Anthem vs UnitedHealthcare: What’s the difference?

In 2004, WellPoint Health Networks Inc and Anthem, Inc. merged and became the nation’s leading health benefits company. In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc. The Anthem companies offer health care plans and related services like dental, vision, behavioral health, life insurance and disability insurance benefits as well as long-term care insurance and flexible spending accounts. Anthem has about 40 million members and is ranked 33rd on the Fortune 500.

UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. It was Dr. Paul Ellwood, who coined the term “health maintenance organization,” and who helped Burke start-up UnitedHealth. In 1979, the company created the first network senior health plan.

To learn more about each company, you can check out the Anthem Overview and UnitedHealthcare Overview.

Which health insurance company is better? We’ve made it easy to compare companies side by side. See how Anthem and UnitedHealthcare ranked among the industry ratings.

Comparison Anthem UnitedHealthcare
Year Founded 2004 1977
Medicare Star Rating 4.5 stars (out of 5)
BBB Rating A+ A+
NAIC Complaint Index 0.30% for individual health insurance
Market Share Percentage 6.3%
Financial Strength Excellent
A.M. Best Rating A-

Pros

Anthem
  • Anthem Inc. is one of the largest providers of health insurance plans in the country, serving approximately 40 million members
  • Anthem Inc. is a financially secure health insurance carrier.
UnitedHealthcare
  • Robust health plans and benefits for Medicare and Medicaid recipients.
  • Marketplace plans for individuals and families that do not qualify for Medicaid or Medicare.
  • Popular mobile app makes it easy to stay on top of your account.
  • UnitedHealth is available in all 50 states.

Cons

Anthem
  • Anthem received some bad press in 2014, for refusing to cover the hospitalization of a man with stage 4 cancers. Anthem ended up paying for coverage after public outcry.
  • In 2017, Anthem was fined for untimely responses to complaints.
UnitedHealthcare
  • Plans are in general more expensive than those of other health insurance providers.

The Anthem Medicaid app is only available to policyholders in 5 states. Indiana, Kentucky, Nevada, Wisconsin and Virginia. The app allows users to find doctors, hospitals, and pharmacies, view claims, pay your bill, and manage your prescriptions.

The Health4Me app from UnitedHealthcare allows you look for doctors and review your coverage and benefits.

Anthem Mobile App
iOS      2.2 42 users
Android      2.9 101 users
UnitedHealthcare Mobile App
iOS      4.5 10.1K users
Android      4.6 16,316 users

Anthem

Anthem is available through the health insurance marketplace or you can get several free quotes here.  Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/.

UnitedHealthcare

UnitedHealth Group offers plans through the health insurance marketplace. You can begin searching for plans here.

Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/.

Anthem

Make sure you use the claim form from your benefit plan because each type is different. You’ll need to get procedures codes from your doctor’s office. File the paperwork within the time limit. Include pre-approval if it’s needed.

UnitedHealthcare

UnitedHealth Group pays network providers directly but if you are billed by a provider, you can contact UnitedHealth Group at 1 (800) 328-5979. If you are filing a claim for an out-of-network provider for an emergency or because you were referred to the provider by UnitedHealth Group you must submit the following information

  • The Policyholder’s name and address.
  • The patient’s name and age.
  • The number stated on your ID card.
  • The name and address of the provider of the service(s).
  • The name and address of any ordering Physician.
  • A diagnosis from the Physician.
  • An itemized bill from your provider that includes the Current Procedural Terminology (CPT) codes or a description of each charge.
  • The date the Injury or Sickness began.
  • A statement indicating either that you are, or you are not, enrolled for coverage under any other health insurance plan or program. If you are enrolled for other coverage you must include the name of the other carrier(s).

The above information should be sent to: UnitedHealthcare P.O. Box 740800 Atlanta, GA 30374-0800

If filing a claim for Outpatient Prescription Drug Benefits, your claims should be submitted to: Optum Rx P.O. Box 29077 Hot Springs, AR 71903

Anthem

Like most health care plans, Anthem has an annual flat-dollar deductible you must meet before your plan begins to pay your medical expenses.

Anthem offers health insurance as a Blue Cross Blue Shield affiliate.

Your policy number is the same as your ID number, which should be on the front of the card.

Your Anthem health insurance will cover diabetic glucose monitoring under the category called Durable Medical Equipment (DME). Costs vary per individual and plan.

UnitedHealthcare

UnitedHealth Group is an American for-profit managed health care company based in Minnetonka, Minnesota. They offer a wide variety of health plans for individuals and businesses. They also offer Medicare and Medicaid.

Medicare Advantage is Medicare Part C, which replaces original Medicare Parts A and B and is administered through a private insurer. Medicare Advantage plans offer some benefits that Original Medicare does not. UnitedHealth also offers special Medicare Advantage plans for patients with Alzheimer’s or chronic dementia.

Yes, in 1998, the company rebranded and changed the name UnitedHealthcare insurance to UnitedHealth Group.

If you don’t have health insurance through an employer, you can buy private insurance for yourself and/or your family with UnitedHealth insurance. For health insurance rates visit here

Source

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