Teladoc Health (NYSE:TDOC) reported fourth-quarter and full-year 2025 results that management said were generally in line with expectations, while outlining a 2026 plan centered on product innovation in integrated care, scaling BetterHelp’s insurance offering, and continued operational efficiency efforts.
Q4 and full-year 2025 results
CEO Chuck Divita said Teladoc’s “financial performance reflects a solid finish to 2025,” with fourth-quarter consolidated revenue of $642 million, slightly higher than the prior-year period. Adjusted EBITDA for the quarter was $84 million, representing a 13% margin and modestly above the midpoint of the company’s guidance range, according to management. Net loss per share in the quarter was $0.14, which included amortization of intangible assets and stock-based compensation.
Teladoc reported full-year free cash flow of $167 million and ended 2025 with $781 million in cash and cash equivalents. The company also noted it retired $550 million in convertible debt at maturity in June and finished the year with net debt to trailing four-quarter adjusted EBITDA under 0.8x.
Segment performance: Integrated Care and BetterHelp
In Integrated Care, fourth-quarter revenue was $409 million, up 4.7% year-over-year and near the upper end of guidance. Management attributed the quarter’s performance to both performance-based revenue and U.S. virtual care visit volume related to a strong flu season. Acquisitions of Catapult Health and Telecare contributed about 260 basis points to growth, and the International business delivered double-digit constant-currency revenue growth.
Chronic care program enrollment was 1.19 million at quarter end, up 2% sequentially, while U.S. Integrated Care membership ended the quarter at 101.8 million members. Fourth-quarter Integrated Care adjusted EBITDA was $65 million, up 23% year-over-year, representing a 16% margin.
For the full year, Integrated Care revenue increased 3.3% to $1.58 billion, with acquisitions contributing around 210 basis points. Divita said U.S. virtual care visit revenue grew double digits year-over-year, offset by lower subscription revenue as Teladoc continues shifting toward visit-based arrangements. Full-year segment adjusted EBITDA rose 2.7% to $239 million, with a 15.1% margin.
At BetterHelp, fourth-quarter revenue was $233 million, down 6.7% year-over-year. Average paying users declined 6% to 375,000, with management citing a low double-digit increase in non-U.S. users that partially offset a low double-digit decline in U.S. users. BetterHelp also generated about $7 million in insurance-based revenue during the quarter, which management said was in line with expectations.
BetterHelp adjusted EBITDA improved to $18 million in the fourth quarter from $4 million in the third quarter, and the adjusted EBITDA margin increased to 7.9% from 1.6%. Management attributed the improvement primarily to a seasonal pullback in advertising spend due in part to higher ad prices during the holiday season.
For 2025, BetterHelp revenue was $950 million, down 9% year-over-year, including $13 million in insurance revenue. Full-year adjusted EBITDA was $42 million, a 4.4% margin versus 7.5% in the prior year, driven by lower revenue and investments to scale the insurance offering, partially offset by a 7% reduction in advertising and marketing spend.
Strategy updates: product innovation, AI platforms, and BetterHelp insurance
Looking to 2026, Divita described four strategic priorities: advancing Integrated Care in the U.S., leveraging Teladoc’s position in virtual mental health, driving value creation through international offerings, and operational excellence.
In the U.S. Integrated Care business, he highlighted a recently launched enhanced 24/7 care offering designed to align with the shift from subscription to visit-driven models by expanding the range of conditions addressed and supporting providers with “real-time access to specialists.” The company also described work in chronic care using “AI-enabled stratification capabilities” to target rising- and high-risk members and support more holistic care coordination, alongside rollout plans for connected devices and in-home testing.
Divita also emphasized Teladoc’s technology investments, including enhancements to the Prism care delivery platform and the new Pulse data and AI platform. He provided examples of AI use cases in chronic care, clinical documentation, hospital safety solutions (via an AI-enabled Clarity tool), and mental health intake and matching, stressing that AI tools are intended to support clinicians rather than replace them.
In BetterHelp, management said scaling insurance coverage is central to the turnaround plan. Divita said BetterHelp is live in 20 states plus Washington, D.C., with more than 4,500 credentialed and enrolled providers and network arrangements that bring covered lives to more than 120 million. He said insurance sessions now exceed 1,200 per day on average, with an annualized revenue run rate of over $40 million.
