United Health Care
ConsumerAffairs Unaccredited Brand
Took my daughter to the Dr., and she prescribed a RX for the symptom. I went to the pharmacy to pick up the RX and gave them my benefit card. The pharmacist then said United Healthcare requires a pre-authorization from the Dr. before they will cover the RX. What? The Dr. prescribed the RX, it's on the counter in front of me. I called United Healthcare and he said the Dr. has to fill out the authorization form with them for certain meds. So after an hour, I left without the RX. The Dr. clearly deemed this the best RX for the patient, as they prescribed the RX. Why is United Health Care not wanting to cover it? Then, to make matters worse, the United Health Care guy couldn't tell me why...
Flu Shots - Coverage denied by provider but UHC says it's covered, but admits to system problems cause claims to be denied. Lab Test from Physical - Coverage denied - same story as above. Past employer chose United Health Care in 1992 and it was terrible. Current employer changed to United Health Care and it has not changed; still terrible.
Medicare plainly states that colorectal screening test AND anesthesia are covered 100% with no co-payment or deductible every 120 months. I have UnitedHealthcare Advantage and they don't seem to think so. I was billed for the anesthesia and had to pay a co-pay and it was applied to my deductible. If you have UHC Advantage, be prepared to pay for your anesthesia if you have a colonoscopy. When they send you a letter recommending that you have this test at "no cost" - NOT TRUE!!! I had the procedure in June. It is now October and I'm still fighting for them to obey the law. All UNC people are polite, but they are not well trained or know the Medicare law.
UHC delayed the approval of durable medical equipment - one excuse after another. My mom was discharged from hospital with orders for a trilogy machine, life-saving equipment. She passed away still waiting for it, even after requesting an expedited claim UHC delays = my mother's death. Avoid this company at all costs. READ ALL THE REVIEWS!!!
While at a doctors office, UHC came back with an amount of $109. I would have to pay for a procedure. I have the procedure done, and after the fact UHC tells me it will be $1,315. I was floored! Another reason I picked the tier of insurance that I did was because it covers a specific procedure. Again, after the fact and the doctors office filing the claim, every month UHC would respond to the office with excuses like"Wrong code", "Shes's not covered", "Wrong code again", "You sent the claim to the wrong department." Every month it was something, and 8 months later, "We don't cover that."
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For three weeks I have been trying to find a doctor. These people don't help only cause frustration. Call to ask a question, they can't answer. Say "will call you back," never do. Your request is not entered into their system. When they do record your concerns and grievances of which seem to be deleted. Next person has no record of your call. Inexperience, limited training and no common sense.
Worst company ever - a total scam - executives should be in Jail. They do not pay claims - lose paperwork - lie on the phone and do not pay bills they should. DO NOT DO BUSINESS WITH THIS COMPANY!!! If there are others out there that feel the same way - let's file a class action lawsuit.
I saw my NP for a herniated disc and she is aware that this is a problem I've been battling since my 20s. I am now in my early 60s. The pain is horrible and I know it well from my history and times I needed surgery. My NP ordered an MRI and they promptly denied it. They insisted I have a month of physical therapy first, which I already know will help minimally at best. The PT clinic I was referred to seldom answers the phone or returns calls and they are a month out with appointments. Probably other people suffering, while United wrings as much money out of their pain as possible before they, too, can get the diagnostics they really need. Like I do. Dreadful, hardnosed company.
I don't know if I despise Verizon Retiree program more or United Health Care. Both have continually messed up my subscription to a Health Care plan that was SUPPOSED to take effect in July. I paid over $200 in monthly premiums through the Benefits Center two months in a row, only to keep being told that UHC "did not have me in the system".
After literally FIGHTING with the both of them on the line for several weeks, I was finally given a member ID number and Group number in SEPTEMBER... but wait - when I tried to check in and get a card, I couldn't find any information. I was then told by VZ Benefits Ctr that my policy was not in the Advantage Care Plan (which I had filled out the paperwork and paid for), but that it was in UHC COMMERCIAL insurance Department.
