(Bloomberg) — UnitedHealth Group Inc., the biggest U.S. health insurer, raised its 2012 profit forecast as enrollment in its plans surged in the third quarter and medical costs stayed stable.

Earnings may reach $5.20 to $5.25 a share this year, the Minnetonka, Minn.-based company said in a statement this week. That would miss the $5.28 average of seven analyst estimates compiled by Bloomberg. The insurer also said its quarterly earnings rose 23% to $1.50 a share, or 5 cents higher than in a preliminary report it gave last week.

UnitedHealth added 2.1 million customers to its medical plans from a year earlier, and the share of customer premiums spent on health care dropped. While revenue and profit will grow, reaching analyst’s 2013 estimates may be a “considerable challenge,” CEO Stephen Hemsley says.

“We expect strong execution to continue in 2013,” Hemsley says. Still, “given the weak business climate and employment outlook in the United States, the mounting pressures on federal and state budgets — to mention just a few of the challenges — we continue to be cautious about 2013 earnings performance.”

Analysts anticipate profit of $5.73 a share in 2013 and $119.4 billion in revenue, according to estimates compiled by Bloomberg.

UnitedHealth’s third-quarter net income rose to $1.56 billion from $1.27 billion, or $1.17 a share, a year earlier. Revenue gained 8% to $27.3 billion.

The numbers showed a “flawless quarter” with “better-than-expected medical costs across” UnitedHealth’s plans, said Brian Wright, a Monness Crespi Hardt & Co. analyst in New York, in a note to clients. The 2012 forecast “continues to leave room for upside, as has been the case all year.”

The company also boosted earnings by 28% at its Optum unit, which provides consulting and technology services to hospitals, governments and other clients and manages drug-benefit plans for employers. Hemsley has said the company wants to double profit from the services unit by 2015.

Medical costs for customers accounted for 79% of premiums collected in the quarter, compared with 81% a year earlier, according to the statement. Enrollment in the company’s medical plans was 36.5 million, compared with 34.4 million a year earlier.

It’s the first big health insurer to announce earnings this quarter. Hartford, Conn.-based Aetna Inc., the No. 3 health plan, is scheduled to report on Oct. 25.

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