United Healthcare 2012 Annual Report Download - page 7

UnitedHealthcare Medicare & Retirement
UnitedHealthcare Medicare & Retirement provides health and well-being services to individuals age 50 and
older, addressing their unique needs for preventive and acute health care services as well as for services dealing
with chronic disease and other specialized issues for older individuals. UnitedHealthcare Medicare & Retirement
is fully dedicated to serving this growing senior market segment, providing products and services in all 50 states,
the District of Columbia, and most U.S. territories and has distinct pricing, underwriting, clinical program
management and marketing capabilities dedicated to risk-based health products and services in this market.
UnitedHealthcare Medicare & Retirement offers a wide spectrum of Medicare products which may be sold to
individuals or on a group basis, including Medicare Advantage plans, Medicare Part D prescription drug
coverage and Medicare Supplement/Medigap products that supplement traditional fee-for-service coverage.
UnitedHealthcare Medicare & Retirement services include care management and clinical management programs,
a nurse health line service, 24-hour access to health care information, access to discounted health services from a
network of care providers and administrative services.
Premium revenues from the Centers for Medicare & Medicaid Services (CMS) represented 29% of UnitedHealth
Group’s total consolidated revenues for the year ended December 31, 2012, most of which were generated by
UnitedHealthcare Medicare & Retirement under a number of contracts.
UnitedHealthcare Medicare & Retirement has extensive distribution capabilities and experience, including direct
marketing to consumers on behalf of its key clients: AARP, the nation’s largest membership organization
dedicated to the needs of people age 50 and over; state and U.S. government agencies; and employer groups.
Products are also offered through employer groups to retirees.
UnitedHealthcare Medicare & Retirement’s major product categories include:
Medicare Advantage. UnitedHealthcare Medicare & Retirement provides health care coverage for seniors and
other eligible Medicare beneficiaries primarily through the Medicare Advantage program administered by CMS,
including Medicare Advantage HMO plans, preferred provider organization (PPO) plans, Point-of-Service (POS)
plans, Private-Fee-for-Service plans and Special Needs Plans (SNPs). Under the Medicare Advantage program,
UnitedHealthcare Medicare & Retirement provides health insurance coverage in exchange for a fixed monthly
premium per member from CMS. Premium amounts vary based on the geographic areas in which members
reside; demographic factors such as age, gender, and institutionalized status; and the health status of the
individual. UnitedHealthcare Medicare & Retirement had approximately 2.6 million members enrolled in its
Medicare Advantage products as of December 31, 2012.
UnitedHealthcare Medicare & Retirement offers innovative care management and clinical programs, integrating
federal, state and personal funding through its continuum of Medicare Advantage products. For high-risk patients
in certain care settings and programs, UnitedHealthcare Medicare & Retirement uses proprietary, automated
medical record software that enables clinical care teams to capture and track patient data and clinical encounters,
creating a comprehensive set of care information that bridges across home, hospital and nursing home care
settings. Proprietary predictive modeling tools help identify members at high risk and allow care managers to
proactively outreach to members to create individualized care plans and help members obtain the right care, in
the right place, at the right time.
Prescription Drug Benefit (Part D). UnitedHealthcare provides Medicare prescription drug benefits (Part D) to
beneficiaries throughout the United States and its territories through its Medicare Advantage and stand-alone Part
D plans. The portfolio of stand-alone Part D plans addresses a large spectrum of beneficiaries’ needs and
preferences for their prescription drug coverage, including low cost prescription options. As of December 31,
2012, UnitedHealthcare had enrolled 6.8 million members in the Part D program, including 4.2 million members
in the stand-alone Part D plans and 2.6 million members in its Medicare Advantage plans incorporating Part D
coverage.
5