UnitedHealthcare's Avery reaches 21 million members, and the 90% figure still needs a definition
UnitedHealthcare's AI assistant Avery now reaches 21 million members, two months ahead of its own target; what the 90% resolution rate counts, and what the company has left unpublished.
UnitedHealthcare's generative-AI member assistant, Avery, now answers questions about benefits, costs and claims for 21 million people. That is about two in five of the 48.3 million consumers the insurer covered at the end of September. 12
The figure appeared in UnitedHealthcare's own member page dated October 5, 2026, and was reported by Becker's Payer Issues on October 8 from a news release the company shared. 34 Avery launched on March 26 to 6.5 million employer-plan members and 160,000 Medicare Advantage members, with a target of 20.5 million across commercial, Medicare and Medicaid by the end of 2026. 5 The company passed its own target with two months to spare.
Product card
| Field | What is known |
|---|---|
| Announced | 21 million members on the company's member page dated October 5, 2026; trade coverage on October 8 and October 26. 13 |
| Structure | Company-built product inside the UnitedHealthcare app and myuhc.com. No purchase, price or vendor partnership disclosed. 5 |
| Launch base | 6.5 million employer-sponsored members and 160,000 Medicare Advantage members on March 26, 2026. 5 |
| Scale now | 21 million commercial, Medicare and Medicaid members. 3 |
| Resolution | 90% of member interactions resolved without an advocate, as reported by the company. 4 |
| Escalation path | The remaining interactions transfer to a human advocate, with the chat synopsis attached so the member repeats nothing. 5 |
| What it answers | Coverage and benefits, cost estimates and balances, provider search and network status, claim status, explanations of benefits, ID cards, rewards. 3 |
| Data foundation | Answers generated on top of what the company calls "ground truth systems" of UnitedHealthcare data. 1 |
| Recognition | Forrester's 2026 Data & AI Impact Award, as cited by the company. 3 |
What the assistant is for
Members reach Avery inside the app or on the website and ask a question in ordinary language. The answer draws on their own plan, so a question about a named doctor returns network status, contact details and location. 3
That answer is only as good as the data underneath it. Craig Kurtzweil, UnitedHealthcare's chief data and analytics officer, told Fierce Healthcare that Avery runs on "ground truth systems" that supply the underlying data, which is what lets the assistant answer with the member's own benefit and claim details. "Making this as accurate as possible is a big piece of gaining that trust with the consumers," Kurtzweil said. 1
At launch the company said Avery can call network primary care offices to schedule appointments on a member's behalf. 5 In October, Kurtzweil described that function as still being built out. 1 The gap between the two statements is the item to track. Booking an appointment means acting on a member's behalf, which is a bigger step than explaining a benefit.
Why the company scaled it in October
UnitedHealthcare's third quarter gives one part of the answer. Revenue was $86.3 billion, earnings from operations $2.8 billion, and the operating margin 3.3% against 2.1% a year earlier. 2 At group level the operating cost ratio fell to 12.8% from 13.5%, and the company attributes part of the improvement to ongoing investment in "operational agentification" alongside consumer and clinician experience. 2
The second part is credibility. The same results package lists the company's prior approval reforms, including a commitment to eliminate 30% of current prior approval volume by the end of 2026 and to publish prior approval metrics. 2 That work sits on the utilisation side of the business, where UnitedHealth is defending a class action over nH Predict, a tool built by its naviHealth subsidiary; a federal magistrate judge in Minnesota ordered broad document production on March 9, 2026. Optum has said medical necessity decisions are made by physicians and that naviHealth is not generative AI. 6
The timing also lines up with buying season. Medicare open enrollment runs from October 15 to December 7, the window when beneficiaries compare plans and call insurers with questions about cost and networks. 7 The 2027 plan year adds its own complexity: UnitedHealthcare is splitting the member ID card from the UCard benefit card and pushing balance and retailer information into the app. 8
What 90% resolved measures
The figure counts interactions that ended without a human advocate picking them up. In March the company put it as members not requiring assistance 90% of the time, and the same number has been repeated ever since. 45
Four things would make it useful to an outside reader, and none has been published: a written definition of what closes an interaction, an accuracy measure against plan documents, member satisfaction or repeat-contact rates, and a cost per interaction. The company's own third quarter quantifies operating cost improvement without attributing a dollar figure to AI. 2
A payer's resolution rate also depends on what members ask. Questions about a deductible are easy to close. Questions about whether a denied claim will be paid, or whether a specialist is covered for a specific procedure, carry consequences, and an assistant that closes them with a wrong answer converts a call-centre saving into an appeal.
How a peer is framing the same problem
Cigna Healthcare will roll out Health Sense in the first quarter of 2027, starting with members managing oncology and cardiometabolic conditions. Its chief medical officer, Stanley Crittenden, told Becker's Payer Issues that Health Sense is "not a separate product or destination", that member context carries across the app and the clinical teams, and that the model does not diagnose, prescribe or alter treatment. 9
The two designs point in different directions. Cigna routes a member with a serious condition toward clinical staff and uses AI to keep the context joined up. UnitedHealthcare gives every member a conversational front door and treats the advocate as the escalation path. Which approach holds depends on how often UnitedHealthcare's answers turn out to be wrong.
What it changes for payer strategy
UnitedHealthcare's 2027 plans add to what a member has to track. The member ID card is splitting from the UCard benefit card, and Surest, the variable-copay product, prices care differently by provider. 18 UCard credits reach more than 70,000 retail locations. 8 Once a plan varies by member, by provider and by benefit category, the assistant's answer becomes the member's working understanding of the contract.
That makes the data layer the defensible asset. Any insurer can license a model; far fewer can resolve a member's question against clean, joined-up benefit, claim and network data in one step, which is what Kurtzweil described as the foundation. 1 The operating cost ratio is where competitors will show whether they can match it.
There is a governance version of the same point. An assistant that fields coverage questions will be judged by what it told members. Answer logs become discovery material in disputes, and a wrong answer about network status or cost sharing becomes a grievance.
What to watch next
- Full membership: Kurtzweil said UnitedHealthcare intends to make Avery available to all of its enrollees. No date has been published, and the remaining 56% of members is the harder half. 1
- A published definition of "resolved": the 90% has not moved since March. A definition with an accuracy measure would be a stronger signal than a higher percentage. 5
- Appointment booking: whether Avery books visits on members' behalf in production, as the March release described, or only explains how to book. 5
- December 7, 2026: Medicare open enrollment closes, giving the first full buying season with Avery at 21 million members. 7
- First quarter of 2027: Cigna launches Health Sense, the first large peer with a named clinical-support model and public plans to validate outcomes. 9
- Fourth quarter results: whether the operating cost ratio keeps falling, and whether UnitedHealth finally puts a dollar figure on AI savings. 2
Two in five UnitedHealthcare members now put their coverage questions to software. The next disclosure that settles the strategy is a definition of what counts as a resolved question, and how often the answer was right.
References
- 1UnitedHealthcare expands AI companion Avery to 21M members
fiercehealthcare.com
- 2UnitedHealth Group Reports Third Quarter 2026 Results
unitedhealthgroup.com
- 3
- 4UnitedHealthcare's AI assistant expands to 21 million members
beckerspayer.com
- 5
- 6
- 7Joining a plan
medicare.gov
- 8
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