The supervisor at VZ Benefits Center was scolding me for applying for that type of policy when I should have been submitted under an Advantage Plan. I had to practically scream at her that it was HER employee's mistake - not my request - that I was put in the wrong section of UHC. Here we are 4 weeks later and I still don't have a membership card, I cannot register online, I couldn't find an up-to-date list of doctors on their website, and when I call to speak with a rep to get a card I'm asked if I would like to schedule a call-back. The call back will be in ONE HOUR, but after I leave my number and the recorded idiot is reading it back to me, it cuts me off mid-sentence and now I have to start all over again?
This is the MOST awful insurance company I have ever dealt with. And shame on Verizon - your Benefits Connection call center employees are NOT doing their jobs well and the supervisor I spoke with was incredibly rude and blamed everything on ME. When she called me back, she was cold as ice and so impolite. Don't know who was worse, as I said. If you have a chance to choose another company, stay away from UHC. And their website is almost always experiencing technical difficulties. I encourage everyone to call their State Insurance commissioner and complain about their issues.
People believe they have coverage, that this is actual health insurance. They pay well below half the going rate, significantly less than Medicaid plans. I've been on hold for 54 minutes at this point for Customer 'Service' with no end in sight.
This is my second review on UHC. I wrote the first one right after we had to change insurance companies to UHC. My husband's company was bought by a bigger company about a year ago and, unfortunately, that company uses United Healthcare. I'm sure it is based solely on the fact that they are the cheapest company. This is evident because UHC does everything they can to not pay for procedures and medications. It is also evident by the service of their customer service department. I called the 1-800 number to make sure they would cover the Anesthesia group that my doctors use for their procedures, as this was suggested in the instruction packet I received from my doctor. They said not all insurers cover General Anesthesia/Monitored Anesthesia Care. Considering my previous experience with UHC, I thought it wise to call the 1-800 number on my card and confirm coverage.
I called and have been waiting for over an hour and counting to speak with a UHC representative. I think that UHC purposely does this hoping that the member will give up and hang up because the member doesn't have the time to wait. However, today I do. We will see if they ever pick up. I will try to update this review later to let you know if they ever answered my call.
Prescription policy is a shame. They refused to provide me with a 5mg pill. Instead they offer a 10mg pill to be cut in half. Problem is that the pill size is just about 3mm!!! So considering the TINY pill size, cutting DOESNT WORK!! It would be a very inaccurate dose... One day I can get 7mg and the next 3 mg!!! No health professional was involved in that irrational prescription policy.
I thought I could solve that problem if I switch back to Horizon. So two days ago, I requested to change back to Horizon (I was with Horizon and made the mistake to switch to UNITED HEALTH CARE couple of weeks ago). Horizon used to provided me with the 5 mg medication for year and half with no one problem... But unfortunately you can't switch HMO easily, any request after the 15th of the month is processed the next month. So today is September 1st, I made the change request 2 days ago but I will have to wait until OCTOBER 1st to have it effectived. I am done, no medication supply, I need my daily medication but I have ZERO supply and there is a long weekend coming!! HMO are closed for holidays.
Since I have been a member of United Health AARP there have been numerous times I have requested numerous pieces of information to be sent to me. I get the patented reply of, "It will take 7 (seven) to 10 (ten) business days for your request to be filled." Why? I have been put on IGNORE for over 15 (fifteen) and if and when I do finally get a representative on the line I have been told, "You need to talk to someone else" and yet another delay. While waiting I also have been disconnected (more than once) which makes for a VERY INFURIATING situation.
This company is run by a bunch of complete dumb asses. Purchased health coverage 3-01-2015, paid same day. Got a letter 3-21-15 insurance will be cancelled due to non-payment. Called company, they can’t take payments by phone. Told to log in online to make payment. I did since it was getting close to next due date. I made a second payment. Both payments now getting credited 3-24-15... looked good right... wrong. They cancelled me 4-30-15 for non-payment. Called so many times to get resolved, each payment was 297.56… One department couldn't see payments. Told to screen shot it and send to another department...
This company sounds too big for them to handle. I was told can’t refund money due to it being cancelled. Paid 2 months even told me I had a thirty day grace period so I should have till May 29th to make next payment. But they cancelled my insurance at end of April for non-payment. But now they can see both my payments which covered March and April and have 30 days to make next payment but cancelled in April. What aren't they following, they gave me no insurance, took my money and said, “Screw you, can’t help.” No card. Called a few times, told it sometimes takes a while with the market place to start insurance. I paid, should have insurance immediately. This company are scam artist. Looking at all complaints on here a lot of these sound very much alike. Take money, nothing in return. Or half ass coverage. UNITED HEALTHCARE IS A GIANT FRAUD COMPANY!!!
