UnitedHealthcare

UnitedHealthcare is the largest health insurer in the country by revenue and membership. Scale brings real advantages and real trade-offs, and both are worth understanding before you enroll.

Where the company came from

UnitedHealthcare grew out of a small Minnesota operation. Charter Med Incorporated was founded in 1974 to manage a physician-led health plan; United HealthCare Corporation was created in 1977 as its parent. From there the company expanded almost continuously through acquisition, becoming UnitedHealth Group and, by the 2000s, the largest health carrier in the United States.

The more consequential development for members came in 2011, when the company consolidated its health services businesses under the Optum brand. Optum encompasses pharmacy benefit management, data and analytics, and a very large physician and care-delivery operation. UnitedHealth Group today is simultaneously one of the country's biggest insurers and one of its biggest employers of physicians — a structure that draws both praise for coordination and scrutiny over conflicts.

What it does well

Network scale

One of the largest provider networks in the country. In most markets the odds that a given specialist is in network are as good here as anywhere.

Digital tools and virtual care

Heavy investment in member apps, virtual visits and cost-estimation tools. For people who want to manage coverage from a phone, the experience is generally strong.

Employer administration

Group reporting, enrollment portals and self-service tend to be well developed, which matters when you have 40 employees and no benefits department.

Integrated pharmacy

Pharmacy benefits run through the same organization as the medical plan, which can streamline prior authorization and specialty drug management.

What to watch for

How to tell whether it fits you

Carrier reputation is close to useless as a selection criterion. What matters is whether this specific plan, with this specific network, covers the providers you actually use. Before you enrol with UnitedHealthcare or anyone else:

• Verify every doctor on your list against the plan’s current directory — and if it matters enough, call the practice and ask them directly. Published directories go stale.
• Look up each prescription on the plan’s formulary and note the tier.
• Read the Summary of Benefits and Coverage before enrolling, not after.
• Check whether the family deductible is embedded or aggregate.
• Confirm the out-of-pocket maximum, in network and out, per person and per family.

Compare the others

• Cigna — Global reach, behavioral health depth, and HSA-friendly design
• Aetna — Retail health integration and a wide spread of plan designs
• Blue Cross Blue Shield — The deepest hospital footprint in most American markets