United Healthcare 2013 Annual Report Download - page 8

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 3 million
people enrolled in its Medicare Advantage products as of December 31, 2013.
Medicare Advantage plans are designed at the local level taking into account member and care provider
preferences, competitor offerings, our historical financial results, our quality and cost initiatives and the long-
term payment rate outlook for that geographic area. Starting in 2012, and phased in through 2017, the Medicare
Advantage rate structure and quality rating bonuses are changing significantly, see Item 7, “Management’s
Discussion and Analysis of Financial Condition and Results of Operations” for further information.
UnitedHealthcare Medicare & Retirement offers innovative care management, disease management and other
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 outreach to members to create individualized care plans and to help members obtain the
right care, in the right place, at the right time.
Medicare Part D. UnitedHealthcare Medicare & Retirement provides Medicare Part D benefits to beneficiaries
throughout the United States and its territories through its Medicare Advantage and stand-alone Medicare Part D
plans. UnitedHealthcare Medicare & Retirement offers two standalone Medicare Part D plans: the AARP
Medicare Rx Preferred and the AARP Medicare Rx Saver plans. The stand-alone Medicare Part D plans address
a large spectrum of beneficiaries’ needs and preferences for their prescription drug coverage, including low cost
prescription options. Each of the plans cover the majority of the drugs covered by Medicare and provides varying
levels of coverage to meet the diverse needs of Medicare beneficiaries. As of December 31, 2013,
UnitedHealthcare had enrolled approximately 8 million people in the Medicare Part D program, including
approximately 5 million individuals in the stand-alone Medicare Part D plans and approximately 3 million in its
Medicare Advantage plans incorporating Medicare Part D coverage.
Medicare Supplement. UnitedHealthcare Medicare & Retirement is currently serving more than 4 million
seniors through various Medicare Supplement products in association with AARP. UnitedHealthcare Medicare &
Retirement offers plans in all 50 states, the District of Columbia, 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 fixed monthly premium per member from the applicable state.
UnitedHealthcare Community & State’s primary customers oversee Medicaid plans, Children’s Health Insurance
Programs (CHIP), and other federal, state and community health care programs. As of December 31, 2013,
UnitedHealthcare Community & State participated in programs in 24 states and the District of Columbia, and served
more than 4 million beneficiaries. The Patient Protection and Affordable Care Act and a reconciliation measure, the
Health Care and Education Reconciliation Act of 2010 (together, Health Reform Legislation) provides for optional
Medicaid expansion effective January 1, 2014. Currently, more than half of our state customers have elected to
expand Medicaid. For further discussion of the Medicaid expansion under Health Reform Legislation, see Item 7,
“Management Discussion and Analysis of Financial Condition and Results of Operations.”
States using managed care services for Medicaid beneficiaries select health plans by using a formal bid process
or by awarding individual contracts. A number of factors are considered by UnitedHealthcare Community &
State when choosing programs for participation including the state’s commitment and consistency of support for
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