(Reuters) -Humana Inc beat third-quarter profit estimates on Wednesday, as a sluggish recovery in elective procedures helped the health insurer keep medical costs in check.

Rivals such as UnitedHealth Group Inc and Elevance Health have also benefited from lower-than-expected medical costs, prompting them to raise their full-year forecasts.

Humana, however, maintained its annual adjusted profit forecast at about $25 per share, just shy of analysts’ expectations of $25.03, according to IBES data from Refinitiv.

Shares of the Kentucky-based company fell nearly 1% in premarket trading.

The insurer expects to grow its membership next year by 7.1% to 8.7% for the Medicare Advantage business, which caters to people older than 65 or with disabilities, amid investor concerns that managed Medicare enrollment could decline once public health emergency due to COVID lifts.

Humana’s guidance to enroll 325,000 to 400,000 Medicare Advantage members next year marks a return to industry rate, one year ahead of schedule, Stephens analyst Scott Fidel said in a note.

Three of Humana’s insurance plans that cover about 356,000 members received five stars rating from a federal government program in October, while rivals CVS Health and Centene saw a sharp decline in ratings for their plans.

In September, Humana raised it forecast, citing no COVID-19 “headwind materializing” and lower-than-expected medical cost trends in the company’s Medicare Advantage and Medicaid businesses.

The company posted a quarterly ratio of medical expenses to premiums collected of 85.6%, compared with the average estimate of 85.69% in a Refinitiv poll of seven analysts. A lower ratio is better for a health insurer as it indicates a tight rein on costs.

Humana said its adjusted profit for the third quarter was $6.88 per share, above estimates of $6.28, according to Refinitiv data.

(Reporting by Raghav Mahobe and Bhanvi Satija in Bengaluru;Editing by Vinay Dwivedi and Maju Samuel)