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Additional Programs and 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 (MAPD) 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

HouseCalls

As part of Medicare Advantage membership, we are now offering our HouseCalls program to qualified retirees in many service areas. HouseCalls is designed to support and complement the retiree’s regular doctor’s care through a visit with a licensed health care practitioner in the retiree’s home.  Our practitioners work with the member to understand current health status and provide information that may help maintain or improve health. Best of all, there is no copay for a HouseCalls visit.

Through our advanced technology we are able to use the HouseCalls visit to help coordinate care with the retiree’s doctors including identification of treatment needs, recommending preventive services, and addressing health education. At the end of the visit the retiree will receive a checklist of topics to discuss with their doctor. We will also provide their physician with a follow-up letter describing the results of the HouseCalls visit. Members who have experienced a HouseCalls visit have indicated very high satisfaction.

Utilization Management

The goal of utilization management is to help ensure individuals get access to appropriate care. 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

Advocate4Me is an enhancement of our customer service model that simplifies the retiree member experience.  Your retirees connect with an Advocate in the way they most prefer – phone, online, or e-mail. Through your exclusive Predictive Personalization tools we use data, analytics, and technology to provide a highly personalized experience for each retiree.

Advocate4Me

Advocates help retirees with:

  • Significant health issues – chronic conditions, gaps in care, medications
  • Complex issues – past calls, appeals, escalation issues, OOA status issues
  • Non-complex issues – preventive care, benefits enrollment, account administration
  • Feeling more confident in their decision

Each Advocate is responsible for following through to personally see that each inquiry is resolved for the retiree.

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 other staff  members to help the retiree meet their needs.

We collaborate with retirees, their families and their providers and strive 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
  • Advanced Illness Care Management
  • Palliative Care Services of End of Life Support
  • Behavioral Health Management Program

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. Services may include:

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

Optional Buy Up programs include:

  • Decision Support Program (Optional)
  • Respiratory Care Management (Optional)
  • Cancer Support Program (Optional)
  • Emergency Room Decision Support (Optional)
  • Emergency and Travel Assistance

*Available to Group Senior Supplement members.

Discover how Retiree Solutions can help your organization.

Call us at:
1-800-496-5881
8 a.m. to 5 p.m. (CST)
Monday through Friday

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