I bought a supplement F plan online, a month later found I needed a prescription plan also, so went back online and got a Medicare complete plan. In May, had a stent installed, a week later got bills over 4000 dollars. Called United Healthcare, they told me I cannot have both policies, and did not honor the supplement plan that would have paid the bills completely, but used the Advantage plan. They continued to take the supplement payment of 183.47 a month from my account, but did not honor the plan. They said nothing they can do. If I can't have both plans together, why let me get them, they say sorry. How many senior citizens are they ripping off on a daily basis? No conscience stealing from seniors with little income.
My employer gave me pretty much no choice but to go to United Health Care. Unfortunately I am on Medicare which means the Medicare Advantage Plan was selected for me. I was told my insurance would be really good because the Medicare Advantage Plan is a PPO. Yeah, right! A PPO is only of value if your doctor will still see you with it.
Shortly after the switch to United Health Care, I found myself filling out more forms in doctor’s office and signing more papers stating that if my insurance did not pay, I would. So when United Health Care denied claims and told me my obligation was $0 that wasn't exactly true because I'd already signed papers with the doctors stating I would still be obligated to pay. I don't blame the doctors though, they need to be paid for their services. Also, I have found that some of my doctors are completely opting out of Medicare which means I can't see them anymore at all but my husband still can. He is not on Medicare so his policy is an HMO.
I have had nothing but good help from them. Fast to OK referrals and they call to make sure I'm getting the kind of car I need. Always a great group. I would recommend them to anyone.
United Health Care reps are polite and professional but poorly trained. They are not knowledgeable & the claims process is tedious & time-consuming due to the constant errors in processing. Unfortunately, I can't change carriers or I would.
In April I started going to the VA for my health care. I had over 400 worth of scripts that I paid for out of my pocket. I filled out the paperwork to be reimbursed for my out of pocket expense and was turned down saying they will not pay a government entity. What the hell??? They will not cover the veterans of the United States? I tried to cancel and was told I can't cancel until Oct. I stopped my auto pay and will not pay them any more money. They have 5 months of payments and have done nothing to help me since I started going to the VA.
I signed up to receive Medicare PART D with United Health Care RX starting July 1, 2017. I had to prepay the month of July $74.30 each for my wife and same amount for myself. A week into July I discovered that the service provided by this company was terrible, both in answering questions as well as being able to talk to them. They even gave me a false phone number when I talked to a man called Moses at the company. He gave me ** which belongs to a spam user.
I then immediately cancelled our membership after having paid for both my wife and self. No problem since I was within the period in which I could change. End of July I receive a bill for two payments of $74.30 claiming I owed that much for July and if I didn't pay up it would go to collection. Not wanting to jeopardize my credit I paid again and tried calling them to receive a refund for the double charge. Cannot talk to anybody who would be able to take responsibility and talk to me. Have all receipts as cancelled checks both for pre and post July as well as confirmation number of the cancellation. Thank you!
I have never dealt with a company that is as frustrating as United Health Care. Every time I call this company to check the status of a claim, I am either told they can't find it, it's not on file, I have to resubmit something, etc. Since I take excellent notes of every conversation with this company I stand my ground and insist the information is there. Generally the information then magically appears in their files. Yesterday I asked a customer service person if they have to look at multiple screens or places to find the information and he said, "Yes, it's not all in the same place." That may be what's creating the problem or it can be outright deceit. I think their tactic is to completely frustrate their customers so they give up on their claim. That would really help their bottom line and I honestly think that's what's going on.
I am a biller for a company that is participating with United Healthcare insurance, this company is not only terrible for and to the members but they're horrible for the providers as well. We call to verify benefits upon and before servicing members, if it requires an authorization (which states at the bottom of the form is not a guarantee of payment). It takes 10-14 business days for a response, we call a few days later to check the status and they say they haven't received anything, we fax again, check a couple more days later, again UHC is stating they haven't received anything. Just another way for UHC to avoid servicing the patient all together.
