Advocacy that sees the big picture

Health care is complicated. No one should have to go it alone. Because we know the system better than anyone, we can help you and your employees navigate it—with UnitedHealthcare Advocacy solutions designed to help save you money and deliver better outcomes and improved experiences. We’ll take care of it, so you don’t have to.

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Advocacy that delivers for employers

Lower cost

We’ll help save you and your employees money. Employers with UnitedHealthcare enhanced Advocacy may save up to 2-4%¹in medical total cost of care.

Better outcomes

We bring together the power of vast data and a broad scope of the health care system under our roof to help deliver better health outcomes for members.

Satisfied members

Personalized and consistent omnichannel support helps members get the most from their benefits and delivers a better experience.

Advocacy that delivers for employees

Proactive guidance

Our data and insights help us identify when members may make suboptimal choices, helping them avoid unnecessary costs.

Compassionate service

Knowing that someone is looking out for them in every interaction, serving with empathy and a personal touch.

Simplified experience

Because we manage multiple parts of the health care ecosystem, we can connect the dots across every touchpoint to streamline the benefits experience.

Program highlights

Digital engagement

Our digital tools help members make better decisions, connect with relevant clinical programs and reduce their costs.

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Personalized member view

Our Advocate dashboard helps us know members, find engagement opportunities, and offer faster, personalized support.

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Social drivers of health

Our Advocates use integrated tools to help find resources and connect members to organizations that can help meet the needs of the whole person.

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Active member intercept

We help members avoid unnecessary costs through near real-time guidance that may lead to more cost-effective choices.

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Custom high-need member management

We use analytics to identify families of children with complex health care needs to help them navigate a system that may not always be set up to support them effectively.

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Third-party integration (UHC Hub)

We help connect members to their full benefit suite, including external point solutions, with a unified telephonic and digital experience.

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The right expert for any situation

One person doesn’t have all the answers. A caller’s needs are anticipated leveraging deep analytics, and we connect them with the right resource from our team-based model to help quickly resolve issues and find the help they need.

Benefits Advocate

Provides plan, claims and coverage expertise with first contact resolution

Health Advocate

Provides financial and health advocacy through claims, wellness and health management expertise

Nurse Advocate

Provides health and clinical education, decision support and expertise from a licensed RN

Pharmacy Specialist

Provides end-to-end service for Rx, including formulary guidance, lower-cost alternative recommendations, home delivery and claims and benefits management (for Optum Rx® direct business)

Behavioral Specialist

Provides expertise on behavioral health including provider selection, benefits explanation and sensitive handling of mental health needs

Super Advocate

Provides complex issue resolution, support for longer-term issues and a focus on cost diversion (for Elite and Premier members only)

Making a difference

Looking out for our members

Video transcript

[ANIMATION OF UNITEDHEALTHCARE LOGO]

[MUSIC PLAYING IN BACKGROUND THROUGHOUT]

[PHONE RINGING]

[VIDEO OF DARRYL ON THE COMPUTER ANSWERING THE PHONE]

[DARRYL SPEAKING ON SCREEN]

DARRYL: Thanks for calling UnitedHealthcare. My name is Darryl. How can I best assist you today?

FEMALE VOICEOVER: At UnitedHealthcare, we strive every day to deliver value to our members and clients,

[Text On Screen – Delivering value]

[VIDEO OF A MAN AND A GIRL SITTING AT A LAPTOP]

from handling routine requests, to getting people to the care they may need

[VIDEO OF MAN ON THE SIDE OF A ROAD BY A TRUCK, TEXTING]

because when it comes to supporting you, advocacy is personal.

[VIDEO OF MAN AND WOMAN TALKING]

[VIDEO OF NUSE WALKING INTO A HOSPITAL ROOM WITH A NEWBORN BABY AND HANDING BABY TO MOTHER]

And because your needs may be growing, we continue to invest in even better advocacy solutions,

[VIDEO OF TWO WOMEN TALKING AT AN OFFICE DESK]

now and for the future.

[Text On Screen – What does this look like?]

[VIDEO OF WOMAN ON HER PHONE AT A KITCHEN TABLE]

So what does this look like? We guide our members through their healthcare journeys by providing hyper personalized support,

[VIDEO OF WOMAN WORKING AT A CALL CENTER]

enabled by our advocate dashboard.

[VIDEO OF WOMAN ON HER PHONE]

Whether the need is with support and resources for clinical care issues

[VIDEO OF PEOPLE GETTING PRDOUCE AT A FOOD SHELTER]

or locating food or housing assistance, we’re there to help.

