eHealth Q3 Revenue Falls 60% as Medicare Season Looms

eHealth, Inc., a US online marketplace that sells Medicare Advantage, Medicare Supplement and other health plans on behalf of insurers, reported its third-quarter 2026 results on November 4, 2026. The company holds an earnings call on the day of release and trades on Nasdaq under the symbol EHTH. The headline numbers look weak, with revenue down by more than half, but the company's business is heavily seasonal and the release spends much of its space on what happens next. This article sets out the figures, explains the terms involved and shows what the full-year guidance implies, with calculations marked as made here.

The quarter

Total revenue for the third quarter was $21.3 million, compared with $53.9 million in the third quarter of 2025, a decrease of 60%. The GAAP net loss was $35.9 million against $31.7 million, and the net loss attributable to common stockholders, after items such as preferred dividends, was $50.4 million against $44.6 million. Adjusted EBITDA, a non-GAAP measure of operating earnings before interest, taxes, depreciation, amortization and certain other items, was a loss of $39.9 million against a loss of $34.0 million.

Costs fell, but by less than revenue. Total operating costs and expenses were $67.6 million against $95.4 million, a drop of 29%. Total marketing and advertising expense was $10.9 million against $24.4 million, a drop of 55%. Operating cash flow was negative $11.2 million against negative $25.3 million, an improvement of $14.1 million. Net adjustment revenue, which captures changes in the company's estimates of commissions on policies written in earlier periods, was a positive $1.4 million, against a positive $12.2 million a year earlier.

Nine-month figures

For the first nine months of 2026, revenue was $142.9 million against $227.8 million, a decrease of 37%. The net loss was $64.2 million against $47.1 million, and adjusted EBITDA was a loss of $52.7 million against a loss of $35.6 million. Operating cash flow for the nine months was positive $19.6 million, against $10.6 million, an increase of 85%.

Members and unit economics

The main driver of revenue is the number of members whose policies are approved by insurers. Medicare Advantage approved members were 11,562 in the quarter against 28,645, a fall of 60%, and 91,764 for the nine months against 141,884, a fall of 35%. Total approved members across all products were 24,394 against 46,270, a fall of 47%. The company also estimates its total Medicare Advantage membership, the customers it has previously enrolled who generate recurring commissions, at 540,653 at September 30, down 7% from 579,914.

The release reports two lifetime value figures, which estimate the commission revenue the company expects to receive over the life of each policy after applying conservative constraints. Constrained lifetime value per Medicare Advantage approved member was $955 against $975, a fall of 2%. Per Medicare Supplement approved member it was $1,424 against $1,467, a fall of 3%. The constraint percentages were unchanged from a year earlier at 5.5% for Medicare Advantage, 4% for Medicare Supplement and 7% for Part D.

Acquisition cost moved the other way. Total acquisition cost per Medicare Advantage equivalent approved member was $2,156 against $1,489, an increase of 45%. That figure divides spending by the volume of approved members, so when volume falls faster than spending, the cost per member rises. Lifetime value of $955 against an acquisition cost of $2,156 is a gap that, on a one-quarter basis, looks unfavorable, but the third quarter comes before the enrollment season, so the comparison may look different once fourth-quarter results are reported.

Balance sheet

Cash, cash equivalents and short-term marketable securities were $88.1 million at September 30, 2026, made up of $57.3 million of cash and $30.8 million of securities. Commissions receivable, the commissions eHealth expects to collect from insurers in future periods and has already recorded as an asset, were $970.6 million, of which $208.8 million was current and $761.8 million non-current. The large receivable relative to cash is a feature of the model: revenue is recognized on an estimated lifetime basis when a policy is approved, while cash arrives over several years.

Guidance and what it implies

The company reiterated its full-year 2026 guidance. Revenue is expected to be between $405.0 million and $445.0 million, GAAP net income between $8.0 million and $25.0 million, adjusted EBITDA between $55.0 million and $75.0 million, and operating cash flow between negative $10.0 million and positive $12.0 million. Net adjustment revenue is expected to be between $17 million and $20 million.

Subtracting the nine-month totals from the full-year ranges gives the fourth quarter the company is implicitly forecasting. Revenue would need to be about $262 million to $302 million, adjusted EBITDA about $108 million to $128 million, and GAAP net income about $72 million to $89 million, all calculated here. In other words, a quarter that would be larger than the first three quarters combined on revenue. That outcome depends on the annual enrollment period, which for Medicare runs from October 15 to December 7.

Chief executive Derrick Duke said the company is seeing "strong consumer demand we are seeing at attractive lead costs," and that "The most important weeks of AEP are still ahead." The release says the company completed its preparations for the enrollment period successfully, and that it improved 90-day retention for the second-quarter 2026 Medicare Advantage cohort under its lifetime advisory model, while cross-selling of ancillary products nearly doubled in the third quarter compared with a year earlier.

Cost reductions

The company also repeated cost targets: more than $60.0 million in annual variable spending reductions and about $30.0 million in annual fixed cost savings. Together they would amount to more than $90 million a year, calculated here, if both are fully achieved.

How to read it

The third quarter of a Medicare broker is typically its smallest, and a year-over-year comparison is complicated by changes in the timing of marketing and enrollments. The more informative questions for readers are whether the fourth quarter delivers the volume implied by guidance, how the lifetime value per member develops, and whether the retention improvements the company reports hold for the cohort enrolled this autumn. Until the fourth-quarter results are published, the guidance is a statement of expectation rather than a result.

Sources: eHealth, Inc.'s third-quarter 2026 earnings release, filed as an exhibit to a current report with the US Securities and Exchange Commission on November 4, 2026. Figures labelled as calculated here are derived from the reported numbers and are not company statements.