Finally, they receive the authorization, it gets approved, patient is serviced, claims deny as not a covered benefit. Even after calling claims department, authorizations department and going through our provider representative, they still refuse to pay the claims because "Authorization does not guarantee payment". What good is an authorization, if you're not going to pay the claims? Also, patients will come in, and we know, for example, an E0118 is not a covered benefit, it is NOT on the Medicaid Fee Schedule, which UHC states they follow, they tell the patients that it is covered and that we're liars. I have personally billed UHC for an E0118, providing the authorization and names and reference numbers of people we spoke to at UHCC along with the claim. They deny as not a covered benefit and when you appeal it they still deny it. Currently, we're one of the many providers being underpaid on multiple claims.
This has been an issue since 2014 (that we're aware of, who knows how long before I came in that they were underpaying these claims), and we have PROOF and a CONTRACT that states EXACTLY what they should be paying when a CLEAN CLAIM is submitted on a 1500 form with ALL documentation attached, and they deny it for "no documentation attached". A previous employee of UHC explained that when paper claims come in the door at UHC, they detach the documents from the claim, the claim gets entered and the documents go somewhere else. Since January of 2015, ours and many other companies have been taking many loses with UHC. They always give patients and providers wrongful information, and we're told that ad providers were to be held accountable.
I would never ever suggest this insurance to any member or, I've already got my family members to switch their insurance, and due to the underpaid claims, we're no longer accepting UHC patients. Our patients are loyal and have already decided they're switching insurance so they can stay with us. I hope this review will help deter people from picking this insurance company, nothing will ever change our minds or make us go back.
I've been trying to get a medication approved from United Health Care for over 2 months. My doctor has submitted 2 PA forms a 2 Appeals in order to get this medication approved. In the last Appeals letter, we included Genetic testing results stating the medication was the ONLY Medication that works within my body. The last Appeals document, my doctor was very transparent as to reasons why this medication is required. I'm now informed that the medication I'm prescribed to take twice a day, exceeds my medication plan. This is Absolutely RIDICULOUS! When did an insurance company become a physician? When did insurance companies decide what or how many medications the patient requires? I had Blue Cross Blue Shield; I'VE NEVER HAD THIS MUCH TROUBLE OBTAINING THE MEDICATIONS THAT MY DOCTOR HAS PRESCRIBED ME!
I've spent countless hours, countless weeks, my doctor has spent countless hours, countless weeks submitting your paperwork. EVERY Time I call United Health Care, I'm transferred to a new person, new division, I'm told to submit new paperwork, I'm told to fax new paperwork. My pharmacy is caught in the middle of this disaster, they are only trying to fill the medication I've been taking for over 4 years, and United Health Care is making this task IMPOSSIBLE!!! This is ABSOLUTELY THE WORST INSURANCE COMPANY I'VE EVER HAD TO DEAL WITH! Their Customer service representatives are not helpful, in fact they are RUDE! I've requested to speak to someone on the corporation level, only to be told, that is not possible.
I certainly cannot begin to tell the nightmare story. Trying to find a PCP was hell enough. On the website for PCP's 50% of those doctors do not take this lousy insurance or they are rated so low with online reviews you might as well pay out of pocket to get decent care. The real test was trying to find a psychiatrist. The Acclaim under Optum is an absolute joke. 89.9% of those type doctors are seeing ONLY in patients, half are not on the plan, even though the website says they are. Called United multiple times. They gave me the same list I was already looking at. A care advocate called back one day and found me a psychiatrist. Catch was - she was in Greenville, TX, oh say about 2 hour drive. That's when I went hunting on my own.
Talked again with them today and they gave me two names of a nurse practitioner. Called those numbers and those two NP's are not even working at the office anymore. When you need mental health, it is impossible as their lousy list is so screwed up, i.e. wrong #'s listed for doctors, you put your zip code in and it may pull up doctors in Houston, when it specifically says they do take this substandard cheaper than dirt insurance on the website, you call and find out they do not.
Verizon has really screwed over its retirees by putting them under doctors and Optum is an absolute joke. They still haven't paid ME back for all the times I had to go out on my own and find another doctor as I paid out of pocket. This is a doctor's office that takes traditional Medicare, so they do not file with United Health Care Medicare Advantage, but United says I can file a claim myself and I will be reimbursed!!! Yeah, when hell freezes over! I have this sorry substandard United government run crap of insurance. Your employees were loyal to you for 40 years and you put them on the lousiest, cheapest insurance you can find.