[VIDEO OF MAN WORKING AT A CALL CENTER]

And for questions that require a little more time,

[VIDEO OF WOMAN AT HER LAPTOP]

we can take ownership and work on behalf of our members towards a resolution.

[VIDEO OF WOMAN ON HER PHONE]

When it comes to their experience, members can avoid unnecessary costs, thanks to near real time notifications

[VIDEO OF WOMAN WORKING AT A CALL CENTER]

and guidance that can lead to more cost effective choices.

[VIDEO OF WOMAN WALKING DOWN THE STREET ON HER PHONE]

Members will be able to access their benefits, even those that aren’t through UnitedHealthcare, in one place,

[VIDEO OF COMPUTER DISPLAYING EXPANDED DIGITAL EXPERIENCE]

through our expanded digital experience. And they can connect with an advocate how and when they want, with a digital chat that starts and stops when it’s convenient for them.

[VIDEO OF PEOPLE HAVING VIDEO CHATS ON THEIR LAPTOPS]

All this, while at home or on the go.

[VIDEO OF MAN ON HER PHONE]

[VIDEO OF CHILD IN A RESPIRATOR]

And when it comes to advocating for people who may need extra help, like members with complex care needs or those seeking gender affirming care,

[VIDEO OF TWO PEOPLE HOLDING HANDS, OFFERING SUPPORT]

we’re expanding our support with compassionate, one to one assistance.

[VIDEO OF NURSE ASSISTING PATIENT]

We know healthcare.

[VIDEO OF WOMAN WORKING AT A CALL CENTER]

[Text On Screen – Relationships]

We have the relationships.

[Text On Screen – Data]

We have the data.

[Text On Screen – Connected]

We’re better connected

[Text On Screen – Proactive]

and powered to be proactive on behalf of our members.

[VIDEO OF GIRL AND MAN SMILING]

[VIDEO OF MAN PLAYING WITH CHILD]

At the end of the day, advocacy isn’t about us.

[VIDEO OF WOMAN AT HER LAPTOP]

[VIDEO OF MAN And WOMAN PLAYING WITH CHILD]

It’s about you and it’s about our members,

[VIDEO OF DARRYL WORKING AT A CALL CENTER]

knowing that someone at UnitedHealthcare is always looking out for them.

DARRYL: All right, sir. You and t∂∂he family have a wonderful evening and thank you for calling UnitedHealthcare.

[ANIMATION OF UNITEDHEALTHCARE LOGO]

[Text On Screen – UnitedHealthcare]

[END MUSIC]

We continue to invest in even better Advocacy solutions, now and for the future

Family Engagement Center

Video transcript

[MUSIC PLAYING IN THE BACKGROUND THROUGHOUT VIDEO]

[Text On Screen – UnitedHealthcare There for what matters™]

[VIDEO OF CARE PROVIDERS WORKING WITH DIVERSE POPULATIONS: A PHYSICAL THERAPIST WORKING WITH A MINOR, A HOME CARE WORKER EMBRACING A PATIENT]

MALE VOICEOVER: UnitedHealthcare, we're there for what matters. For employees and members, that means offering advocacy products for diverse populations, especially those with complex healthcare needs.

[Text On Screen – UnitedHealthcare Family Engagement Center]

That's the heart of UnitedHealthcare's Family Engagement Center,

[Text On Screen – FEC]

or the FEC. The FEC is a specialized team that focuses on members who may need additional support.

[Text On Screen – Specialized team]

[Text On Screen – LGBTQIA+ community, Adults who have complex health needs, Children & youth with special health care needs, Members navigating a rare disease or undiagnosed condition]

These populations include people within our LGBTQIA+ community, adults who have complex health needs, children and youth with special health care needs, and members navigating a rare disease or undiagnosed condition.

[Text On Screen – Embrace, Listen, Take ownership]

[GRAPHIC OF A HAND WITH A HEART ON THE TIP OF A FINGER, A SIGN POST WITH ICONS REPRESENTING DIFFERENT PATHS OF THE HEALTHCARE JOURNEY: STETHOSCOPE, ER, HOSPITAL CROSS]

The Family Engagement Center seeks to embrace, listen, and then take ownership of the situation to help members navigate their health journey.

[Text On Screen – Carry the bags]

[GRAPHIC OF LUGGAGE AND BAGS]

A phrase we commonly use emphasizes our goal to carry the bags for our members.

[Text On Screen – Care Advisors]

Let's look at the FEC team, starting with care advisors.

