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ARTICLE Additional Programs & Services

Additional Programs & Services

Encourage your retirees to take advantage of health and wellness programs and services that could make a positive difference in their lives – and your costs.

Who is eligible?
Retirees enrolled in one of our UnitedHealthcare Medicare Advantage plans (HMO and PPO) have access to a variety of programs and services. Participation in some programs may require qualification based on diagnosis or risk assessment. Retirees enrolled in our Group Senior Supplement plans have access to a more limited set of services.

What programs & services are available?
It's more than just living, it's about living well. We have developed wellness, disease management and care management programs to form an integrated continuum, with a focus on supporting healthy lifestyle choices, reducing fragmentation and serving the whole person. Programs offered may include:

  • Prevention and Wellness
  • Utilization Management
  • Disease Management Solutions
  • Personal Health/Care Management
  • Advanced Illness Services 

Prevention and Wellness
Please note: The products and services described below are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the plan's grievance process.

The following services promote wellness, may improve health literacy and support good health care decision-making. Services may include:

  • Health Risk Assessments
  • Access Support Program*
  • Senior Fitness Program*
  • Discount Hearing Aids*
  • Emergency and Travel Assistance (Optional)*
  • Preventive Care Reminders
  • Web-based Health Resources
  • NurseLine Program*
  • Solutions for Caregivers Program*
  • HouseCalls – an innovative home assessment program available to qualified members of select Medicare Advantage programs

Utilization Management
The goal of utilization management is to help ensure individuals get the right care at the right time in the right setting. UnitedHealthcare is dedicated to helping optimize clinical outcomes while being effective stewards of health care resources. Our programs may include:

  • Intake Notification
  • Pre-Service Review
  • Concurrent Review
  • Post-Service Review

Clinically Integrated Delivery Model (CIDM)
Our clinically integrated primary nurse delivery model provides one nurse to help manage health care needs related to case and disease management. Retirees identified for telephonic outreach, regardless of identification method (e.g., inpatient hospitalization, predictive modeling, health risk assessment, NurseLine, etc.), are assigned one care manager nurse. The care or disease manager conducts telephonic outreach to retirees to engage them in the program.

If the retiree has a need for specialized services beyond case management or disease management, such as behavioral health, the assigned nurse will help coordinate services with the appropriate program nurse and will be the main point of contact for the duration of the retiree's engagement within that program. The assigned primary nurse will receive and review on a periodic basis the status of the retiree while in any active program and if necessary, will contact and work with any other staff to help ensure that the retiree receives appropriate care.

We collaborate with retirees, their families and their providers to help improve overall health and well-being. Our primary care nurse model focuses on the whole person and assists with transitions of care, coordinating complex care needs and management of chronic conditions including but not limited to:

  • Heart Failure
  • Diabetes
  • Coronary Artery Disease

Specialized Case Management programs are managed by a nurse with experience in specific clinical areas such as:

  • Kidney Resource Services Program
  • Transplant Resource Services Program

Advanced Illness Services
Our advanced illness program provides compassionate support to retirees and families compromised by catastrophic health concerns through holistic, preference-sensitive, personal health management programs, palliative care services and end-of-life support. The program may include:

  • Advanced Illness Care Management
  • Palliative Care Services or End of Life Support
  • Behavioral Health Management Program
  • Treatment Decision Support Program (Optional)*

Optional Buy Up programs include:

  • Treatment Decision Support Program Optional)
  • Respiratory Care Management (Optional)
  • Cancer Support Program (Optional)
  • Emergency Room Decision Support (Optional)

*Available to Group Senior Supplement members.

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