability of $22 million for 2025, with Medicare Advantage membership climbing 38% to over 113,000. Despite ongoing industry cost pressures, medical trends remained controlled, and the firm issued optimistic 2026 guidance projecting significant revenue expansion and initial GAAP net income positivity.”
Clover Health Investments Reports Q4 2025 Results
Clover Health Investments, a Medicare Advantage-focused insurer leveraging technology for better member outcomes, released its fourth-quarter and full-year 2025 financial results, highlighting continued momentum in membership expansion and revenue scaling while navigating elevated healthcare utilization trends affecting the broader industry.
In the fourth quarter, total revenues reached $487.7 million, reflecting a 44.7% increase from the same period a year earlier. This figure comfortably exceeded consensus estimates by more than $20 million in some reports, driven primarily by robust growth in Insurance revenues, which stood at $486 million for the quarter, up 47% year-over-year. The performance underscores the company’s success in attracting new Medicare Advantage enrollees during a competitive Annual Enrollment Period and retaining existing members effectively.
For the full year 2025, total revenues climbed to $1.9 billion, a solid 40% improvement over 2024 levels. Insurance revenues specifically grew 41% to $1.9 billion, reflecting the scaling of the Medicare Advantage business. Average membership growth for the year was around 33%, with year-end Medicare Advantage membership hitting 113,803, up 38% year-over-year. This positions Clover as one of the faster-growing players in the Medicare Advantage space despite market headwinds.
On the earnings side, the company reported a GAAP net loss of $86 million for the full year, or approximately $0.17 per basic share, wider than the prior year’s loss due in part to investments in growth and new member onboarding costs. Adjusted metrics painted a more positive picture: Adjusted EBITDA came in at $22 million for 2025, marking the first full year of Adjusted EBITDA profitability. Adjusted net income was $20 million, with adjusted EPS at 4 cents for the year.
In the fourth quarter specifically, adjusted EPS was a loss of 5 cents, in line with expectations and improved from some prior periods when factoring in growth-related dilution. The company highlighted strong contribution profit from returning members at around $200 per member per month (PMPM), while new member contribution losses narrowed to $145 PMPM, indicating improving cohort economics over time.
Medical cost management remained a focal point. Underlying incurred medical cost trends, excluding pharmacy, were held to about 5% year-over-year, demonstrating discipline amid industry-wide pressures in outpatient services and seasonal Part D impacts from Inflation Reduction Act changes. Despite these challenges, Clover improved its Part D margins and delivered higher gross profit overall. The Insurance Benefits Expense Ratio (BER) for the year was 90.9%, and the company introduced Consolidated Gross Profit as a key operating metric, which totaled $356 million in 2025.
Selling, general, and administrative expenses rose modestly in absolute terms but improved significantly as a percentage of revenue. Adjusted SG&A as a percent of total revenues declined by approximately 410 basis points year-over-year to 17%, reflecting operational leverage as the business scales.
Liquidity remained solid, with $320 million in consolidated cash, cash equivalents, and investments at year-end, including $122 million at the parent and unregulated subsidiaries level. Operating cash flow usage in the quarter was influenced by working capital timing.
Looking ahead, Clover provided full-year 2026 guidance that signals confidence in continued execution:
Average Medicare Advantage membership: 154,000–158,000
Total revenues: $2.81 billion–$2.92 billion
Consolidated Gross Profit: $470 million–$510 million
Adjusted EBITDA: $50 million–$70 million
GAAP Net Income: breakeven to $20 million
This outlook anticipates sustained above-market membership growth, building on industry-leading 2026 AEP results with 53% year-over-year growth, strong returning member retention, and further improvements in cohort profitability powered by Clover’s data-driven care model.
The results reinforce Clover’s dual focus on rapid, high-quality growth and disciplined path toward sustained profitability in the evolving Medicare Advantage landscape.
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