UHC unveils Benefit Assist to speed up critical medical claims

As more working Americans find themselves living paycheck to paycheck and unable to pay even $1,000 in the event of an emergency, UnitedHealthcare this month began offering Benefit Assist, a supplemental health program that aims to speed up the payment of unforeseen medical claims.

The new service, which is available to all clients and employees enrolled in UHC’s accident, critical illness or hospital indemnity protection plans, is supported by a team of UHC Benefit Assistants who contact eligible plan participants via phone or e-mail following a critical illness diagnosis, hospital stay or serious accident. The benefit assistants help the employee “kick-start the claim process soon after the related medical diagnosis or treatment to facilitate a faster payout so that the patient can focus on healing and getting well,” according to UHC.

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Medical examination tools hang on a wall in an exam room at Perry Memorial Hospital in Princeton, Illinois, U.S., on Wednesday, Oct. 11, 2017. Senate in both political parties say they've reached agreement on fixes to stabilize Obamacare just two weeks before Americans start signing up for 2018 coverage. Photographer: Daniel Acker/Bloomberg

UHC found that people enrolled in supplemental plans often wait weeks or months to start the related claim process, or neglect to do so entirely. Thus, they are delaying or missing a cash benefit that can help pay out-of-pocket expenses or cover lost income, according to UHC.

UHC has seen a growing demand for these types of products even though similar plans have been in the market recently, says Tom Wiffler, CEO, UnitedHealthcare Specialty Benefits.

“We find particular interest especially with the basic personal financial economics where you have two-thirds of American employees have less than $1,000 on hand to pay out-of-pocket expenses,” he says. “These programs can fill in those gaps and create some financial assurance for people who might otherwise be faced with bills that they can't juggle.”

Payouts under UnitedHealthcare supplemental plan coverage can reach $5,000 or more under accident and hospital indemnity plans, and critical illness coverage can reach up to $40,000. Benefit Assist is open to companies with 250 or more employees enrolled in UHC’s medical and supplemental health plans.

“A handful of companies” began piloting the program earlier this year. Wiffler declined to name the companies that currently offer Benefits Assist.

Processing claims in a timely manner is the aim of Benefit Assist. “If plan participants are UHC Medical and UHC Supplemental Health members, we're able to look at their medical claims to identify eligible critical illnesses and accidents that our fall under our claims and then reach out to them proactively to start the claims process and get to the benefit payout,” says Gary Harger, UHC’s vice president of supplemental health plans.

UHC says that this program could be advantageous to plan participants enrolled in high-deductible health plans with a health savings account who perhaps don't have all their medical claims paperwork in an organized fashion.


“It's really about trying to avoid those scenarios where people having to wait for the benefit payout under their supplemental plan or in some cases, maybe they don't know that they have a benefit payout that they just need to file for,” says Wiffler.

He adds, “We’re trying to proactively help the member make the most of their supplemental benefits.”

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