UnitedHealthcare

Advocacy that sees the big picture

Healthcare is complicated. No one should have to go it alone. Because we know the system better than anyone, we can help you and your employees navigate it—with advocacy solutions designed to help save you money that may help lead to better outcomes and improved experiences.
We’ll take care of it, so you don’t have to.

Advocacy that delivers for employers

Lower cost

We’ll help save you and your employees money. You may save up to 2-4%1 in medical total cost of care.

Better outcomes

Our results may deliver up to 4% lower inpatient admissions, up to 10% lower ER visits, and on average an 18% increase in nurse program engagement.1

Satisfied members

We'll give your employees a better experience, resulting in a 10%2 Improvement in NPS.

Advocacy that delivers for employees

Proactive guidance

Our data and insights help us identify when members may make suboptimal choices, helping them avoid unnecessary costs.

Compassionate service

Knowing that someone is looking out for them in every interaction, serving with empathy and a personal touch.

Simplified experience

Because we manage multiple parts of the health care ecosystem, we can connect the dots across every touchpoint to streamline the benefits experience.

Advocacy that guides at every step

Onboarding

We guide members through enrollment, so they understand their plan and how to make it work for them to avoid unexpected costs.

Engagement

Members receive a personalized experience—through incentive programs, wellness coaching, targeted health goals, and guidance to avoid financial surprises.

Care

We coordinate needs across multiple touchpoints with both the member and providers to help ensure members receive appropriate care.

Resolution

We help members understand billing, coverage, and work quickly to resolve any issues.

Support

We walk with our members, helping them make informed choices, avoid issues, and advocate for them across their health care journeys.

Advocacy program highlights

Digital engagement

Our digital tools help members make better decisions, connect with relevant clinical programs and reduce their costs.

Personalized member view

Our Advocate dashboard helps us know members, find engagement opportunities, and offer faster, personalized support.

Social determinants of health

Our Advocates use integrated tools to help find resources and connect members to organizations that can help meet the needs of the whole person.

Active member intercept

We help members avoid unnecessary costs through near real-time guidance that may lead to more cost-effective choices.

Custom high need member management

We use analytics to identify families of children with special needs to help them navigate a system that may not always be set up to support them effectively.

Point of care support

Physician solutions designed to help members when they may need them most—which may lead to more efficiency, lower costs and better health outcomes.

The right expert for any situation

One person doesn’t have all the answers. A caller’s needs are anticipated leveraging deep analytics and we connect them with the right resource from our team-based model to help quickly resolve issues and find the help they need.

Benefits Advocate

Provides plan, claims and coverage expertise with first contact resolution.

Health Advocate

Provides financial and health advocacy through claims, wellness and health management expertise.

Nurse Advocate

Provides health and clinical education, decision support, and expertise from a licensed RN.

Pharmacy Specialist

Provides end-to-end service for Rx, including formulary guidance, lower cost alternative recommendations, home delivery, and claims and benefits management.

Behavioral Specialist

Provides expertise on behavioral health including provider selection, benefits explanation, and sensitive handling of mental health needs.

Super Advocate

Provides complex issue resolution, support for longer term issues, and a focus on cost diversion (for Elite and Premier members only).

Advocacy that makes a difference 

Advocacy you can rely on

Named “World’s Most Admired Company” in Insurance and Managed Care by Fortune, 10 years running.3

2.6 Million
members in advocacy products.

$3 Billion+
annual investment in data, technology, and innovation.4

750 Billion+
digital transactions processed annually (including 2 billion claims).

$1 Billion
in health-related incentive rewards earned since 2016 through Rally Health.

92%
member satisfaction with Advocate4Me.5

79%
of Advocate4Me calls include aclinical program offer.6

57%
of clinical programs offered inAdvocate4Me are accepted.6

80%
shifts of tier 3 prescriptions using PreCheck MyScript.7

COVID-19: Taking care of our members

Coronavirus is profoundly impacting the health and finances of people around the world. As a global leader in health care, we immediately understood that our members would need unprecedented support throughout the pandemic. And UnitedHealth Group has responded with the full force of our organization in a number of ways to help.8

  • Waived all cost sharing for COVID-19 diagnosis and treatment.
  • Provided unlimited telehealth visits at no cost.
  • Removed all COVID-19 prior authorizations.
  • Expanded assistance for socially isolated members, coordinating access to medications, supplies, food, care and support programs.
  • Provided early refills, prolonged authorizations, and increased home delivery options for medication to ensure no shortages.
  • Extended hours at our behavioral health pharmacies to ensure medication adherence for those with mental health and substance use disorders.
  • Allowed grace periods for employers and individuals to pay premiums.
  • Facilitated coverage transitions to ensure current members maintain health insurance.
  • Opened a special enrollment period to allow commercial customers to add employees who previously declined health benefit coverage.
  • Provided $1.5 billion in direct customer and consumer support through premium credits, cost-sharing waivers and other efforts. 

The scale of the challenges that COVID-19 brings is enormous. The safety and health of our members and the communities we live in will continue to receive our focus and resources for the duration of this pandemic.

Different plans for different needs

Core

A proactive, highly-personalized experience helping members make informed choices and employers manage costs.

  • Predictive Personalization
    Robust data and technology to help guide members to the right resource.
  • Proactive Outreach
    Outbound calls and emails to educate members about their care options.
  • Improved Engagement
    Active referrals of members into appropriate clinical and wellness programs.

Elite

Increased employee engagement and a higher-touch experience, with a designated team of Advocates who are specifically trained on your company’s benefit plan and priorities.

  • Everything in Core
    All of the features from the Core plan are included.
  • Virtual Customized Care Team 
    Advocacy, wellness, and clinical teams operate as a virtually connected team for members, with Advocates’ direct extensions and voicemail available to members.
  • Expanded Advocate Role 
    Advocates offer enhanced services, including outbound call, and are empowered to engage an expert in real time.

Premier

Our most sophisticated package, with a co-located service team that includes dedicated Operations and Medical Directors, as well as clinicians who focus on quality and cost opportunities specific to your employee population.

  • Everything in Elite
    All of the features from the Elite plan are included.
  • Co-located Customized Team
    Team is located together with Operations and Medical Directors leading real-time coordination (replaces the Elite virtual team).
  • Medical Rounds
    Clinicians conduct medical rounds to provide an escalated level of clinical engagement and oversight for acute and chronic members.
  • Actionable Insights
    Employer-specific analytics are generated daily to enable the team to actively support your employees’ care and provide them with a top-notch experience.