Clover Health Improves 2026 Guidance as Q3 Revenue Rises 53%

Clover Health Investments Corp. (NASDAQ: CLOV) reported sharp revenue and membership growth for the third quarter of 2026 while remaining profitable on a GAAP basis, prompting the Medicare Advantage insurer to improve the lower end of every full-year guidance range.

Third-quarter revenue rose 53% year over year to $759 million as Medicare Advantage membership increased 45% to 158,907. Clover posted GAAP net income of $6 million, adjusted EBITDA of $16 million and adjusted net income of $15 million.

For the first nine months of 2026, total revenue increased 57% from a year earlier. GAAP net income reached $62 million, a $98 million year-over-year improvement, while adjusted EBITDA more than doubled to $97 million from the comparable period.

Membership growth and maturing cohorts support results

Clover attributed its revenue growth to higher Medicare Advantage enrollment, strong retention and the continued maturation of member cohorts managed through its Clover Assistant technology. The company said cohort economics were progressing as anticipated.

Third-quarter consolidated gross profit, a non-GAAP measure, climbed 77% to $130 million. Management said the improvement reflected membership growth and retention, along with expected performance from the 2025 and 2026 cohorts and higher gross profit as members matured under Clover Assistant.

The Insurance benefits expense ratio was 91.1% for the quarter. Clover defines the non-GAAP ratio as net medical expenses incurred and quality-improvement costs divided by net premiums earned.

Operating expenses continued to rise as the company expanded. Third-quarter SG&A increased 26% to $123 million, while adjusted SG&A rose 60% to $114 million. However, year-to-date adjusted SG&A represented 15% of total revenue, an improvement of about 120 basis points from a year earlier. Clover attributed the lower expense ratio to fixed-cost leverage while continuing to invest in Clover Assistant, clinical capabilities, Counterpart Health and its insurance operations.

At quarter-end, Clover held $513 million of consolidated cash, cash equivalents and investments. Parent-company and unregulated subsidiaries accounted for $153 million of that amount.

Full-year guidance improves at the lower end

Clover now expects 2026 revenue of $2.97 billion to $3.00 billion, compared with its previous range of $2.92 billion to $3.00 billion. The company forecasts adjusted EBITDA of $75 million to $85 million, raising the lower end from $70 million.

Guidance for consolidated gross profit was revised to $540 million to $555 million from $525 million to $555 million. Clover also narrowed its expected average Medicare Advantage membership range to 157,000-158,000 from 156,000-158,000.

Full-year GAAP net income is projected at $25 million to $35 million, compared with the prior forecast of $20 million to $35 million. Clover did not provide GAAP reconciliations for projected adjusted EBITDA or consolidated gross profit, saying the corresponding amounts could not be reasonably calculated without unreasonable effort.

Management said enrollment activity for the 2027 annual enrollment period was tracking well, with significant growth supported by product positioning in Clover’s core markets. The company did not provide a specific 2027 membership forecast.

Clover also highlighted a five-star rating for its flagship PPO plan for Payment Year 2028, covering about 98% of current membership. Its PPO plans received a 4.82-out-of-five score on HEDIS measures for Plan Year 2027, which the company identified as the highest score nationally among the qualifying non-SNP PPO plans included in its analysis.

Technology investment remains a priority

Clover’s operating strategy centers on using Clover Assistant to support physicians in identifying and managing chronic conditions. The technology covers about two-thirds of members, according to the presentation, and the company reported an approximately 1,500-basis-point medical cost ratio differential between member cohorts whose primary-care physicians use the platform and those whose physicians do not.

For 2026, management is focused on engaging new members in Clover Assistant-powered care, expanding Counterpart Health to third-party customers, improving clinical quality and balancing profitability with investment in technology, member benefits and the customer experience.

The outlook remains subject to enrollment, medical-cost, execution and other risks identified in Clover’s regulatory filings. The company also cautioned that its forward-looking targets are not guarantees and that actual results could differ materially. Several of the performance measures used in the presentation are non-GAAP figures, which Clover said should be considered alongside, rather than as substitutes for, its GAAP results.