I had total hip replacement in June, 2017. United Health Care made payment to the assistant surgeon in a timely matter. But the surgeon's charge was denied. I might not be the smartest person on earth, but does that make any sense? I contacted United Health and asked why the assistant surgeon was paid and the surgeon was not, doing the exact same surgery, on the exact same patient, on the exact same hip. The answer was the coding was wrong.
I checked and the coding is the exact same for both surgeons. So I am under the impression, if United Health doesn't want to cover the costs, they can say the coding is incorrect and not cover the expense. This has also happened with 11 visits to the physical therapist that treated me after surgery. So far United Health has denied over $8000.00 of benefits. I paid for the insurance but I guess it comes down to coding if your costs are covered.
I incurred a bill of $198 from Honor Health in Scottsdale AZ on Jan 18, 2016. Today is August 3, 2017. Since February 2016 I have made no less than 32 calls to UHC to get reimbursed. I paid this bill late last year in frustration. I have been shuffled between UHC Tier 1 and LifePrint with each saying the other is responsible. Each time a new case has been opened or a rep told me it was sent to the wrong group; one excuse after another. Nobody has the power to resolve a case especially one involving such a small sum of money. You should not expect a response without a 30 day period going by after any call to Member Services. It just gets shuffled from one group to another. During this period I was told to submit written claims with receipts to 2 different P.O. boxes in 2 different states. Nobody ever responded and there is no phone number to these claims offices.
Today Member Services said the National Experience Center could help, but this office would not accept new calls. While I had no complaint about the actual doctor experience in 2016, UHC member services is set up to avoid a quick resolution. This company seems to be gigantic. You can never get the same person more than once, that person expresses empathy but cannot resolve a problem! The buck stops with nobody. This company should be either dissolved or completely reorganized with "customer service" in mind. There is no excuse for the way they treat consumers. My next step is to call back in 30 more days. UHC management: are you listening???
I have sent numerous letters and made many phone calls to UHC about the horrible experience I had after surgery. I was charged for services that I was not given. There were many other problems also. I have letter from hospital stating they agreed with my complaints but they were sorry and could not lower my part of the charges. UHC denied my appeal, seemingly not even reading any of the details, letters from me and the hospital. They sent me a letter reviewing my medical plan! I knew I had copays and coinsurance payments with my plan - that WAS NOT my appeal. I was NOT appealing my charges, I was appealing the charges from the hospital that should not have been.
I spoke to a manager at UHC again and she is resubmitting the claim. I can't afford an attorney to "sue" the hospital because for a few thousand it would not be worth an attorney's time. It is ridiculous that UHC won't investigate my medical records and ask for funds to be returned to them, they just went ahead and paid the bill even though I did not get all the services. Another thing, home physical therapy came to my house a couple of times for a few minutes and they we canceled physical therapy. They charged as if I had spent hours with them and UHC paid that also. And they wonder why premiums are so high in the US. Sucks.
Example 1: Patient A has AARP Plan 1 HMO. Upon verification, no auth or referral is needed. Patient A was seen about 16 times. After some denials and collections back and forth, all dates were paid, leaving a patient copay of $40/visit, except one DOS where they decided to pay less, claiming the patient owed $80. We tried clearing this discrepancy up with the insurance but it wasn't until we notified the patient what was going on and spoke with our "senior provider advocate" that the issue was resolved (half a year later). Why do we need to file an appeal for a mistake clearly made by the insurance? Issue: Resolved.
Example 2: Patient B also has AARP Plan 1 HMO. She has many claims denied because the provider did not state the time spent on procedure codes. After much back and forth, and addendums, most claims were paid and some still pending. However for 1 DOS, we received a denial because OPTUM alleges that requested info was not received, even though we submitted it on their online portal, Link. We called them to tell them that we submitted the info requested online, giving them the ticket # **. We were told it was rerouted for review and to give them 15-30 days.
We rcvd notice from OPTUM about a week after stating "requested info not rcvd." Called OPTUM again and was told that the claims review team denied it because they are now confused with all the dates on the clinical notes submitted. The claims review team (which is unreachable) is perplexed by "date of daily note," "date of injury/onset/change of status," "date of original eval," and "date of birth" all being on one piece of paper. The only way to resolve is if we further submit an appeal or submit another reconsideration. Why do we need to file an appeal for a mistake clearly made by the insurance? Issue: Pending.
