Cigna vs UnitedHealth: Revenue, Profit and Business Model
Cigna reported $274.9B of revenue in FY2025 and $6B of net income. UnitedHealth reported $447.6B of revenue in FY2026 and $12.1B 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
UnitedHealth
- Latest revenue
- $447.6B (FY2026)
- Net income
- $12.1B
- Net margin
- 2.7%
- Revenue growth
- +9.2% a year, FY2016–FY2026
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.
UnitedHealth
UnitedHealth Group grew 2025 revenue 12% to $447.6 billion, yet earnings from operations fell from $32.3 billion in 2024 to $19.0 billion as Medicare Advantage and Optum Health medical costs ran well above pricing. Net margin was 2.7% and operating cash flow was $19.7 billion. 2026 is a repair year: management guided to more than $439 billion in revenue, a slight decline from planned right-sizing of membership, and after a Q2 with $112.0 billion revenue, $8.0 billion operating earnings and an 86.7% adjusted medical care ratio, raised adjusted EPS guidance to $19.50 to $20.00.
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 |
UnitedHealth
| Year | Revenue | Net income | Margin | Growth | Source |
|---|---|---|---|---|---|
| FY2026 | $447.6B | $12.1B | 2.7% | +0.0% | |
| FY2025 | $447.6B | $12.1B | 2.7% | +11.8% | Source |
| FY2024 | $400.3B | $14.4B | 3.6% | +7.7% | Source |
| FY2023 | $371.6B | $22.4B | 6.0% | +14.6% | Source |
| FY2022 | $324.2B | $20.1B | 6.2% | +12.7% | Source |
| FY2021 | $287.6B | $17.3B | 6.0% | +11.8% | Source |
| FY2020 | $257.1B | $15.4B | 6.0% | +6.2% | Source |
| FY2019 | $242.2B | $13.8B | 5.7% | +7.0% | Source |
| FY2018 | $226.2B | $12B | 5.3% | +12.5% | Source |
| FY2017 | $201.2B | $10.6B | 5.2% | +8.8% | Source |
| FY2016 | $184.8B | $7B | 3.8% | — | 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.
UnitedHealth
- Insurance premiums
- Administrative services fees
- Medicare Advantage
- Medicaid managed care
- Optum Rx pharmacy benefit management
- Optum Health care delivery
- Optum Insight data and technology
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.
UnitedHealth
How it makes money
UnitedHealth makes money in two connected ways. UnitedHealthcare collects premiums from employers, individuals and government programs (Medicare Advantage and Medicaid) and earns fees for administering self-funded employer plans; profit depends on keeping medical costs below premiums.
Growth strategy
UnitedHealth is focused on pricing and benefit design, medical cost management, Medicare Advantage discipline, Medicaid and employer offerings, Optum Rx scale, Optum Health care delivery, technology, data analytics, and value-based care capabilities.
Competitive advantage
UnitedHealth's advantage is vertical integration. It combines the largest U.S. health insurer with Optum's pharmacy, care delivery, data, analytics, and services assets, giving it scale in claims, benefits, networks, prescriptions, and care management.
Questions about Cigna vs UnitedHealth
Which company has higher revenue — The Cigna Group or UnitedHealth Group Incorporated?
The Cigna Group reported $274.9B (FY2025), while UnitedHealth Group Incorporated reported $447.6B (FY2026). By last reported revenue, UnitedHealth Group Incorporated is the larger business, with The Cigna Group reporting a smaller revenue base. Note: these are from different fiscal years and are not a direct like-for-like comparison.
What is the market cap of The Cigna Group vs UnitedHealth Group Incorporated?
The Cigna Group's market capitalisation stands at $71.9B, while UnitedHealth Group Incorporated's is $450.0B. UnitedHealth Group Incorporated 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 UnitedHealth Group Incorporated?
The Cigna Group generates $4.06M / employee in revenue per employee, while UnitedHealth Group Incorporated generates $1.15M / 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 UnitedHealth Group Incorporated make money?
The Cigna Group and UnitedHealth Group Incorporated generate revenue in fundamentally different ways. The Cigna Group: Cigna makes money in two ways. UnitedHealth Group Incorporated: UnitedHealth makes money in two connected ways.
Which company is valued higher relative to revenue — The Cigna Group or UnitedHealth Group Incorporated?
On a price-to-sales (P/S) basis, The Cigna Group trades at 0.3x P/S and UnitedHealth Group Incorporated at 1.0x P/S. UnitedHealth Group Incorporated 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 UnitedHealth Group Incorporated?
By last reported revenue, UnitedHealth Group Incorporated ($447.6B (FY2026)) is the larger company compared to The Cigna Group ($274.9B (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 UnitedHealth overview