UMR: Health Insurance Explained [2025]
UMR health insurance is an often misunderstood type of insurance. As a self-funded insurance plan, the insured employers will assume the financial burden borne by most healthcare-related costs. UMR is a third-party administrator.
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Brandon Frady
Licensed Insurance Agent
Brandon Frady has been a licensed insurance agent and insurance office manager since 2018. He has experience in ventures from retail to finance, working positions from cashier to management, but it wasn’t until Brandon started working in the insurance industry that he truly felt at home in his career. In his day-to-day interactions, he aims to live out his business philosophy in how he treats hi...
Licensed Insurance Agent
UPDATED: Dec 22, 2024
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UPDATED: Dec 22, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance providers please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- UMR stands for United Medical Resources and was founded in 1983
- UMR is not a health insurance provider per se, but should rather be viewed as a third-party administrator
- UMR is meant to give administrative assistance to a variety of health insurance plans that are self-funded
There are many types of health insurance coverage floating around out there, so it can be difficult to keep them all straight. UMR health insurance is an often misunderstood type of insurance.
As a self-funded insurance plan, the insured employers will assume the financial burden borne by most healthcare-related costs.
While it is true that some organizations will undoubtedly organize their own self-funded insurance plans, most will opt to make use of the third-party administrator that is United Medical Resources insurance.
It should also be noted that some companies that use a self-funded plan will have a stop-loss insurance policy designed to cover them for any medical treatment claims made over a set amount.
Self-funded health insurance plans are typically used when there is no employer contribution towards employee benefits or if the company does not wish to contribute toward its employees’ healthcare needs.
Third-party administrators (TPAs) offer a range of services including administration, billing, and processing claims for insurers that provide group health policies. UMR insurance providers have contracted these services from TPAs, including UMR full form in Medical Billing.
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Is UMR a UnitedHealthcare company?
In 2002, UnitedHealthcare acquired Midwest Security Administration, marking its initial foray into administering healthcare-related insurance plans, which later included services like UMR dental provider login and the provider portal for UnitedHealthcare Shared Services.
It was in 2005 that UnitedHealthcare actually expanded even further when it purchased United Medical resources. One other historical item of note is that UnitedHealthcare purchased Fiserv Health in 2008.
Currently, all three administrative divisions of the company have been consolidated under UMR. This structure remains unchanged to this day, influencing aspects such as UMR insurance plans, and the difference between UMR and UHC.
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What is UMR insurance?
To understand UMR healthcare and its overall impact on the health insurance industry, it is helpful to know some of the following statistics.
- The main headquarters for UMR is in Cincinnati, but it also has local and regional offices across the country
- Currently, more than 3,000 people are employed with UMB
- Employees serve roughly 1,400 clients with self-funded health plans
- Clients include individual companies, state governments, and employer formed groups
- There are more than two million subscribers to UMR
- UMR medical insurance currently processes roughly 14 million claims every year
These statistics help to highlight the scope of UMR, but it is also helpful to get a picture of the range of services that the organization is able to provide via these self-funded insurance plans.
What services are offered?
When UMR is utilized, self-funded plans can be more comprehensively managed. These plans include not only medical insurance, but plans for disability, vision, and dental as well.
UMR effective works to tailor the services that it offers to the specific needs of each company that becomes its client including handling the claims process from start to finish, reporting issues, and cost control analysis.
Some clients may have multiple types of self-funded insurance plans administered by UMR, while others may utilize only one or two plans. For more specific details, such as Farm Bureau UMR health insurance, the UMR headquarters address, or the UMR dental insurance provider phone number, further information can be provided upon request.
For example, a company might offer a health insurance plan through an HMO, but self-fund its dental and vision insurance using UMB as its third-party administration.
UMR coverage includes the following:
- a host of pharmacy benefits
- programs aimed at wellness
- stop-loss coverage
It is also important to note that UMR provides its clients with certain discounts on in-network health services with UnitedHealthcare’s PPO Network is utilized. It also offers more than 100 other partner networks that employer insurance plans can utilize.
Is UMR a good place to work?
There are mixed reviews about working at UMR. Some employees have commented that the customer service jobs are difficult because you are dealing with medical issues and insurance claims and it’s a high-stress environment with lots of incoming calls from angry customers.
Others have mentioned that the position provides adaptable work hours and a comprehensive benefits package that covers fertility benefits and mental health support under UMR health insurance plans including UMR eye insurance.
There is an extensive training program to prepare you for a job at UMR, and several reviews noted that there were good opportunities for advancement.
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What are UMR’s policies and procedures?
In theory, UMR works like any other medical insurance company. The employer will provide a list of covered benefits to the employee, along with possible deductible and co-insurance requirements that need to be met.
In deference to an actual HMO plan, however, the employer will fund the plan on their own.
Any claims that are made against the policy will be paid out of this fund, and all of the expenses are organized by UMR.
