Welcome to UnitedHealthcare. Ideally, better health coverage should cost less. In reality, now it can.

Transcription

1 Welcome to UnitedHealthcare Ideally, better health coverage shold cost less. In reality, now it can.

2 The plan designed with both qality and affordability in mind. Consistent, qality care is vitally important. Now yo can pay less ot-of-pocket and get higher plan coverage when yo see specialty physicians with both UnitedHealth Premim qality of care and cost efficiency designations. When yo need a specialist, yo want to make informed choices. Welcome to the UnitedHealthcare plan. Enjoy one of the nation s largest networks of physicians and facilities. Almost anywhere in the United States yo ll find participating doctors, hospitals, or pharmacies for the same coverage levels yo get at home. Make the most of preventive care coverage, so little concerns don t become big problems later (see yor specific plan for details). Talk to nrses or other health professionals who can answer qestions abot yor health toll-free, all day any day. Access health information at yor fingertips on myhc.com. This is yor health history, medical library and evalation tool, all rolled into one secre, easy-to-se Web site. Pls, get disconts on thosands of wellness prodcts offered standalone or packaged together, and flexibly delivered on an employer-paid or employee-paid basis.

3 Maximize yor health benefits. When yo need a specialty physician, maximize yor health plan benefits by making sre the specialist yo choose has the UnitedHealth Premim designation for both qality of care and cost efficiency. Finding the right physician is the most important thing yo can do for yor health care Bt it isn t always easy. We provide the information yo need to help yo make a more informed decision on where to seek care. and now, for yor pocket book. When yo visit a specialty physician who has UnitedHealth Premim designations for both qality of care and cost efficiency, yo pay lower copayments for office visits, and get higher plan coinsrance coverage. That s why it s important to choose careflly. To get the most from yor UnitedHealthcare plan, find a qality and cost efficiency designated specialty physician by visiting and click on Find a Physician or Facility. Look for a physician with the two star designation: Qality and Efficiency of Care criteria met. When yo become a member, yo will also receive a convenient wallet card that helps direct yo to specialty physicians who have both qality of care and cost efficiency designations. Yor ID card will inclde a Cstomer Care phone nmber for easy access to designation information.

4 Specialty Care Yo pay less ot-ofpocket and get higher plan coverage when yo see specialty physicians with the two-star United Premim qality of care and cost efficiency designation. Specialty care physicians are physicians in the following medical specialties: Allergy Cardiology (non-interventional) Cardiothoracic Srgery Electrophysiology Endocrinology Infectios Disease Interventional Cardiology Nephrology Nerology Nerosrgery Orthopaedic Srgery Plmonology Rhematology Spine Srgery Sports Medicine Total Joint Replacement How the UnitedHealth Premim program works. UnitedHealth Premim is an innovative program that evalates eligible physicians against scientifically defined medical gidelines for qality and cost efficiency. Physicians mst first meet qality of care gidelines and only then are they evalated for their cost efficiency. UnitedHealth Premim qality of care designation When evalating qality of care, we review a physician s performance against nationally accepted standards from medical organizations and governmental agencies sch as the Amblatory Care Qality Alliance, the National Committee for Qality Assrance (NCQA), and the American College of Cardiology, as well as scientific advisory boards. This is important to yo becase following evidencebased care gidelines has been shown to have a positive impact on the qality of care and safety of patient care 1. 1 Committee on Qality of Health Care in America, Institte of Medicine (2001), Crossing the Qality Chasm: A New Health System for the 21st Centry. Washington, DC.: The National Academies Press.

5 UnitedHealth Premim cost efficiency designation Only those physicians who meet qality standards are then reviewed for cost efficiency. Efficiency evalates the tilization and cost of medical and diagnostic resorces. Cost efficiency criteria are based on patient care provided over an entire episode of care, inclding the appropriate se of diagnostic testing, prescribed medications, the procedre itself, follow-p care and the associated costs. Measrement also factors in the amont of re-do procedres and complicationrelated expenses. We measre cost efficiency at the local level, becase we recognize that there are differences in what it takes to deliver a service in one market verss another. For more information on the UnitedHealth Premim designation program, visit Primary care physicians are physicians in family practice, general practice, internal medicine, pediatrics, and obstetrics and gynecology. The UnitedHealth Premim program evalates these specialties, however, with this plan yor copayment and coverage are not affected by the primary care physician s designation. When yo receive services from primary care physicians, yo will enjoy the highest level of plan benefits coverage. To find a UnitedHealth Premim-designated doctor, jst look for the stars!

