In 2016 UnitedHealth joined 11 other health insurance carriers to offer plans in the California State Exchange: Covered California. It was short lived. They announced in May of 2016 that they would be leaving California’s individual market including Covered California in 2017. This would affect approximately 1,200 California exchange members they had acquired in 2016. Members would have coverage until the end of 2016, when they would be given the option to switch to a different carrier for 2017.
UnitedHealth cited the reason for leaving as heavy losses and Obamacare marketplaces as risky business. California is not the only marketplace they are exiting, but many others nationwide.
Peter Lee, director of Covered California, was critical of UnitedHealth’s reasons by saying he felt it was wrong to blame Obamacare as the reason to leave instead of owning up to business mistakes on rates and networks that lead to their financial losses.
2016 Coverage Regions
Plan coverage was offered in 5 of the 19 pricing regions throughout California in 2016.
|Pricing Region 1||Pricing Region 9||Pricing Region 10||Pricing Region 12||Pricing Region 13|
|Northern counties||Central Coast||Central Valley||Central Coast||Eastern Region|
|Include but are not limited to: Lake County Shasta County Humboldt County||Santa Cruz County San Benito County Monterrey County||San Joaquin County Mariposa County Merced County Stanislaus County Tulare County||San Luis Obispo County Santa Barbara County Ventura County||Mono County Inyo County Imperial County|
Who They Are
UnitedHealthcare has the claim to fame of being the largest single health carrier in the nation. It operates as a division of its parent company UnitedHealth Group Inc. The headquarters is in Minnetonka, Minnesota. Counting all subsidiaries and divisions of UnitedHealthcare, they serve approximately 70 million members across the U.S.
UnitedHealthcare’s mission is to “help people live healthier lives and help make the health system work better for everyone.”
For 2015 Fortune 500 ranked “UnitedHealth Group” the top insurance and managed care sector company of it’s “World’s Most Admired Companies” list. This was the fifth year in a row that they ranked the number one in their sector overall.
The National Committee of Quality Assurance (NCQA) has awarded the NCQA Health Plan Accreditation to many of UnitedHealthcare’s health plans. These health plans are the Commercial HMO, HMO/POS, and PPO plans and the Marketplace HMO and PPO plans.
There will be two networks members can access if they select UnitedHealthcare through Covered California. Most members will be covered on their Core PPO network. Those that select the minimum coverage plan will have access to the Core Essential network.
To view the provider directory, please click here.
The Future is Here
Through MyUHC.com members have a centralized online place where they can manage their claims, pay providers, as well as access primary care doctors through virtual visits. These online, secured video-based visits can be done through a computer, tablet, or mobile phone 24 hours a day.
Another helpful tool that members can take advantage of is the Cost Calculator. This tool helps get an estimate of a procedure or treatment on actual contracted rates of a network provider, specific to their plan so they know what to expect.
Through the 24/7 advice nurse phone line, a registered nurse is always on stand-by to provide guidance to health care needs or concerns that come up without warning.
And just recently UnitedHealthcare launched its Health4Me mobile App. This app conveniently allows patients to find providers, obtain health care cost estimates, and access real time account balances like deductibles, etc.