Overall, representatives are generally nice but rather unhelpful, with a few exceptions. Advice for other providers: keep track of everything you send (call reference numbers and even the total number of pages sent) and submit everything you can either online or via fax because you can expect these people either a. provide inaccurate info (say they never rcvd anything) and/or b. redirect back and forth with OPTUM and UHC and/or c. tell you to file an appeal or another recon (which really means, hope you have better luck next time but in the meantime, please wait 30-60 days).
Company switched from BCBS to United Health Care. I have been taking certain medicines for years and able to stay healthy with Crohn's. Now I have to switch to other medicines and fail before I can get medicines I know work. A big THANK YOU to the folks at United Health Care for screwing over consumers. I think it's time to get new job that offers BCBS. They make you jump through too many hoops. Look folks I'm just trying to stay outta the hospitals. I do believe that costs a little more. LOL Thanks HR at CRANEMASTER for making the switch since you obviously have affiliation with them! FALSE statements like you'll definitely be able to keep your maintenance medications. What a joke.
Recently, I received a total permanent disability from Ohio Police & Fire. The insurance coverage they offer is through United Health Care (UHC). I'm on specialty drugs and UHC will not work with or pay for these with the current pharmacy. Instead, you're REQUIRED to buy these drugs through their "specialty pharmacy" or they WILL NOT pay anything towards them. Their prices for the same GENERIC drug are 50% higher.
When I transferred these prescriptions to them, they then would not fill them at the designated time to make sure that I didn't have to be without them and have a lapse between dosages. Only after three (3) continual days of calling and being pushed off to one after another "so-called" service representatives, on the third day I was about to melt down and lose my religion, but was lucky enough to finally be connected to a young lady named Nina who was a trouble shooter. Ms. Nina worked with me for about two and a half hours by reaching out to other departments and their home office. To make a long story short, Nina corrected the problem, made sure that my medication was shipped out so that I wouldn't be without it and corrected the reorder problem.
However, while still working as a policeman, I was for a time our union president and on various occasions had cause to deal with insurance companies and Worker Compensation. Then as now, these companies employ tactics that will either deny services, attempt to coerce you into accepting inferior services or deny paying valid claims - UNLESS you appeal these rulings and demand proper services and payment. They also count on most people becoming complacent or just surrender and either pay for something that they shouldn't have to or accept the second rate services. It readily appears that UHC utilizes these operating procedures on an everyday/every claim basis.
These practices and other like them, are how and why our health care system have given rise to multi-billion dollar industries (insurance companies and big pharmaceutical companies). Unfortunately, our legislators and other public officials don't adequately do their jobs to protect the taxpayer, senior citizen, veterans and all others that rely on them to act in the best interest of the public at large. These insurance companies can continue to use these slipshod methods because they have huge leverage through lobbying our elected official with enormous campaign contributions if these officials vow to support actions that further strengthens their hold on the poor working class. These assaults on the workers (both still working, retired or disabled) must come to an end. We must be watchful and do everything in our power to right these ongoing great wrongs. Thank you for giving me a chance to blow off some steam.
United Health Care expert review by Joseph Burns
UnitedHealthCare is the largest single health care carrier in the United States. It currently covers approximately 70 million Americans and contributes large amounts of money to medical research every year.
- Lots of options: UnitedHealthCare provides a wide range of plan options for individuals, families and employers.
- Offers Medicaid plans: Low-income consumers may be able to get Medicaid insurance through UnitedHealthCare.
- Offers Medicare Advantage plans: Seniors may be able to get their Medicare insurance through UnitedHealthcare’s Medicare Advantage plans.
- Best for: Senior citizens, heads of families, employees
Health Insurance Contributing Editor
An independent journalist, Joseph Burns is the health insurance topic leader for the Association of Health Care Journalists and contributes to AHCJ’s Covering Health blog. He has also written about health policy and the business of health care for a wide variety of publications, including Healthcare Finance News, Hospitals & Health Networks, Managed Care magazine, Ophthalmology Management, TaxACT.com, and The Dark Report.
United Health Care Company Information
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- United Health Care