It acts as a third-party administrator overseeing the plan’s administration to ensure every employee receives adequate coverage and the healthcare they deserve, as noted in UMR health insurance reviews.
Case Studies: UMR: Health Insurance Explained
Case Study 1: John’s Experience with UMR Health Insurance
John, a 35-year-old software engineer, joined UMR health insurance, initially uncertain about its coverage. Through policy review and consultation, he gained clarity and understanding of the plan’s benefits. This case study showcases John’s experience and the advantages he discovered with UMR.
Case Study 2: Sarah’s Cost Savings with UMR Health Insurance
Sarah, a 42-year-old small business owner, faced significant healthcare expenses due to a chronic condition. Seeking a cost-effective solution, she switched to UMR health insurance. Through this case study, we delve into Sarah’s experience, examining the cost-saving measures and specialized programs offered by UMR that helped alleviate her financial burden.
Case Study 3: James’ Access to Comprehensive Care through UMR Health Insurance
James, a 50-year-old retiree, chose UMR health insurance for continued comprehensive coverage. This case study explores his experience, emphasizing the extensive network of healthcare providers and facilities available to UMR policyholders. With UMR, James found peace of mind in accessing the care he needed during his retirement.
Case Study 4: Maria’s Seamless Claims Process with UMR Health Insurance
Maria, a 28-year-old marketing executive, found relief from complex health insurance claims when she switched to UMR. This case study focuses on her experience, highlighting the streamlined claims process and prompt reimbursements that simplified her healthcare journey. With UMR, Maria enjoyed a user-friendly system that made her life easier.
Case Study 5: David’s Personalized Support from UMR Health Insurance
David, a 39-year-old sales manager, found personalized support and guidance with UMR health insurance. This case study highlights his experience, emphasizing the tailored resources and services provided by UMR. David’s healthcare decisions were positively impacted by the personalized assistance he received from UMR.
Case Study 6: Lisa’s Wellness Initiatives with UMR Health Insurance
Lisa, a 45-year-old teacher, was committed to leading a healthy lifestyle and wanted an insurance provider that supported her wellness goals. By selecting UMR health insurance, she gained access to various wellness programs and initiatives. This case study explores Lisa’s journey, highlighting the wellness benefits provided by UMR and their contribution to her overall well-being.
Case Study 7: Mark’s International Coverage with UMR Health Insurance
Mark, a 32-year-old international business consultant, found the ideal health insurance with UMR, offering comprehensive international coverage. This case study highlights Mark’s experience, emphasizing the advantages and flexibility he gained by choosing UMR for his global healthcare needs. UMR provided him with the necessary support and coverage for his international lifestyle.
Case Study 8: Emily’s Family-Focused Benefits with UMR Health Insurance
Emily, a 36-year-old working mother, found family-focused benefits with UMR health insurance. This case study explores her experience, highlighting UMR’s comprehensive coverage for pediatric care, maternity, and specialized services for children. The family-oriented benefits provided by UMR positively impacted Emily’s family’s well-being.
In Conclusion
Keep in mind that UMR is essentially a third-party administrator.
UMR is hired by an employer and its sole aim is to help ensure the claims made by the insured are paid correctly. This hiring is done in an effort to keep healthcare-related expenses to a minimum and enable the individual to focus on his or her own well-being.
It is important to remember that UMR is not a health insurance company by any stretch of the imagination. You cannot purchase any kind of medical plan directly from UMR.
The employer under this arrangement will agree to pay a certain portion of the health care costs that are not paid by the insured. Finally, remember that UMR is now a part of the UnitedHealthcare Company. This means it works closely together to create programs that benefit both parties involved.
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Frequently Asked Questions
What is UMR?
UMR, which stands for “United Medical Resources,” is a third-party administrator (TPA) specializing in health insurance services. They collaborate with employers and insurance carriers to handle various aspects of health insurance plans, including claims processing, network management, and customer service. This aligns with UnitedHealthcare Integrated Services, Inc. and is part of UMR’s UnitedHealthcare Choice Plus. The UMR abbreviation stands for United Medical Resources, emphasizing their role in effectively managing health insurance services.
How does UMR fit into the health insurance process?
UMR, under the UnitedHealthcare company, functions as an intermediary between employers or insurance carriers and healthcare providers and policyholders. They manage tasks such as claims processing, provider network management with UnitedHealthcare Choice Plus providers, customer service, and offering tools and resources for policyholders to manage their health benefits through UnitedHealthcare Shared Services.
Do I purchase health insurance directly from UMR?
No, UMR is not an insurance company. They act as a third-party administrator (TPA) working with insurance carriers and employers to manage health insurance plans. Typically, you obtain health insurance coverage through your employer or an affiliated insurance carrier. For those with UMR, it is essential to understand the list of in-network providers for UMR and the specifics of gym membership coverage with UMR insurance.
What services does UMR provide?
