Medical plans
With tailored network strategies and innovative benefit and plan designs, UnitedHealthcare medical plans are built to help meet the care and cost needs of your clients and their employees.
Our innovative approach to care and coverage
Delivering access to quality care at lower costs
Our network strategies are designed to deliver powerful solutions that may enhance overall plan value and performance. Plan designs are built for access, supported by the nation's largest proprietary network1 and designed to guide employees to evidence-based, cost-efficient care.
Encouraging health ownership
Plan designs and popular benefits — such as $0 copays, virtual care access and more — are built to help promote healthier choices and encourage employees to take steps toward better health.
Delivering a better health care experience
Plans include access to tools and resources designed to help employees understand their plan and navigate the health care system to get care, at the right place, at the right time.
Collaborating closely with providers
Through incentives, value-based arrangements and collaborative data sharing, we help enable delivery of quality, cost-efficient care. Tools and resources like Naviguard aim to protect all parties from egregious billing, to ensure providers are paid quickly for their services and to keep out-of-network charges in check for members.
Improving access to care, lowering costs
Infused with expertise and analytics, UnitedHealthcare medical plans are driven and supported by curated strategies and solutions like these, with the goal of delivering better health and lower costs.
Centers of Excellence (COEs)
Our COE program is designed to drive lower costs, fewer complications and shorter recovery times, such as a 22% shorter length of hospital stay for transplant patients compared to the national benchmark.2
Payment integrity
Experts estimate that 25% of all health care spending is wasteful.3 Our payment integrity solutions work to help reverse this trend by implementing strategies like focused claims reviews to help identify errors and fraud/abuse, which has resulted in $34.86 average savings per member per month.4
Provider relationships
Patients who regularly engaged with a primary care provider (PCP) had 10% lower costs than those who didn’t.5 And because PCPs can impact 62% of the health care dollar,5 we work closely with providers with the goal of achieving better results on everything from site of care guidance to reducing unnecessary or duplicative testing to cost-effective prescribing.
UnitedHealth Premium® Program
Share with your clients
Solutions designed to help improve claims accuracy and control costs.
Program helps employees locate quality and cost-efficient providers and review options.
See why this network option helps your clients' employees make more informed choices in their health care.
Learn more about this open-access plan offering a large national network with more than 1 million doctors and over 6,000 hospitals.6
A selection of UnitedHealthcare medical plan options
These traditional open-access health plans give employees and covered family members the freedom to choose a network physician or specialist from the UnitedHealthcare Choice/Choice Plus network without a referral from a primary care provider (PCP).
- With Choice plans, employees must receive care from network providers for benefits to be covered. There is out-of-network coverage for emergency services only
- Choice Plus plans include plan coverage for out-of-network providers at a lower benefit level
Navigate and Charter offer a variety of plan design options that provide traditional benefits with the guidance of a PCP.
- Both have their own national network that employers can narrow, which is different than with the Choice network
- For Navigate and Charter, non-network coverage is not available, except in the case of emergency care, or it's provided at the lowest level of coverage for some plan options
Not available in all states; reach out to your UnitedHealthcare representative regarding availability in your market.
The Surest health plan is an ACA-compliant, copay-only health plan solution available to employers with 51+ employees and designed to give employers the opportunity to offer a sustainable, intuitive health benefit without shifting costs to employees. The Surest plan leverages the nationwide UnitedHealthcare provider network. Available self-funded and fully insured.
Not available in all states; reach out to your UnitedHealthcare or Surest representative for availability.
Tiered benefits are built on traditional UnitedHealthcare plans and include additional features that help encourage employees and covered family members to receive their care from providers and facilities that may offer the greatest value, with the flexibility to access the larger network at higher cost-sharing.
- Premium tiering allows for tiering on UnitedHealth Premium® designated PCPs and specialists
- Hospital tiering on Premium designated PCPs, specialists and hospitals (market restrictions apply)
- Place of service differentials help empower employees to receive a lower cost-share if services are delivered from a freestanding facility versus a hospital-based facility
- Preferred lab tiering allows employees to receive lab services at no additional cost when services are delivered by a Preferred Lab facility
NexusACO plans offer access to high-performing providers and Accountable Care Organizations (ACOs) through tiered plan designs.
- Multiple plans are available to help meet employer needs, including non-referral open access plans and PCP centered plans with referral requirements
UnitedHealthcare Flexwork™ is a new coverage making healthier possible for all by providing comprehensive, customizable benefit options for full-time, part-time, and anytime employees.
Health plans with surplus refund potential
Designed for more flexibility and simplicity, UnitedHealthcare Level Funded and All Savers® Alternate Funding plans are built to give businesses more ways to save. Because these plans are based on plan participants’ actual medical claims, health plans may get a surplus refund at year-end if those claims are lower than expected.7
More savings - exemption from many Affordable Care Act (ACA) regulations and state premium taxes
More stability - fixed monthly plan costs and safeguards to help protect businesses from unexpected high claims
More flexibility - a variety of plan designs, plus wellness programs and telemedicine at no additional cost
A limited benefit plan with coverage focusing on 100% preventive care and preventive medications. Preventive Plan meets the minimum standard requirements for value and affordable health care coverage required to be offered by certain employers.
Only for self-funded employer groups with at least 100 employees.
UnitedHealthcare Global provides multinational companies with comprehensive international insurance, assistance, security, intelligence and remote medical solutions from a single provider. Our tailored approach and expert knowledge in health and security services is designed to help globally mobile employees receive the care and support they need while helping organizations optimize their international workforce’s well-being.
The future of group health insurance plan designs
Health plan designs are evolving to help better manage costs and streamline access to care for employees.
