(Reuters) -Humana forecast annual profit below Wall Street estimates on Tuesday, signaling that costs from its government-backed plans for older Americans would remain elevated for the rest of the year.

Shares of the company fell 5% to $253.20 in volatile premarket trading.

The health insurer is a top provider of Medicare Advantage plans, under which the U.S. government pays private insurers a set rate to manage healthcare for people aged 65 and older, or with disabilities. It has been struggling with elevated medical costs for the last few quarters.

The company sees 2025 adjusted profit per share of about $16.25, compared to analysts' estimate of $16.71 per share, according to data compiled by LSEG.

On an adjusted basis, Humana reported a fourth-quarter loss of $2.16 per share, in line with analysts' estimates.