UnitedHealth Group and CVS Health each reported more than $400 billion in 2025 revenue. These are the largest US health insurers and managed-care companies, ranked by total company revenue for fiscal year 2025.
Illustration: the 12 largest US health insurers by FY2025 total revenue, from UnitedHealth Group ($447.6 billion) at #1 to Oscar Health ($11.7 billion) at #12.
| Rank | Insurer (group) | Total revenue FY2025 (US$ billions) | Premium revenue (US$ billions, if sourced) | Members (millions, if sourced) | HQ | Ownership | Main brands |
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealth Group | 447.6 | 352.2 | 49.8 | Minnetonka, MN | Publicly traded | UnitedHealthcare, Optum |
| 2 | CVS Health (Aetna) | 402.1 | — | 26.6 | Woonsocket, RI | Publicly traded | Aetna, CVS Caremark, CVS Pharmacy |
| 3 | The Cigna Group | 274.9 | — | 18.1 | Bloomfield, CT | Publicly traded | Cigna Healthcare, Evernorth, Express Scripts |
| 4 | Elevance Health | 197.6 | — | 45.2 | Indianapolis, IN | Publicly traded | Anthem Blue Cross Blue Shield, Wellpoint, Carelon |
| 5 | Centene | 194.8 | 174.6 | 27.6 | St. Louis, MO | Publicly traded | Ambetter, Wellcare, Health Net |
| 6 | Humana | 129.7 | — | — | Louisville, KY | Publicly traded | Humana, CenterWell |
| 7 | Kaiser Foundation Health Plan | 127.7 | — | 12.5 | Oakland, CA | Non-profit | Kaiser Permanente, Risant Health |
| 8 | Health Care Service Corporation (HCSC) | 66.8 | — | 27.3 | Chicago, IL | Mutual (customer-owned) | Blue Cross and Blue Shield of IL, TX, OK, NM, MT |
| 9 | Molina Healthcare | 45.4 | 43.1 | 5.5 | Long Beach, CA | Publicly traded | Molina Healthcare, Molina Marketplace |
| 10 | Highmark Health | 32.4 | — | — | Pittsburgh, PA | Non-profit | Highmark Blue Cross Blue Shield, Allegheny Health Network |
| 11 | Blue Shield of California | 28.8 | — | — | Oakland, CA | Non-profit | Blue Shield of California |
| 12 | Oscar Health | 11.7 | — | 2.0 | New York, NY | Publicly traded | Oscar |
No matching rows.
Read this first: insurers are ranked by total revenue for fiscal year 2025 as each company or organization reported it, as of October 28, 2026. Total revenue is not the same as insurance revenue. UnitedHealth Group includes Optum, CVS Health includes its pharmacies and Caremark pharmacy benefit manager, Cigna includes Evernorth (Express Scripts), Kaiser’s figure includes its hospitals and Risant Health, and Highmark’s includes its Allegheny Health Network hospitals; so these totals overstate premium revenue. The premium column is filled only where we found the figure (Centene’s is “premium and service” revenue); a dash means we did not source it. Members are covered lives from company reports: UnitedHealth’s is UnitedHealthcare consumers served, Cigna’s and Elevance’s medical members, Oscar’s year-end effectuated members; definitions differ by company. Non-profit and mutual insurers are included only where a FY2025 revenue figure was published. HCSC’s figure comes from regulatory filings as reported by Becker’s, and other Blue Cross Blue Shield companies were not ranked. This is a business ranking, not coverage or medical advice.[1]
UnitedHealth Group is the largest by total revenue: $447.6 billion in 2025, up 12 percent. About $352.2 billion of that was premiums; the rest comes largely from Optum’s products and services. UnitedHealthcare served 49.8 million consumers in 2025. Its revenue includes Optum, so it is far more than insurance alone.[1]
CVS Health reported record 2025 revenues of $402.1 billion, up 7.8 percent. Aetna’s medical membership ended 2025 at about 26.6 million. A large share of CVS’s revenue comes from pharmacy and its Caremark pharmacy benefit manager (PBM), so total revenue overstates its insurance-only business.[2]
Cigna’s 2025 revenue was $274.9 billion, up 11 percent, driven mainly by Evernorth Health Services (pharmacy benefits, specialty and care services). Cigna Healthcare’s medical membership fell 5 percent to 18.1 million, largely because it sold its Medicare business to HCSC in 2025. The video is from Cigna Healthcare’s channel.[3]
Elevance Health (formerly Anthem) reported operating revenue of $197.6 billion for 2025, up about 13 percent (some outlets cite about $199.1 billion, which appears to include investment income; the rank is the same either way). Its health plans had about 45.2 million medical members at year-end, down about 1 percent on Medicaid attrition. Its Carelon segment, which includes CarelonRx, reported $71.7 billion in revenue before eliminations.[4]
Centene, focused on Medicaid, Medicare and ACA marketplace plans, reported $194.8 billion in total 2025 revenue, up 19.4 percent; premium and service revenues were $174.6 billion. It reported total at-risk membership of about 27.6 million at year-end and a net loss of $6.7 billion for the year. It guided to lower 2026 revenue.[5]
Humana, known for Medicare Advantage, reported GAAP revenue of $129.7 billion for 2025, up from $117.8 billion in 2024. We did not source a year-end 2025 membership figure, so that cell is blank.[6]
Kaiser Permanente reported operating revenue of about $127.7 billion for 2025, up from $115.8 billion. That figure combines Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and Risant Health, so it includes hospital and care-delivery revenue. Membership was reported at about 12.5 million.[7]
HCSC, the largest customer-owned health insurer, reported total revenue of $66.8 billion for 2025 per regulatory filings, up from $62.8 billion, and a net loss of more than $1.9 billion. It reports 27.3 million members, helped by buying Cigna’s Medicare business. The video is from Blue Cross and Blue Shield of Illinois, an HCSC plan.[8]
Molina Healthcare, focused on government-sponsored plans such as Medicaid, reported total revenue of $45.4 billion for 2025 (up 12 percent), of which $43.1 billion was premium revenue. Membership was about 5.5 million at year-end. We did not find an official video we could verify, so an illustration is shown.[9]
Highmark Health, a Pittsburgh-based non-profit, reported $32.4 billion in 2025 revenue, up 11 percent, and a $175 million net loss. Of that, $24.8 billion came from its health plans and $5.7 billion from Allegheny Health Network, its hospitals, so the total is not insurance-only.[10]