Medicaid Program
UnitedHealthcare Community Plan is the Medicaid managed care division of UnitedHealth Group, offering low-cost health insurance plans — including Medicaid, Dual Special Needs Plans, CHIP, and ACA Marketplace plans in 23 states — to low-income adults, children, pregnant women, elderly individuals, people with disabilities, and dual-eligible beneficiaries.
- Company typePublic
- Founded1977
- HeadquartersNot specified in source, United States
- Headcount11–50
- GTM typeB2C
- OfferingServices
What Medicaid Program does
UnitedHealthcare Community Plan is the Medicaid managed care product line of UnitedHealthcare Insurance Company, a Connecticut-incorporated operating subsidiary of UnitedHealth Group (NYSE: UNH). The division offers low-cost or no-cost health insurance to populations eligible under state Medicaid programs — including low-income adults, children, pregnant women, elderly adults, and people with disabilities — as well as Dual Special Needs Plans (D-SNPs) for beneficiaries eligible for both Medicare and Medicaid, the Children's Health Insurance Program (CHIP), and ACA Marketplace Individual & Family plans available in 23 states. Plan eligibility, benefits, and provider networks are determined at the state level, with the federal CMS providing program oversight and market share data references.
The core technology is a government-managed Medicaid health insurance platform delivering managed care services through state contracts; UnitedHealthcare operates as a Medicare Advantage organization with both Medicare contracts and State Medicaid Program contracts. Plan distribution is multi-channel: state Medicaid agency applications handle eligibility, a website-based plan finder and eligibility checker enable self-service enrollment, member ID-card customer service lines support ongoing engagement, and contracted provider networks (with primary care physician referral coordination) deliver care. The platform supports 13 languages and caregiver resources for dual-eligible members.
The business model runs on capitation payments (per-member-per-month premiums) from state Medicaid programs — a recurring subscription-style revenue stream with low-to-no-cost pricing for members. Plans are insured through UnitedHealthcare Insurance Company or its affiliates; specific Medicaid segment revenue is not disclosed, but the parent UnitedHealthcare division reported $271B in 2023 revenue within UnitedHealth Group's $400.3B total. Customer segments span six Medicaid-eligible personas plus a dual-eligible segment, with state agencies acting as the institutional buyer and individual beneficiaries as end members.
Medicaid Program firmographics
Firmographics- Name
- Medicaid Program
- Legal name
- UnitedHealthcare Insurance Company
- Website
- https://medicaid.com
- Company type
- Public
- Founded year
- 1977
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- UnitedHealthcare Community Plan is the Medicaid managed care division of UnitedHealth Group, offering low-cost health insurance plans — including Medicaid, Dual Special Needs Plans, CHIP, and ACA Marketplace plans in 23 states — to low-income adults, children, pregnant women, elderly individuals, people with disabilities, and dual-eligible beneficiaries.
- Ownership category
- akta.pro rank
Medicaid Program industry classification
Industry- Product category
- Medicaid Managed Care
- NAICS
- Services for the Elderly and Persons with Disabilities (624120), Social Assistance (624)
- SIC
- Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)
- akta.pro primary industry
- Medicaid Expansion (ACA Adult) Managed Care Plans (HLAEAEAB)
- akta.pro secondary industries
- Children’s & Family Medicaid Managed Care Plans (HLAEAEAF), Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)
Keywords
Where Medicaid Program is headquartered
LocationHeadquarters
- HQ city
- Not specified in source
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Medicaid Program business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure, Supply Chain
Revenue model
- Medicaid Managed Care Premiums: UnitedHealthcare receives capitation payments from state Medicaid programs to provide health coverage to eligible beneficiaries. Revenue is derived from per-member-per-month premiums paid by state governments for managed care plan administration.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Medicaid plans - low to no cost |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels3 records
Medicaid Program product offering
Product offeringCore offering
UnitedHealthcare Community Plan provides low-cost or no-cost government health insurance plans to eligible low-income individuals under state-managed Medicaid programs, plus Dual Special Needs Plans (D-SNP) for those eligible for both Medicare and Medicaid, the Children's Health Insurance Program (CHIP) for infants/children/teens, and ACA Marketplace Individual & Family plans in 23 states. Plans are insured through UnitedHealthcare Insurance Company or its affiliates under contracts with state Medicaid programs and CMS, with coverage designed for low-income adults, children, pregnant women, elderly adults, and people with disabilities.
Product overview
UnitedHealthcare Community Plan offers a multi-product health insurance portfolio consisting of Medicaid plans for low-income individuals, Dual Special Needs Plans (D-SNP) for those with both Medicare and Medicaid coverage, ACA Marketplace Individual & Family plans available in 23 states, and CHIP coverage for children. The offerings are designed to serve different population segments based on income level, age, disability status, and insurance eligibility.
Differentiator
Problem solved
Functional benefit
Brands
- Dual Special Needs Plans (D-SNP): Plans for individuals eligible for both Medicare and Medicaid, offering extra benefits like dental, vision care and more at no extra cost.
- CHIP
- ACA Marketplace Plans
Products and services
- Medicaid Health insurance program covering eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities, providing federally required benefits such as hospital visits, doctor visits, prenatal care, nursing home services, home health services, and emergency medical transportation. Eligibility is determined by each state Medicaid agency based on state-specific income and categorical requirements.
- Dual Special Needs Plans (D-SNP) Medicare Advantage plans that combine Medicare and State Medicaid Program coverage for individuals eligible for both programs, providing extra benefits such as dental and vision care at little to no additional cost (with $0 premium for members with Extra Help/Low Income Subsidy).
