HQY vs UNH: Which Is the Better Buy in 2026?

Same yardstick, side by side (as of August 2026). Valuation lined up like this is most meaningful for two names in the same corner of the market, which these are. Figures are approximate; verify before investing.

The metrics above tell you which is the marginally better business. The bigger risk for most people is not picking the slightly worse stock, it is over-concentrating. HQY and UNH share themes, so owning both, or adding either to what you already hold, can quietly push a large share of your portfolio into one bet.

This is the part a generic comparison page cannot answer, because it depends on what you own. Connect your brokerage and Walnut shows your real, combined HQY and UNH exposure, flags overlap with your existing positions, and tells you if adding one would tip you past a concentration you are comfortable with, read-only by default, with your login staying at your broker. Walnut is not an investment adviser.

HealthEquity, Inc. is the largest independent non-bank custodian of health savings accounts in the United States, and it also administers the flexible spending accounts, health reimbursement arrangements, COBRA and commuter benefits that sit alongside them. As of April 30, 2026 it held 10.6 million HSAs containing $37.1 billion of member assets, plus 7.2 million other consumer-directed benefit accounts, for 17.8 million total accounts. Almost none of that comes from consumers directly: it reaches members through their employers, and employers through benefits brokers, health plans and retirement recordkeepers. Revenue arrives in three lines: service fees from employers and members, custodial revenue on the interest spread from member cash placed with insurance-company partners and banks, and interchange on every swipe of a member's benefits card. Custodial is the biggest and by far the most profitable, at $174.3 million of the $354.6 million booked in the quarter ended April 30, 2026, against only $11.7 million of direct cost.

Full HQY guide

UnitedHealth Group is the largest US health insurer and one of the largest healthcare companies in the world. It runs through two main engines. UnitedHealthcare is the insurance arm, providing employer, individual, Medicare Advantage, and Medicaid health plans to tens of millions of members. Optum is the faster-growing health-services arm: Optum Health (physician groups and care delivery, including value-based care), Optum Insight (healthcare data, analytics, and technology), and Optum Rx (one of the largest pharmacy benefit managers in the country). The combination lets UnitedHealth manage both the financing and the delivery of care, capturing margin across the system and using vast claims data to manage costs. Headquartered in Minnetonka, Minnesota, UnitedHealth is a Dow component and one of the largest companies in the S&P 500 by revenue. Its scale, vertical integration, and Medicare Advantage leadership define its competitive position.

Full UNH guide

Both fit overlapping themes, but they are not interchangeable. The useful comparison is which set of drivers and risks you want exposure to.

• HQY drivers: The cash repricing ladder; Balances that compound whether or not accounts do.
• UNH drivers: Optum growth engine; Medicare Advantage scale.

A faster-growing, richer-valued name usually swings harder, so it suits a longer horizon and a higher tolerance for volatility; a steadier, more cash-generative business suits a more conservative or income-minded investor. The honest test is which set of risks you could hold through a drawdown: Custodial revenue is the profit engine and it depends on rates HealthEquity does not control, so a sustained decline in market yields would eventually reset renewing contracts lower, just as slowly as the current tailwind arrived. For UNH, unitedHealth faces a difficult medical-cost environment: rising utilization (especially in Medicare Advantage) can spike the medical loss ratio and compress margins, as the company has experienced.

Growth-minded investors who believe the theme has years to run tend to accept the richer multiple for more upside; value-minded investors lean toward the cheaper forward earnings and steadier profile. Pick HQY if you believe its drivers more; UNH if you believe its. Many investors hold both, but since they share themes, that is a concentrated bet, not diversification. Decide deliberately and check overlap. For the full detail, see the HQY and UNH guides.

HQY. HealthEquity runs a January fiscal year, so the quarter ended April 30, 2026 is fiscal 2027's first, reported May 28, 2026. Net debt is modest at roughly $680 million ($600 million of 4.50% notes due 2029 plus a drawn revolver, against $265 million of cash), which puts enterprise value near $9.3 billion, or about 15x the midpoint of guided adjusted EBITDA. Because custodial revenue carries almost no direct cost, small changes in the yield on member cash swing earnings far more than equivalent changes in account count.

UNH. UnitedHealth's revenue is enormous but its insurance margins are thin by design, so earnings hinge on the medical loss ratio and Optum's higher-margin growth. The valuation reflects scale and integration but has been pressured by cost inflation, regulatory uncertainty, and reputational headwinds. The market weighs Optum's durable growth against insurance-cycle and political risk.

Headline figures (approximate, August 2026): HQY shows revenue (ttm) ~$1.34B, latest quarter (q1 fy2027, ended april 30, 2026) ~$354.6M revenue, +7% year over year, q1 fy2027 earnings ~$69.4M net income, ~$0.82 diluted (~$1.24 non-GAAP), hsa assets under custody ~$37.1B (~$17.5B cash, ~$19.6B invested); UNH shows revenue (ttm) ~$400 billion, operating margin ~6-8%, net income (ttm) ~$15-22 billion (sensitive to medical costs), medical loss ratio ~85-89%.

HQY and UNH are related but distinct: same themes, different businesses and risks. Neither wins in the abstract; the right pick is whichever thesis you actually believe, sized so you are not over-concentrated in one theme. Walnut can show your combined HQY and UNH exposure against your real portfolio. It is not an investment adviser.