Cigna vs Elevance Health: Revenue, Profit and Business Model
Cigna reported $274.9B of revenue in FY2025 and $6B of net income. Elevance Health reported $199.1B of revenue in FY2025 and $5.7B of net income.
Latest financial snapshot
Cigna
- Latest revenue
- $274.9B (FY2025)
- Net income
- $6B
- Net margin
- 2.2%
- Revenue growth
- +11.4% a year, FY2020–FY2025
Elevance Health
- Latest revenue
- $199.1B (FY2025)
- Net income
- $5.7B
- Net margin
- 2.8%
- Revenue growth
- +7.8% a year, FY2023–FY2025
Financial summary
Cigna
Revenue grew from $160.4 billion in 2020 to $274.9 billion in 2025, largely from Evernorth pharmacy volume, specialty drugs and new PBM clients. 2025 shareholders' net income was $6.0 billion ($22.18 per share), up from $3.4 billion in 2024, when results included a $2.7 billion after-tax loss on the VillageMD investment. Adjusted income from operations was $8.0 billion ($29.84 per share) in 2025. In the first half of 2026 Cigna reported $140.2 billion in revenue and $3.3 billion in shareholders' net income, and it raised 2026 adjusted EPS guidance to at least $30.45. The quarterly dividend was raised to $1.56 per share in February 2026.
Elevance Health
Revenue rose from $171.3B in 2023 to $177.0B in 2024 and $199.1B in 2025, helped by premium-rate increases, acquisitions and Medicare Advantage growth that offset Medicaid attrition. Net income was $5.662B in 2025 on operating income of $7.199B. Growth slowed in 2026 as the company deliberately shrank unprofitable Medicaid, Medicare Advantage and employer risk business: operating revenue was $49.5B in Q1 2026 and $49.8B in Q2 2026. In July 2026 Elevance raised full-year guidance to at least $20.10 GAAP diluted EPS and at least $27.00 adjusted EPS, with operating cash flow of at least $6.0B, and paid a $1.72 quarterly dividend.
Revenue and profit by year
Cigna
| Year | Revenue | Net income | Margin | Growth | Source |
|---|---|---|---|---|---|
| FY2025 | $274.9B | $6B | 2.2% | +11.2% | Source |
| FY2024 | $247.1B | — | 0.0% | +26.6% | Source |
| FY2023 | $195.3B | — | 0.0% | +8.2% | Source |
| FY2022 | $180.5B | — | 0.0% | +3.7% | Source |
| FY2021 | $174.1B | — | 0.0% | +8.5% | Source |
| FY2020 | $160.4B | — | 0.0% | — | Source |
Elevance Health
| Year | Revenue | Net income | Margin | Growth | Source |
|---|---|---|---|---|---|
| FY2025 | $199.1B | $5.7B | 2.8% | +12.5% | Source |
| FY2024 | $177B | — | 0.0% | +3.3% | Source |
| FY2023 | $171.3B | — | 0.0% | — | Source |
Where the revenue comes from
Cigna
- Evernorth Health Services
Majority of revenue
Pharmacy benefit services, home delivery and Accredo specialty pharmacy dispensing, plus eviCore and MDLive care services.
- Cigna Healthcare (U.S.)
Second-largest
Premiums from insured employer and individual plans and stop-loss, plus administrative fees from self-funded employers.
- International Health
Smaller share
Health benefits for multinational employers and globally mobile individuals.
Elevance Health
- Health Benefits
About 83% of FY2025 revenue (premiums)
Commercial, Medicare, Medicaid, BlueCard, FEP, and other insured or administrative health-plan products.
- CarelonRx
Pharmacy services
Pharmacy benefit management and related pharmacy services integrated with Elevance's health-plan base and external customers.
- Carelon Services
Health services
Care delivery, behavioral health, analytics, and other services designed to manage care and cost.
- Investment Income and Other
Supplemental
Investment income and other revenue streams tied to the insurance and services platform.