UMR provides a variety of services for health insurance administration. This includes claims processing, managing provider networks, offering customer service support, verifying eligibility, pre-authorizing medical procedures, and providing online tools for policyholders to manage their benefits. These integrated services from United Healthcare ensure comprehensive UMR benefits, including coverage for therapists under UMR insurance.
How does UMR handle claims processing?
When a healthcare provider renders medical services covered by your health insurance plan, they submit a claim to UMR for processing. UMR evaluates the claim, checks the coverage against the UMR fee schedule, and determines the payment amount based on the plan’s benefits. Once verified, UMR communicates the payment details to both the provider and the policyholder through the UMR Card.
What is the difference between UMR and UnitedHealthcare?
UMR is a third-party administrator (TPA) that manages self-funded health plans for employers. UnitedHealthcare (UHC) is a health insurance company that offers various health plans, including those administered by UMR. Essentially, UMR is part of UHC but functions specifically to administer employer-sponsored plans.
Are there doctors near me that accept UMR?
To locate nearby doctors who accept UMR, you can use UMR’s online provider search tool on their website or reach out to UMR customer service for help. For more details, including the meaning of UMR insurance and reviews of UMR insurance, visit their official site.
Does UMR cover acupuncture?
Coverage for acupuncture under UMR plans depends on the specific employer-sponsored plan. You should review your plan documents or contact UMR customer service to confirm if acupuncture is covered.
Does UMR cover blood work?
Generally, UMR plans do cover blood work, but the specifics can vary based on your employer’s plan. It’s best to check your plan details or contact UMR directly for confirmation.
Does UMR cover chiropractic care?
UMR often covers chiropractic care, but coverage specifics can vary. Check your plan documents or contact UMR customer service for details.
Does UMR cover mental health?
Yes, UMR typically covers mental health services, but the extent of coverage can depend on your specific plan. Review your benefits or contact UMR for more information.
Does UMR cover telehealth?
Many UMR plans include coverage for telehealth services. Check your plan documents or contact UMR to confirm the details.
Does UMR health insurance cover gym memberships?
Coverage for gym memberships is not typically included in UMR health plans, but some employers may offer wellness programs that include gym membership discounts. Check with your employer or UMR.
Is UMR a Medicare Advantage plan?
No, UMR is not a Medicare Advantage plan. UMR is a third-party administrator for employer-sponsored health plans.
Is UMR a PPO or HMO?
UMR administers various types of health plans, including PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization) plans. The type of plan depends on what your employer offers.
Is UMR a good insurance?
UMR itself is not an insurance company but a third-party administrator. The quality of the insurance depends on the employer-sponsored health plan they administer. Generally, UMR is known for providing good administrative services.
Is UMR and UHC the same?
UMR is a part of UnitedHealthcare (UHC), but they are not the same. UHC is an insurance company, while UMR functions as a TPA for employer-sponsored plans.
Is UMR commercial insurance?
UMR administers commercial insurance plans for employers, meaning it manages employer-sponsored health insurance plans.
Is UMR good insurance?
The quality of insurance administered by UMR depends on the specific employer-sponsored plan. UMR is generally known for reliable administration of these plans.
Is UMR insurance Medicaid?
No, UMR does not administer Medicaid plans. It manages employer-sponsored health plans.
Is UMR the same as Optum?
No, UMR and Optum are different entities under the UnitedHealth Group umbrella. UMR is a TPA for employer-sponsored health plans, while Optum provides healthcare services and technology.
Is UMR the same as UnitedHealthcare?
UMR is a subsidiary of UnitedHealthcare, specializing in administering employer-sponsored health plans.
How long does it take UMR to process a claim?
Claim processing times can vary, but UMR typically processes claims within 30 days. For specific inquiries, contact UMR customer service.
How much does it cost to have a baby with UMR insurance?
The cost of having a baby under UMR insurance varies based on your specific plan’s coverage for maternity and childbirth. Check your plan details or contact UMR for an estimate.
What does UMR insurance stand for?
UMR stands for United Medical Resources.
What is the UMR customer service phone number?
The UMR customer service phone number can vary based on your specific plan. It is typically listed on the back of your insurance card or on UMR’s website.
What is UHSS insurance?
UHSS stands for UnitedHealthcare Shared Services, a part of UnitedHealthcare that provides administrative support and services.
Where is UMR headquarters?
UMR is headquartered in Wausau, Wisconsin.
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Brandon Frady
Licensed Insurance Agent
Brandon Frady has been a licensed insurance agent and insurance office manager since 2018. He has experience in ventures from retail to finance, working positions from cashier to management, but it wasn’t until Brandon started working in the insurance industry that he truly felt at home in his career. In his day-to-day interactions, he aims to live out his business philosophy in how he treats hi...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about auto insurance. Our goal is to be an objective, third-party resource for everything auto insurance related. We update our site regularly, and all content is reviewed by auto insurance experts.