[GRAPHICS REPRESENTING A CARE PROVIDER TALKING TO A MEMBER]

A member is paired with a care advisor as the primary point of contact for their needs and the needs of their family.

[Text On Screen – Personal connection]

[Text On Screen – Finding solutions]

[ANIMATION OF A MAZE]

Many of the care advisors have a personal connection to these populations, which may help make them more effective at finding solutions for those who need help.

[GRAPHICS REPRESENTING A CARE PROVIDER]

Each time they call, that member is automatically routed directly to their assigned care advisor.

[Text On Screen – One-on-one relationship]

[ANIMATION OF TALK BUBBLES, REPRESENTING MULTIPLE CONVERSATIONS WITH MULTIPLE REPRESENTATIVES]

This one on one relationship means a member doesn't have to tell their story multiple times to multiple representatives.

[Text On Screen – Multi-disciplinary support team]

For complex situations, care advisors connect with our multidisciplinary support team.

[Text On Screen – Nurses, Behavioral health specialists, Medical directors, Pharmacists, Spiritual care advisors]

This team is staffed with nurses, behavioral health specialists, medical directors, pharmacists, and spiritual care advisors for compassionate support.

[Text On Screen – Here are a few examples]

Here are a few examples of what that may look like.

[Text On Screen – LGBTQIA+]

[GRAPHICS REPRESENTING NETWORK OF SPECIALIZED CARE ADVISORS]

When someone identifies as LGBTQIA+ or has gender affirming care needs, we have a dedicated team of specialized care advisors trained to help members navigate the health care system.

[Text On Screen – Find a provider]

This could include helping them find a provider that meets their personal preferences

[Text On Screen – Help understanding pre-requisites & coverage]

or helping to understand prerequisites and coverage.

[Text On Screen – Diagnostic odyssey]

If a patient is on a diagnostic odyssey searching for answers about their condition,

[Text On Screen – Collaborates with UHC network providers]

the FEC collaborates with UnitedHealthcare network providers that can help search for a diagnosis and make care recommendations.

[Text On Screen – Waiting for life-changing therapy]

[ANIMATION OF HANDS ON A COMPUTER KEYBOARD]

[Text On Screen – Delivered quickly]

If a member is waiting for a life changing therapy, a care advisor monitors authorizations, which may help make sure treatment can be delivered as quickly as possible.

[GRAPHICS REPRESENTING A CARE PROVIDER TALKING TO A MEMBER]

And it all starts with that one on one connection with their care advisor,

[Text On Screen – Call, Click, Tap]

who is just a call, click, or tap away.

[Text On Screen – We want to be there to support you]

We want to be there to support you.

[Text On Screen – We want to be there for what matters]

We want to be there for what matters.

[Text On Screen – Family Engagement Center]

The Family Engagement Center from UnitedHealthcare.

[UNITED HEALTHCARE LOGO]

[Text On Screen – UnitedHealthcare]

[END MUSIC]

The Family Engagement Center supports members with complex conditions who may need additional support

What our members have to say

“The Advocate was great: she was really lovely today. I've never had someone at an insurance company advocate so diligently for me.”

“The person I spoke with went above and beyond. She called my pharmacy, she called my pediatrician, and she resolved my issue and I never had to do anything. It was wonderful.”

“She answered my really complex questions. She was patient. I just overall had an amazing experience. So, thank you to her — you're making a difference for all of us.”

Read more

Barb’s Story

Barb’s⁸high blood pressure put her at risk for diabetes. This was exacerbated by the recent deaths of her father and two sons that left her overcome with grief, unable to maintain a regular diet and skipping doctor visits.

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Eli’s Story

Eli⁸ and his provider were planning for "top" surgery (double mastectomy for female-to-male transition) and had submitted a prior authorization. The procedure initially wasn’t approved because of a missing therapist letter (a necessary part of the clinical documentation). Eli called his Transgender Benefits Specialist.

Read more

Kassidy's Story

At the age of four, Kassidy⁸was diagnosed with a rare condition causing muscle weakness and skeletal abnormalities. She had to rely on family to help her perform simple tasks. Her mother, Kaitlin*, recognized that a powered wheelchair would significantly improve Kassidy's quality of life and enable her to be more mobile, but the process wasn’t simple.

