Medical Claims Liability (Tables)

12 Months Ended

Dec. 31, 2025

The following table summarizes the change in medical claims liability for the year ended December 31, 2025 ($ in millions):


	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2025	$	10,299	$	3,358	$	4,463	$	188	$	18,308
Less: Reinsurance recoverables	18		—		47		—		65
Balance, January 1, 2025, net	10,281		3,358		4,416		188		18,243
Incurred related to:
Current year	85,697		34,869		37,397		2,146		160,109
Prior years	(1,247)		(550)		(495)		(23)		(2,315)
Total incurred	84,450		34,319		36,902		2,123		157,794
Paid related to:
Current year	75,872		30,651		32,213		1,955		140,691
Prior years	8,500		2,533		3,482		162		14,677
Total paid	84,372		33,184		35,695		2,117		155,368
Plus: Premium deficiency reserve	—		(92)		—		—		(92)
Plus: Divestitures	—		—		—		(109)		(109)
Balance, December 31, 2025, net	10,359		4,401		5,623		85		20,468
Plus: Reinsurance recoverables	16		—		60		—		76
Balance, December 31, 2025	$	10,375	$	4,401	$	5,683	$	85	$	20,544

The following table summarizes the change in medical claims liability for the year ended December 31, 2024 ($ in millions):


	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2024	$	10,814	$	3,612	$	3,460	$	114	$	18,000
Less: Reinsurance recoverables	5		—		44		—		49
Balance, January 1, 2024, net	10,809		3,612		3,416		114		17,951

Incurred related to:
Current year	78,886		21,170		26,548		1,708		128,312
Prior years	(1,370)		(575)		(509)		7		(2,447)
Total incurred	77,516		20,595		26,039		1,715		125,865
Paid related to:
Current year	69,351		18,036		22,547		1,522		111,456
Prior years	8,693		2,655		2,492		119		13,959
Total paid	78,044		20,691		25,039		1,641		125,415
Plus: Premium deficiency reserve	—		(158)		—		—		(158)
Balance, December 31, 2024, net	10,281		3,358		4,416		188		18,243
Plus: Reinsurance recoverables	18		—		47		—		65
Balance, December 31, 2024	$	10,299	$	3,358	$	4,463	$	188	$	18,308

The following table summarizes the change in medical claims liability for the year ended December 31, 2023 ($ in millions):


	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2023	$	11,253	$	3,431	$	1,921	$	140	$	16,745
Less: Reinsurance recoverables	7		—		19		—		26
Balance, January 1, 2023, net	11,246		3,431		1,902		140		16,719

Incurred related to:
Current year	79,747		19,487		19,966		1,480		120,680
Prior years	(1,537)		(343)		(150)		(6)		(2,036)
Total incurred	78,210		19,144		19,816		1,474		118,644
Paid related to:
Current year	69,904		16,631		16,823		1,367		104,725
Prior years	8,743		2,582		1,479		133		12,937
Total paid	78,647		19,213		18,302		1,500		117,662
Plus: Premium deficiency reserve	—		250		—		—		250
Balance, December 31, 2023, net	10,809		3,612		3,416		114		17,951
Plus: Reinsurance recoverables	5		—		44		—		49
Balance, December 31, 2023	$	10,814	$	3,612	$	3,460	$	114	$	18,000

Consolidated incurred and paid claims development as of December 31, 2025 is as follows ($ in millions):


Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	120,680	$	118,709	$	118,324
2024			128,312		126,382
2025					160,109
	Total incurred claims				$	404,815

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	104,725	$	117,635	$	118,114
2024			111,456		125,631
2025					140,691
	Total payment of incurred claims				384,436
	All outstanding liabilities prior to 2023, net of reinsurance				290
	Magellan Health medical claims liabilities held for sale				(109)
	Medical claims liability, net of reinsurance				$	20,560

Incurred and paid claims development for the Medicaid segment as of December 31, 2025 is as follows ($ in millions):


Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	79,747	$	78,517	$	78,282
2024			78,885		77,872
2025					85,697
	Total incurred claims				$	241,851

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	69,904	$	77,952	$	78,194
2024			69,351		77,527
2025					75,872
	Total payment of incurred claims				231,593
	All outstanding liabilities prior to 2023, net of reinsurance				101
	Medical claims liability, net of reinsurance				$	10,359

Incurred and paid claims development for the Medicare segment as of December 31, 2025 is as follows ($ in millions):


Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	19,487	$	19,008	$	18,830
2024			21,171		20,798
2025					34,869
	Total incurred claims				$	74,497

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	16,631	$	18,778	$	18,783
2024			18,036		20,674
2025					30,651
	Total payment of incurred claims				70,108
	All outstanding liabilities prior to 2023, net of reinsurance				104
	Medical claims liability, net of reinsurance				$	4,493

Incurred and paid claims development for the Commercial segment as of December 31, 2025 is as follows ($ in millions):


Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	19,966	$	19,698	$	19,725
2024			26,548		26,027
2025					37,397
	Total incurred claims				$	83,149

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	16,823	$	19,420	$	19,650
2024			22,547		25,748
2025					32,213
	Total payment of incurred claims				77,611
	All outstanding liabilities prior to 2023, net of reinsurance				85
	Medical claims liability, net of reinsurance				$	5,623

Incurred and paid claims development for the Other segment as of December 31, 2025 is as follows ($ in millions):


Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	1,480	$	1,486	$	1,487
2024			1,708		1,685
2025					2,146
	Total incurred claims				$	5,318

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year	2023 (unaudited)		2024 (unaudited)		2025
2023	$	1,367	$	1,485	$	1,487
2024			1,522		1,682
2025					1,955
	Total payment of incurred claims				5,124
	All outstanding liabilities prior to 2023, net of reinsurance				—
	Magellan Health medical claims liabilities held for sale				(109)
	Medical claims liability, net of reinsurance				$	85

Consolidated information is summarized as follows (in millions):


	December 31, 2025
Claim Year	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance		Total IBNR Plus Expected Development on Reported Claims		Cumulative Paid Claims
2023	$	118,324	$	4	624.1
2024	126,382		347		665.0
2025	160,109		13,125		709.9

Information for the Medicaid segment is summarized as follows (in millions):


	December 31, 2025
Claim Year	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance		Total IBNR Plus Expected Development on Reported Claims		Cumulative Paid Claims
2023	$	78,282	$	4	346.0
2024	77,872		155		317.9
2025	85,697		7,244		308.1

Information for the Medicare segment is summarized as follows (in millions):


	December 31, 2025
Claim Year	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance		Total IBNR Plus Expected Development on Reported Claims		Cumulative Paid Claims
2023	$	18,830	$	—	200.7
2024	20,798		82		255.1
2025	34,869		1,567		282.8

Information for the Commercial segment is summarized as follows (in millions):


	December 31, 2025
Claim Year	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance		Total IBNR Plus Expected Development on Reported Claims		Cumulative Paid Claims
2023	$	19,725	$	—	72.9
2024	26,027		107		86.4
2025	37,397		4,242		112.5

Information for the Other segment is summarized as follows (in millions):


	December 31, 2025
Claim Year	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance		Total IBNR Plus Expected Development on Reported Claims		Cumulative Paid Claims
2023	$	1,487	$	—	4.5
2024	1,685		3		5.6
2025	2,146		72		6.5

CENTENE CORP 10-K