UnitedHealth booked 75.358 billion dollars of medical cost against 86.956 billion of premium in the second quarter. The medical-care ratio printed 86.7 percent, against 89.4 percent a year earlier. Cost against premium is the product.
Medical cost is the numerator. Premium is the price.
The 16 July 2026 second-quarter release is the last owned filing. Net favorable prior-period development was 860 million dollars, most of it 2026 dates of service. Full-year medical care ratio outlook 88.1 percent, plus or minus 25 basis points, tighter than the 88.8 percent band printed on 27 January. That ratio is the company's own product of cost and price. A CMS Medicare Advantage rate is a different object.
UnitedHealthcare served 48.5 million people in the second quarter, down 525,000 sequentially. Seniors served through Medicare Advantage, including complex Medicaid, contracted by 965,000 since year-end 2025. Community and State contracted 380,000 in the quarter, Louisiana exit plus eligibility. Employer and Individual contracted 145,000. Optum Health served about 700,000 fewer value-based care patients. Those are census lines. They are mix. No CMS payment rate, star-revenue coefficient, or bid-to-benchmark sat on the owned filing.
Optum printed 65.7 billion dollars of revenue and 4.0 billion of operating earnings. That is care delivery, insight, pharmacy. UnitedHealthcare premium of 86.956 billion, with medical cost of 75.358 billion against it, is the insurance book. Optum at 65.7 billion of revenue is the other file. Keep the files separate. The rate lives where premium has to cover the next claim.
Gallup, May to June 2026, has 11 percent of US adults currently taking a GLP-1 for weight loss, up from 3 percent two years earlier. Foundayo shipped 1 April 2026. A Medicare Part D copay as low as $50 from 1 July sits in that same published copy. A trial can show weight. A claims file shows who kept paying. For a managed-care book the leftover year is a year of care the rate has to cover: muscle, joint, nurse. Hostess is a snack unit. UnitedHealth is a claims file.
The 16 July filing already printed both sides of the fraction. Cost against premium is still the product. The leftover year of GLP-1 care still has to be priced into the next claim.
Cost against premium is the product. The 16 July filing is the grade.