Business model and strategy
Cigna
How it makes money
Cigna makes money in two ways. Evernorth Health Services, the larger business by revenue, runs Express Scripts pharmacy benefit management, Accredo specialty pharmacy, home-delivery pharmacy, eviCore utilization management and MDLive virtual care; it earns dispensing margins, administrative and service fees, and purchasing economics on prescription drugs for health plans and employers.
Growth strategy
Cigna's growth plan centers on Evernorth: winning PBM clients with the rebate-free and transparent pricing models, growing Accredo specialty pharmacy and biosimilar programs, and selling services such as EncircleRx for GLP-1 cost management and Embarc Benefit Protection for gene therapies to other health plans and employers.
Competitive advantage
Cigna's edge is scale in pharmacy plus a capital-light medical business. Evernorth managed about 118 million pharmacy customers at June 30, 2026, giving it purchasing power with drug makers and pharmacies, and Accredo is one of the largest U.S. specialty pharmacies.
Elevance Health
How it makes money
Elevance makes money in two ways. First, its Health Benefits segment collects premiums from employers, individuals and government programs and pays members' medical claims; profit depends on keeping the benefit expense ratio (89.7% in Q2 2026) below premium levels and on fees for administering self-funded employer plans.
Growth strategy
Elevance is pruning lower-margin business, such as exiting standalone Medicare Part D plans for 2026 and the D.C. Medicaid market, while investing in medical cost management, provider connectivity and Carelon. Recent deals that extend Carelon include BioPlus specialty pharmacy (2023), Kroger Specialty Pharmacy (2024) and CareBridge home-based care (reported at about $2.7B, 2024 to 2025).
Competitive advantage
Elevance's main edge is its Blue Cross Blue Shield licenses in 14 states, which give it dense local provider networks and strong brand recognition with employers, plus access to the national BlueCard network. Owning CarelonRx and Carelon Services lets it keep pharmacy and care-management revenue that rivals without those assets pay to third parties.
Questions about Cigna vs Elevance Health
Which company has higher revenue — The Cigna Group or Elevance Health, Inc.?
The Cigna Group reported $274.9B (FY2025), while Elevance Health, Inc. reported $199.1B (FY2025). By last reported revenue, The Cigna Group is the larger business, with Elevance Health, Inc. reporting a smaller revenue base.
What is the market cap of The Cigna Group vs Elevance Health, Inc.?
The Cigna Group's market capitalisation stands at $71.9B, while Elevance Health, Inc.'s is $80.0B. Elevance Health, Inc. carries the higher market valuation, reflecting investors' expectations of its future earnings power relative to The Cigna Group.
Which is more financially efficient — The Cigna Group or Elevance Health, Inc.?
The Cigna Group generates $4.06M / employee in revenue per employee, while Elevance Health, Inc. generates $2.05M / employee. The Cigna Group shows higher revenue efficiency per headcount, though this reflects business model differences — capital-light software companies routinely outperform labour-intensive manufacturers on this metric.
How do The Cigna Group and Elevance Health, Inc. make money?
The Cigna Group and Elevance Health, Inc. generate revenue in fundamentally different ways. The Cigna Group: Cigna makes money in two ways. Elevance Health, Inc.: Elevance makes money in two ways.
Which company is valued higher relative to revenue — The Cigna Group or Elevance Health, Inc.?
On a price-to-sales (P/S) basis, The Cigna Group trades at 0.3x P/S and Elevance Health, Inc. at 0.4x P/S. Elevance Health, Inc. commands a higher revenue multiple, typically indicating that investors expect faster growth or higher future margins compared to The Cigna Group. A higher multiple is not inherently better — it may also signal that the stock is priced for perfection.
Is The Cigna Group bigger than Elevance Health, Inc.?
By last reported revenue, The Cigna Group ($274.9B (FY2025)) is the larger company compared to Elevance Health, Inc. ($199.1B (FY2025)). Revenue scale is one dimension of size — market capitalisation, employee count, and geographic reach are also relevant depending on the context.
Figures come from each company's filings and the sources linked beside them. Amounts reported in another currency are shown in US dollars at an approximate rate and marked with ~. Back to the Cigna vs Elevance Health overview