United Healthcare 2012 Annual Report Download - page 8

Medicare Supplement. UnitedHealthcare Medicare & Retirement is currently serving approximately 4 million
seniors through various Medicare Supplement products in association with AARP. We offer plans in all 50 states
and most U.S. territories. These products cover varying levels of coinsurance and deductible gaps that seniors are
exposed to in the traditional Medicare program.
UnitedHealthcare Community & State
UnitedHealthcare Community & State is dedicated to providing diversified solutions to states’ programs that care
for the economically disadvantaged, the medically underserved and those without the benefit of employer-funded
health care coverage in exchange for a monthly premium per member from the applicable state.
UnitedHealthcare Community & State’s primary customers oversee Medicaid plans, the Children’s Health
Insurance Program (CHIP), and other federal, state and community health care programs. States using managed
care services for Medicaid beneficiaries select health plans using either a formal bid process, or award individual
contracts. As of December 31, 2012, UnitedHealthcare Community & State participates in programs in 25 states
and the District of Columbia, serving approximately 3.8 million beneficiaries. UnitedHealthcare Community &
State serves populations that range in size from 9,000 people to more than 600,000 people. For those states or
counties that choose not to enter into risk arrangements, UnitedHealthcare Community & State offers a variety of
management services that leverage its infrastructure and experience, as well as the considerable health care
system assets of UnitedHealth Group.
The primary categories of eligibility for the programs served by UnitedHealthcare Community & State include
Temporary Assistance for Needy Families (TANF), CHIP, Aged Blind and Disabled, SNPs, Long-Term Care,
Childless Adults & Programs, Dual Medicare-Medicaid Eligible (dually eligible) beneficiaries and other federal
and state health care programs (e.g., Developmentally Disabled, Rehabilitative Services). The health plans and
care programs offered are designed to address the complex needs of the populations they serve, including the
chronically ill, those with disabilities and people with higher risk medical, behavioral and social conditions.
UnitedHealthcare Community & State leverages the national capabilities of UnitedHealth Group, delivering them
at the local market level to support effective care management, regulatory partnerships, greater administrative
efficiency, improved clinical outcomes and the ability to adapt to a changing market environment.
UnitedHealthcare Community & State coordinates resources among family, physicians, other health care
providers, and government and community-based agencies and organizations to facilitate continuous and
effective care. For example, the Personal Care Model establishes an ongoing relationship between health care
professionals and individuals who have serious and chronic health conditions to help them maintain the best
possible health and functional status, whether care is delivered in an acute care setting, long-term care facility or
at home. Programs for families and children focus on high-prevalence and debilitating chronic illnesses such as
hypertension and cardiovascular disease, asthma, sickle cell disease, diabetes, HIV/AIDS and high-risk
pregnancies. Programs for the long-term care population focus on dementia, depression, coronary disease and
functional-use deficiencies that impede daily living.
Additionally, there are more than nine million dually eligible beneficiaries who typically have complex
conditions with costs of care that are far higher than a typical Medicare or Medicaid beneficiary. While these
individuals’ health needs are more complex and more costly, they have historically been in unmanaged
environments. As of December 31, 2012, UnitedHealthcare serves more than 250,000 members in legacy dually
eligible programs through Medicare Advantage and SNPs. In 2013, UnitedHealthcare Community & State will
help implement Ohio’s Integrated Medicare-Medicaid Eligible (MME) program, one of the first in the country
under the new CMS design.
UnitedHealthcare International
UnitedHealthcare International provides solutions for consumers of domestic or cross-border health care
management, insurance, and administration services; regardless of their geographic location, language or cultural
origins. UnitedHealthcare International’s goal is to create business solutions that are based on local infrastructure,
culture and needs, and that blend local expertise with experiences from the U.S. health care industry.
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