Clover Health Raises 2026 Outlook on Membership Growth
The Medicare Advantage insurer posted higher third-quarter membership, revenue and profit and named a permanent chief financial officer.
Updated on Nov. 5, 2026 in Healthcare
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Clover Health raised its full-year 2026 financial outlook after reporting third-quarter Medicare Advantage membership growth of 49% year-over-year to approximately 157,000 members. The company also posted $759 million in total revenue, up 53%, and $130 million in profit, up 77%.
Why it matters
The results show continued expansion in the Medicare Advantage market and a shift toward profitability for the company. Clover attributes its efficiency gains partly to applying artificial intelligence across the company as it scales.
Clover Health reported third-quarter revenue of $759 million, up 53% year-over-year, and profit of $130 million, up 77%. The company now projects full-year 2026 revenue of $2.97 billion to $3 billion and adjusted EBITDA of $75 million to $85 million.
The players
Clover Health
Clover Health is a Medicare Advantage insurer that uses technology and data-driven care management to serve older adults.
Clay Thornton
Clay Thornton is the chief financial officer of Clover Health, previously serving in an interim capacity before his permanent appointment.
Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services is the federal agency that administers Medicare and assigns star ratings to Medicare Advantage plans.
The details
Clover Health's flagship PPO plan earned five stars for payment year 2028 from the Centers for Medicare & Medicaid Services, and its HMO plan earned four and a half stars. The company also ranks first nationally among comparable PPO plans on core HEDIS measures for the third consecutive year. Clover Health appointed interim CFO Clay Thornton as its permanent chief financial officer.
Timeline
Third quarter 2026: membership and profit growth reported.
November 5, 2026: earnings call announcing the raised outlook and CFO appointment.
Payment year 2028: CMS star ratings awarded to the flagship PPO and HMO plans.
2026: company expects its first full year of GAAP net income profitability.
Healthcare Landscape
Clover's star ratings come from the CMS Medicare Advantage star ratings system, which scores plans on quality measures that feed into federal payments. Strong ratings under that system have become a key factor in how Medicare Advantage insurers compete for enrollment.
Medicare Advantage enrollees choosing among plans can weigh the five-star PPO and four-and-a-half-star HMO ratings when comparing coverage. The company's growth reflects expanding enrollment options for seniors across the United States.
The takeaway
Growth in Medicare Advantage enrollment and quality ratings can signal which plans are gaining traction with seniors. Readers comparing coverage should review plan star ratings directly before deciding.
What happens next
Clover Health expects its first full year of GAAP net income profitability in 2026.
Further reading
For broader context on how insurers operate in this segment, see Healthcare.
Source note: This article includes information reported by FierceHealth.
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