6 One resorce many benefits. Do I head to the doctor s office, rgent care or the emergency room? I ve jst received a diagnosis. How do I get information on treatment options? What are the costs and side effects of my new prescriptions? Care24 services can help. With the UnitedHealthcare plan, yo can call anytime, day or night, to speak with a nrse or other professional abot yor health condition, find a doctor for yor sitation, take medication safely and connect with other resorces. Nrses can provide coaching to keep yo and yor family healthier and help yo save money. Yo also can take advantage of Treatment Decision Spport, which can help yo make an informed, confident choice abot what treatment is right for yo. Important: The Care24 nrses are information sorces only and cannot provide medical advice. Conslt yor health care professional for appropriate diagnosis and treatment. Easy ways to manage yor health and yor benefit plan. Or member Web site, myhc.com, provides yo access to reliable, easy to nderstand health information pls cstomized health improvement programs sch as smoking cessation, stress management or weight loss. Even before yo become a member, se the Plan Cost Estimator to help yo better identify yor health care coverage needs and to choose the best benefit plan for yo. And once yo ve enrolled with UnitedHealthcare, yo can manage yor UnitedHealthcare benefit plan and many of yor health care needs throgh myhc.com: Find ot when yor health care claims have been paid. Record yor health stats and family medical history with the personal health record Find pharmacy information and tips on how to save money on prescription drgs Refill mail order prescriptions online Access valable and reliable health care information Create an emergency medical wallet card to display vital medical information and family contacts.

7 Special help when yo really need it. Or care management and disease management programs help yo manage complex health care needs and difficlt chronic conditions sch as asthma or diabetes. Specialized resorces can be available if yo are facing a transplant or have cancer or congenital heart disease from choosing the right medical center to help with travel isses. Thank yo for considering UnitedHealthcare. For more information abot UnitedHealthcare dring yor enrollment, please visit s online at For qestions abot yor benefit plan coverage talk with yor employer s benefits administrator.

8 Designations within the UnitedHealth Premim designation program are displayed in UnitedHealthcare online physician directories at myhc.com. Yo shold always conslt myhc.com for the most crrent information. Premim designations are a gide to choosing a physician and may be sed as one of many factors yo consider when choosing the physicians from whom yo receive care. If yo already have a physician, yo may also wish to confer with him or her for advice on selecting other physicians. Physician evalations have a risk of error and shold not be the sole basis for selecting a physician. Please see myhc.com for detailed program information and methodologies. Only individal physicians and facilities that meet UnitedHealth Premim designation criteria, or physicians in designated specialties who are part of medical grops that meet UnitedHealth Premim criteria for grop practices and who have sfficient claims data for analysis, may be designated. All physicians and facilities that contract with UnitedHealthcare have met credentialing reqirements. Regardless of designation, plan enrollees have access to all physicians and facilities in the UnitedHealthcare network. Specialties for which there are no qality gidelines crrently established in the program are exclded from evalation and are noted as sch. Insrance coverage provided by or throgh United HealthCare Insrance Company or its affiliates. Administrative services provided by United HealthCare Insrance Company, United HealthCare Services, Inc. or their affiliates. The Care24 program integrates elements of traditional employee assistance and work-life programs with health information lines for a comprehensive set of resorces. Program components may not be available in all states or for all grops. Care24 is a registered trademark of UnitedHealth Grop, Inc., sed by permission. De to the potential for a conflict of interest, legal consltation will not be provided on isses that may involve legal action against Optm or its affiliates, inclding UnitedHealthcare, or any entity throgh which the caller is receiving Optm services directly or indirectly (e.g. employer or health plan). Care24 may not be available in all states or for all grop sizes. Components sbject to change /08 Consmer 2008 United HealthCare Services, Inc.