Clover posts $6.4M Q3 profit as MA membership jumps 45%

Clover Health reported GAAP net income of $6.4 million for the third quarter of 2026 in its results release on Nov. 4, a swing of about $31 million from a net loss of $24.4 million a year earlier. The company furnished the release to the SEC in a Form 8-K the same day. The Nasdaq listed Medicare Advantage insurer paired that profit with 45% membership growth and a five star rating on its flagship PPO for payment year 2028.

The quarter by the numbers

Total revenues reached $759.3 million, up 52.9% from $496.7 million in Q3 2025. Consolidated gross profit on a non GAAP basis was $129.8 million, up 77.3%. Adjusted EBITDA came in at $16.1 million, up from $2.1 million. The insurance benefit expense ratio improved to 91.1% from 93.5%.

Medicare Advantage membership under management stood at 158,907 on Sept. 30, 2026, up 45% from 109,226 a year earlier. Average membership for the quarter was 158,383, up 46.3%. Year to date average membership was 156,610, up 48.8%.

Through nine months, Clover posted GAAP net income of $61.8 million. The same period in 2025 was a loss of $36.2 million. Cash, cash equivalents, and investments totaled $512.6 million at quarter end.

CFO Clay Thornton moved into the role on a permanent basis effective Nov. 4, according to the same 8-K. CEO Andrew Toy leads the company.

Five stars on the flagship PPO

Clover said about 98% of its current membership sits in its flagship PPO, which received a five star rating for payment year 2028. The company also claimed a third consecutive year of nation leading HEDIS performance without publishing the score in the release.

Stars set quality bonus payments in Medicare Advantage. Plans at four stars or higher generally earn a quality bonus on their benchmark, and five star plans can enroll members outside the standard annual enrollment windows. One year of ratings feeds payment two years later, which is why the payment year 2028 result shows up in this quarter’s release.

The contrast with larger rivals is sharp. CVS Health’s Aetna unit sued CMS over its star ratings, a fight we covered in our report on that lawsuit. Humana rebuilt its position for 2027, which we tracked in our Humana 2027 star ratings story. For the mechanics of how plans recover a rating, see our Stars 2027 rebuild.

Guidance raised for the full year

Clover lifted its 2026 outlook. The company now projects average Medicare Advantage membership of 157,000 to 158,000, total revenues of $2.97 billion to $3.00 billion, GAAP net income of $25 million to $35 million, and adjusted EBITDA of $75 million to $85 million. Full year GAAP profitability at that level would mark a first for the company.

The membership guidance range sits near the Q3 average of 158,383. Watch fourth quarter membership against that band during annual enrollment, when competitors market hardest.

What to do with this

• Plan leaders: pull the Stars cut points for payment year 2028 and compare your PPO book against Clover’s five star result. If your PPO lost a star, the Stars 2027 rebuild walks through the levers.
• Shoppers: a five star plan can accept enrollments outside the standard windows. Check whether the Clover PPO is sold in your county before you assume the rating applies to you.
• Finance teams: reconcile the $6.4 million table figure against the “$6 million” headline, and track Q4 membership against the 157,000 to 158,000 guidance range.