United Healthcare 2015 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 services dealing
with chronic disease and other specialized issues common among 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. UnitedHealthcare Medicare &
Retirement has distinct pricing, underwriting, clinical program management and marketing capabilities dedicated
to health products and services in this market.
UnitedHealthcare Medicare & Retirement offers a selection of products that allow people to obtain the health
coverage and services they need as their circumstances change. UnitedHealthcare Medicare & Retirement is
positioned to serve seniors who find that affordable, network-based care provided through Medicare Advantage
plans meets their unique health care needs. For those who prefer traditional fee-for-service Medicare,
UnitedHealthcare Medicare & Retirement offers both Medicare Supplement and Medicare Prescription Drug
Benefit (Medicare Part D) prescription drug programs that supplement their government-sponsored Medicare by
providing additional benefits and coverage options. Beneficiaries with special needs are served through
UnitedHealthcare Medicare & Retirement Dual, Chronic and Institutional Special Needs Plans (SNPs) in many
markets. 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.
UnitedHealthcare Medicare & Retirement’s seniors-focused care management model enables it to operate at a
medical cost level below that of traditional Medicare. This model is based on more than 20 years of expertise in
chronic disease care management, underpinned by a proprietary technology platform. These capabilities help
improve the health and well-being of older, disabled or otherwise vulnerable individuals. For example, through
UnitedHealth Group’s HouseCalls program, nurse practitioners performed approximately 1 million in-home
preventative care visits in 2015 to identify, document and help close gaps in care for seniors.
Premium revenues from the Centers for Medicare & Medicaid Services (CMS) represented 26% of UnitedHealth
Group’s total consolidated revenues for the year ended December 31, 2015, most of which were generated by
UnitedHealthcare Medicare & Retirement.
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, and state and U.S. government agencies. Products are also
offered through employer groups and agent channels.
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 plans,
Private-Fee-for-Service plans and SNPs. Under the Medicare Advantage program, UnitedHealthcare Medicare &
Retirement provides health insurance coverage in exchange for a fixed monthly premium per member from CMS
plus, in some cases, consumer premiums. Premium amounts received from CMS 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 served more than 3 million people
through its Medicare Advantage products as of December 31, 2015.
Medicare Advantage plans are designed to compete 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
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