- Children's Health Insurance Program (CHIP) Low-cost or no-cost health coverage for uninsured infants, children, and teens, providing regular checkups and medical care.
- ACA Marketplace Individual & Family Plans Health insurance plans sold through the Affordable Care Act Health Care Marketplace for individuals and families who buy their own coverage, available in 23 states.
Companies that use Medicaid Program
Customer profileSegments6 records
Ideal customer profiles1 record
Medicaid Program technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Medicaid Program partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- CMS (Centers for Medicare & Medicaid Services)coreFederal agency that governs Medicare and works with state Medicaid programs. UnitedHealthcare's D-SNP plans are Medicare Advantage organizations with Medicare contracts and State Medicaid Program contracts. CMS provides market share enrollment data used in plan marketing materials.
Scale indicators2 records
Recent moves5 records
Expansion highlights5 records
Medicaid Program competitors and assessment
Company assessmentRegional players
- Health Net (Centene subsidiary): Centene-owned health plan offering Medicaid managed care in California and other Western states. Competes with UnitedHealthcare Community Plan in California Medicaid market and serves as a regional complement to Centene's broader national Medicaid strategy.
- Blue Cross Blue Shield of California: Major California-based health plan that operates Medi-Cal (Medicaid) managed care plans in California. Competes with UnitedHealthcare Community Plan in California and is one of the largest Medicaid providers in the state, though largely geographically concentrated on the West Coast.
- Kaiser Permanente: Integrated healthcare provider-insurer that operates Medicaid plans in selected states (primarily California, Colorado, and the Pacific Northwest). Competes with UnitedHealthcare Community Plan in overlapping markets but with a fundamentally different integrated care model and limited geographic footprint.
Direct peers
- Molina Healthcare: A leading Medicaid managed care company focused exclusively on government-sponsored healthcare programs including Medicaid, Medicare, and Dual-Eligible plans. Molina operates in 20+ states and directly competes with UnitedHealthcare Community Plan for state Medicaid contracts.
- AmeriHealth Caritas: A national managed care company specializing in Medicaid, CHIP, and Medicare Advantage plans. Operates in multiple states and is a direct competitor in the Medicaid managed care market, particularly for contracts serving vulnerable populations.
- Elevance Health (Anthem): Major Blue Cross Blue Shield licensee that operates Medicaid managed care plans in multiple states through Anthem Blue Cross Blue Shield plans. Offers Medicaid, Medicare Advantage, and dual-eligible products that directly compete with UnitedHealthcare Community Plan.
- CareSource: A nonprofit managed care company focused on government-sponsored health insurance programs including Medicaid, Medicare, and D-SNP. Operates in multiple states including Ohio, Indiana, Kentucky, and Georgia, directly competing for state Medicaid contracts.
- Humana: Major Medicare Advantage insurer with a growing Medicaid presence through state contracts. Humana's D-SNP and dual-eligible offerings overlap significantly with UnitedHealthcare's D-SNP product, and its Medicaid plans compete in multiple states.
- Centene Corporation: The largest Medicaid managed care organization in the U.S., serving over 15 million Medicaid members across 30+ states. Centene is the most direct competitor to UnitedHealthcare Community Plan in Medicaid managed care, with similar capitation-based revenue model and state-by-state contract structure.
Broad incumbents
- CVS Health (Aetna): Through its Aetna subsidiary, CVS Health offers Medicaid managed care plans in multiple states. CVS is a broader healthcare conglomerate with pharmacy benefit management, retail clinics, and insurance arms, making it a broad incumbent rather than a pure-play Medicaid competitor.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Medicaid Program social profiles
Digital presenceMedicaid Program financial estimates
Financial estimateRevenue estimate
Valuation estimate
Medicaid Program leadership team
Management profileNumber of profiles
Medicaid Program funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Medicaid Program M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Medicaid Program
What does Medicaid Program do?
UnitedHealthcare Community Plan provides low-cost or no-cost government health insurance plans to eligible low-income individuals under state-managed Medicaid programs, plus Dual Special Needs Plans (D-SNP) for those eligible for both Medicare and Medicaid, the Children's Health Insurance Program (CHIP) for infants/children/teens, and ACA Marketplace Individual & Family plans in 23 states. Plans are insured through UnitedHealthcare Insurance Company or its affiliates under contracts with state Medicaid programs and CMS, with coverage designed for low-income adults, children, pregnant women, elderly adults, and people with disabilities.
Is Medicaid Program a public or private company?
Medicaid Program is a public company. It is classified as public and is currently operating.
When was Medicaid Program founded?
Medicaid Program was founded in 1977. It employs 11 to 50 people.
Where is Medicaid Program based?
Medicaid Program is headquartered in Not specified in source, United States, in the North America region.
How does Medicaid Program make money?
One revenue line is on record: medicaid Managed Care Premiums.
Who are Medicaid Program's main competitors?
Regional players on record are Health Net (Centene subsidiary), Blue Cross Blue Shield of California and Kaiser Permanente. Direct peers are Molina Healthcare, AmeriHealth Caritas, Elevance Health (Anthem), CareSource, Humana and Centene Corporation. CVS Health (Aetna) is listed as a broad incumbent.
Does Medicaid Program have an API?
No public API is recorded for Medicaid Program.
What industry is Medicaid Program in?
Medicaid Program's product category is Medicaid Managed Care. Its primary akta.pro industry code is HLAEAEAB, Medicaid Expansion (ACA Adult) Managed Care Plans, with a secondary code of HLAEAEAF, Children’s & Family Medicaid Managed Care Plans. Its NAICS code is 624120 and its SIC code is 6324.