Q4 Consolidated Results and Profitability
Q4 consolidated revenue of $642M was slightly higher year-over-year; Q4 adjusted EBITDA was $84M, representing a 13% margin, modestly above the midpoint of guidance.
Full-Year Adjusted EBITDA and Free Cash Flow
Full-year adjusted EBITDA of $281M (11.1% margin) and full-year free cash flow of $167M demonstrate positive cash generation and profitability progress despite a net loss on a GAAP basis.
Strong Integrated Care Performance
Integrated Care Q4 revenue of $409M grew 4.7% YoY; Q4 adjusted EBITDA rose 23% YoY to $65M with a 16% segment margin. Full-year segment revenue grew 3.3% to $1.58B and adjusted EBITDA increased 2.7% to $239M.
Chronic Care and Membership Momentum
Chronic Care enrollment was 1.19M at quarter end (+2% sequentially). U.S. integrated care membership finished the quarter at 101.8M members, providing a large cross-sell addressable base.
Balance Sheet Strength and Debt Reduction
Ended 2025 with $781M in cash after retiring $550M of convertible debt in June; net debt to trailing Q4 adjusted EBITDA was under 0.8x at year-end, improving leverage metrics.
BetterHelp Insurance Traction
BetterHelp insurance sessions exceed 1,200 per day with an annualized revenue run rate >$40M; company expects 2026 insurance revenue of $75M–$90M and an exit run rate >$100M, indicating strong early traction.
Operational and Quality Milestones
Achieved ISO 9001 certification for key U.S. Integrated Care processes; launched Teladoc Health Pulse data & AI platform and enhanced 24/7 care offering to drive care quality and scale.
International Growth and Strategic Partnerships
Integrated Care and BetterHelp international revenue grew in mid-teens/double-digits (constant currency); BetterHelp non-U.S. revenue was nearly 24% of segment revenue. Partnerships include AARP exclusivity and Walmart collaboration, and localized launches in multiple European markets.
2026 Financial Guidance Shows Stability
2026 consolidated revenue guidance $2.47B–$2.59B (midpoint roughly flat with 2025); consolidated adjusted EBITDA guidance $266M–$308M (midpoint ~2% YoY growth). Stock-based comp projected below $60M (at least $20M YoY reduction).