Shares of health insurance giant UnitedHealth Group (UNH 19.66%) stock imploded this morning, falling 19% through 11 a.m. ET after reporting Q4 earnings. The weird thing is... UnitedHealth didn't miss earnings, or at least not at first glance.
Analysts forecast UnitedHealth to earn $2.11 per share on $113.7 billion in sales. Sales came up short at $113.2 billion, but earnings were on target at $2.11 per share, adjusted for one-time items (i.e., non-GAAP).
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UnitedHealth Q4 earnings
So earnings were on target... or were they? At first glance, things look fine for UnitedHealth Group. Quarterly sales grew a respectable 12% in Q4, and adjusted earnings were at least no worse than expected. Dig a little deeper, though, and you'll notice that UnitedHealth's earnings from operations were only $380 million -- a year-over-year decline of 95%!
Worse, on the bottom line, earnings calculated under generally accepted accounting principles (GAAP) evaporated. UnitedHealth earned $5.98 per share in Q4 2024; in Q4 2025, however, it earned just $0.01 per share.
That's within one rounding error of a 100% decline.
Granted, for the full year, things were a bit better. 2025 sales grew about 12% to $447.6 billion, and while earnings declined, they didn't disappear entirely. UnitedHealth reported $13.23 per share for all of 2025, a 15% decline.
NYSE: UNH
Key Data Points
Is UnitedHealth stock a sell?
Investors should see some improvement in 2026. Despite all the headlines today about flatlining Medicare Advantage rates, UnitedHealth forecasts 2026 sales of "greater than $439 billion." That's not growth; it's a decline of up to 2%. Regardless, GAAP earnings should rebound to $17.10 or more, giving UnitedHealth stock a forward P/E ratio of about 16.7.
At that price, today's UnitedHealth sell-off just might turn out to be a buying opportunity.
