Most of the country’s largest insurers reported year-over-year increases in medical cost ratios in 2025.
Centene reported the highest medical loss ratio at 91.9%, 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.
Payers ranked by 2025 MLRs:
1. Centene
2025: 91.9%
2024: 88.3%
2023: 87.7%
2. Molina Healthcare
2025: 91.7%
2024: 89.1%
2023: 88.1%
3. CVS Health
2025: 91.2%
2024: 92.5%
2023: 86.2%
4. Humana
2025: 90.2%
2024: 89.8%
2023: 88%
5. Elevance Health
2025: 90%
2024: 88.5%
2023: 87%
6. UnitedHealth Group
2025: 89.1%
2024: 85.5%
2023: 83.2%
7. Cigna Group
2025: 84.4%
2024: 83.2%
2023: 81.3%
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