Management also discussed partnerships intended to broaden awareness and funnel growth, including BetterHelp being named the exclusive online therapy provider for AARP, with an expected launch “over the next 60 days,” and a partnership with Walmart through its Better Care Services initiative. International expansion remains a focus, with non-U.S. revenue representing nearly 24% of BetterHelp segment revenue in 2025 and localized launches in several European countries.
2026 outlook and key assumptions
For 2026, Teladoc guided consolidated revenue to $2.47 billion to $2.59 billion, approximately level with 2025 at the midpoint, and adjusted EBITDA to $266 million to $308 million, representing 2% year-over-year growth at the midpoint. The company guided free cash flow to $130 million to $170 million, citing a working capital build tied to BetterHelp’s insurance growth and lower net interest income after the paydown of 2025 converts and lower assumed interest rates.
Segment-level guidance included:
- Integrated Care: 2026 revenue growth of 0.4% to 3.9%, with the midpoint including about 60 basis points of acquisition tailwind. Adjusted EBITDA margin guidance of 15.1% to 16.1%, representing an increase of about 45 basis points at the midpoint. The company also cited an expected $5 million to $7 million tariff headwind in 2026.
- BetterHelp: 2026 revenue expected to decline 7% to 0.5% versus 2025, with insurance revenue expected at $75 million to $90 million and an exit annualized run rate of more than $100 million. BetterHelp adjusted EBITDA margin was guided to 3% to 4.6% for the full year.
For the first quarter of 2026, Teladoc guided consolidated revenue to $598 million to $620 million and adjusted EBITDA to $50 million to $62 million. BetterHelp first-quarter revenue is expected to be down 11.25% to 7% year-over-year, with insurance revenue of $10 million to $13 million. Teladoc said it is targeting sequential quarterly BetterHelp revenue improvement beginning in the second quarter and continuing through the rest of 2026.
On Integrated Care membership, the company expects U.S. integrated care members to end 2026 in a range of 97 million to 100 million, modestly down from 2025 due to reductions at certain health plan clients tied to government programs, including the expiration of enhanced Affordable Care Act subsidies.
Q&A: revenue growth path, health plan trends, ad spend, and debt plans
During the Q&A, Divita addressed questions about the path back to more consistent revenue growth. He reiterated that Integrated Care has faced a headwind from the ongoing shift from subscription to visit-based revenue, though he said the impact should moderate as visit revenue now comprises more than half of U.S. virtual care revenue. He also pointed to chronic care opportunities and said BetterHelp’s insurance scaling is key to its turnaround.
On demand trends, Divita said employer channels showed “really good demand and results” in 2025, while health plan conversations were “mixed” given macro uncertainty, but increasingly strategic. He cited Catapult’s virtual checkup use case for Medicare Advantage annual wellness visits and said Teladoc’s enhanced 24/7 care offering is resonating with health plans.
Management acknowledged the historical correlation between BetterHelp advertising spend and direct-to-consumer cash-pay revenue, while arguing the company can improve ad efficiency and reallocate resources toward insurance and international growth. Divita also said BetterHelp’s margin mix impact is “totally the insurance side,” while describing international as having a different profile but still meeting targeted bottom-line margins.
Finally, Teladoc said its free cash flow and net loss guidance does not assume changes to its current debt structure, but it is evaluating options for its 2027 convertible notes. Management said it currently expects to address the notes in two phases: paying off a substantial portion potentially before year-end through a combination of balance sheet cash and new term loan debt, then retiring the remaining balance at maturity with existing cash.
About Teladoc Health (NYSE:TDOC)
Teladoc Health, Inc is a leading global provider of virtual healthcare services, offering on-demand medical consultations via phone, video, and mobile app platforms. The company connects patients with licensed physicians and specialists for non-emergency medical issues, mental health support, dermatology, and chronic condition management. By leveraging digital technologies and data analytics, Teladoc aims to enhance accessibility, reduce healthcare costs, and improve patient outcomes through personalized care plans and remote monitoring.
Teladoc’s service portfolio includes general medical visits, behavioral health sessions, expert medical services for complex cases, and wellness programs designed to support chronic disease management such as diabetes, hypertension, and heart disease.