Read more

Advocacy you can rely on

3.8M

members in our enhanced Advocacy products²

75

Net Promoter Score® (NPS®) for members in an enhanced Advocacy product³

92^%

overall member satisfaction with UnitedHealthcare Advocacy programs⁴

31^%

fewer transfers, on average compared to Core model⁵

94^%

first call resolution, up to 3-point improvement over Core model⁶

89^%

program acceptance rate within enhanced Advocacy⁷

23^%

increase in clinical program enrollment⁶

up to 12^%

fewer inpatient days and 3% higher utilization of lower-cost sites of care, e.g., Centers of Excellence (COEs), urgent care⁶

Guidance at every step

Onboarding

We guide members through enrollment, so they understand their plan and how to make it work for them to avoid unexpected costs.

Engagement

Members receive a personalized experience—through incentive programs, wellness coaching, targeted health goals and guidance to avoid financial surprises.

Care

We coordinate needs across multiple touchpoints with both the member and providers to help ensure members receive appropriate care.

Resolution

We help members understand billing, coverage, and work quickly to resolve any issues.

Support

We walk with our members, helping them make informed choices, avoid issues, and advocate for them across their health care journeys.

Different plans for different needs

Core

A proactive, highly personalized experience helping members make informed choices and employers manage costs.

Predictive Personalization
Robust data and technology to help guide members to the right resource.
Proactive Outreach
Outbound calls and emails to educate members about their care options.
Improved Engagement
Active referrals of members into appropriate clinical and wellness programs.

Elite

Increased employee engagement and a higher-touch experience, with a designated team of Advocates who are specifically trained on your company’s benefit plan and priorities.

Everything in Core
All of the features from the Core plan are included.

Virtual Customized Care Team
Advocacy, wellness, and clinical teams operate as a virtually connected team for members, with Advocates’ direct extensions and voicemail available to members.

Expanded Advocate Role
Advocates offer enhanced services, including outbound calls, and are empowered to engage an expert in real time.

Premier

Our most sophisticated package, with an integrated service team that includes dedicated Operations and Medical Directors, as well as clinicians who focus on quality and cost opportunities specific to your employee population.

Everything in Elite
All of the features from the Elite plan are included.
Integrated Customized Team
Team is integrated with Operations and Medical Directors leading real-time coordination (replaces the Elite virtual team).
Medical Rounds
Clinicians conduct medical rounds to provide an escalated level of clinical engagement and oversight for acute and chronic members.
Actionable Insights
Employer-specific analytics are generated daily to enable the team to actively support your employees’ care and provide them with a top-notch experience.

Learn more about the value our enhanced Advocacy models provide:

Enhanced Advocacy Case Study

View (pdf)

Premier Advocacy BCRT Analysis

View (pdf)

Net Promoter, Net Promoter System, Net Promoter Score, NPS and the NPS-related emoticons are registered trademarks of Bain & Company, Inc., Fred Reichheld and Satmetrix Systems, Inc.

Footnotes

2019-2020 UHC employer study including 387 clients, 4.8M members and $19.2B in medical spend. Analysis completed on a continuous medical enrollment basis. Medical costs risk adjusted for age and gender. Value impact based on comparing clients by the adoption platform features vs not (e.g. enhanced vs core advocacy). Actual client results may vary based on specific clinical programs the client has or maturity of implementation.
Total reflects current active membership and sold future effective dates with client membership projections determined by Sales/UW. 3.7M is net membership after including terms
2023 Elite & Premier Advocate4Me® performance reporting for post-call NPS and UES Satisfaction
UnitedHealthcare Services, performance reporting, 2023
2023 Performance reporting, comparing Enhanced Advocacy Advocate4Me members (Elite/Premier) to Advocate4Me Core members
2021 Performance reporting, comparing enhanced advocacy members (Elite/Premier) to Advocate4Me Core members
2023 Combined Enhanced Advocacy performance reporting for Program Acceptance Rate
Name has been changed to protect patient privacy.

Disclaimers

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through the program is for informational purposes only and provided as part of your health plan. Wellness nurses, coaches and other representatives cannot diagnose problems or recommend treatment and are not a substitute for your doctor’s care. Your health information is kept confidential in accordance with the law. The program is not an insurance program and may be discontinued at any time. Additionally, if there is any difference between this information and your coverage documents (Summary Plan Description, Schedule of Benefits, and any attached Riders and/or Amendments), your coverage documents govern.

The Centers of Excellence (COE) program providers and medical centers are independent contractors who render care and treatment to health plan members. The COE program does not provide direct health care services or practice medicine, and the COE providers and medical centers are solely responsible for medical judgments and related treatments. The COE program is not liable for any act or omission, including negligence, committed by any independent contracted health care professional or medical center.

Employee benefits including group health plan benefits may be taxable benefits unless they fit into specific exception categories. Please consult with your tax specialist to determine taxability of these offerings.

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates.