UnitedHealth Group beat third-quarter earnings expectations and finally hiked its 2020 forecast after holding off while trying to gauge COVID-19’s impact.

But the nation's largest health insurance provider also is thinking conservatively about its 2021 growth prospects as the coronavirus continues to spread widely.

Health insurers have approached 2020 forecasts cautiously, even though many reaped huge profits in the first half as the pandemic kept people home and out of the health care system.

Both analysts and insurers have said they expected medical costs to rise in the second half of the year, as communities that had shut down opened back up and people felt more comfortable seeking elective surgeries.

UnitedHealth said Wednesday that both care patterns and prescription volumes approached normal levels in its recently completed quarter. The company now expects 2020 adjusted net earnings to range between $16.50 to $16.75 per share.

That compares to a forecast it first laid out late last year for earnings of between $16.25 and $16.55 per share. UnitedHealth usually raises its forecast a couple of times during the year.

The new range mostly exceeds the average forecast on Wall Street for earnings of $16.57 per share, according to FactSet.

But the range's middle point is only about 1% higher than the same spot in the previous forecast, and it implies fourth-quarter earnings that could fall short of expectations, SVB Leerink analyst Stephen V. Tanal said in a research note.

Based in Minnetonka, Minnesota, UnitedHealth Group Inc. runs a health insurance business that covers about 48 million people, mostly in the United States.

Its Optum segment also runs one of the nation’s largest pharmacy benefit management operations as well as a growing number of clinics and urgent care and surgery centers.

Overall, the company’s net income dropped 10% to $3.17 billion in the quarter, due partially to costs tied to the pandemic.

The company booked medical costs from COVID-19 care and testing. It also gave some customers premium breaks and temporarily waived fees like co-payments for doctor visits.

UnitedHealth's adjusted earnings totaled $3.51 per share in the third quarter. Revenue rose about 8% to $65.11 billion.

Analysts expected, on average, adjusted earnings of $3.10 per share in the quarter on $63.79 billion in revenue, according to financial data provider FactSet.

CEO David Wichmann told analysts Wednesday that the company still has confidence in its long-term goal of 13% to 16% earnings growth.

But he also noted that the pandemic’s impact remains a big potential challenge. They still don’t know how it will affect the economy or a return to more normal levels of health care use. He told analysts to expect UnitedHealth to begin with a conservative starting point for next year.

The company will talk more about its growth prospects at its Dec. 1 investor conference.

Company shares slipped less than 2% to $325.72 Wednesday morning, while the Dow Jones Industrial average was flat.

Shares of UnitedHealth, a Dow component, have hit several all-time high prices so far this year.

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Follow Tom Murphy on Twitter: @thpmurphy