UnitedHealthcare
UnitedHealthcare is one of the largest health insurance providers in the United States, offering employer-sponsored health benefits, individual and family plans, Medicare and Medicaid plans, and managed care services. UnitedHealthcare provides APIs for healthcare providers through the UHC API Marketplace for eligibility verification, claims management, and prior authorization, and FHIR R4-compliant Interoperability APIs for patient data access and provider directory services per CMS mandates.
Real signal across most facets with visible, nameable gaps — the contract exists but is thin, or the portal is good while governance and commercial terms are absent.
API Evangelist profiles UnitedHealthcare the way a machine reads it — 53 machine-readable artifacts across 7 APIs, pulled from the provider's own public surface and indexed so a developer, an analyst, or an AI agent can evaluate it against every other provider on the network.
Every provider in the network is reduced to the same set of machine-readable artifacts — OpenAPI contracts, event specifications, GraphQL schemas, runnable collections, pricing and rate-limit signals, security posture, OAuth scopes, and the agent surfaces (MCP servers and skills) that let software drive the API on its own. We profile them because the interface is the part of a company you can actually inspect: it is a truer signal of what a provider does than any marketing page. From those artifacts we compute the Kin Score — UnitedHealthcare scores 49.1/100 (developing), with a separate agent-readiness read of 48/100 (agent ready). The full breakdown is below, followed by every artifact we hold — each card links through to its machine-readable definition on apis.io.
Kin Score
This is the API Evangelist rating — a single, repeatable read computed from the artifacts on this page. Green fill is points earned; the red track is points possible, so every bar shows earned-versus-possible at a glance.
Kin Score
How this is scored →scored 2026-07-27 · rubric v0.5
How we profile UnitedHealthcare
Each block below is one kind of artifact we hold for UnitedHealthcare. For each we say what it is and why it earns a place in the profile, then list every one we've indexed — capped at two rows, scroll within the panel for the rest.
APIs 7
Each API is captured as its own OpenAPI definition — every operation, parameter, and response. This is the single most useful machine-readable description of what an API does, and it's what lets us score, lint, mock, and generate against it without asking the provider for anything.
Individual APIs this provider publishes, each with its own machine-readable definition.
UnitedHealthcare Claims API
Claim pre-check, submission, and inquiry
UnitedHealthcare Eligibility API
Real-time eligibility and benefit verification
UnitedHealthcare Formulary API
Drug formulary and coverage information
UnitedHealthcare Patient Access API
FHIR R4 Patient Access API for member health data
UnitedHealthcare Prior Authorization API
Prior authorization and referral actions
UnitedHealthcare Provider Directory API
FHIR R4 Provider Directory API for network information
UnitedHealthcare Providers API
Provider demographics and directory
Scroll within the panel for all 7 ·
Open Collections 2
Open, tool-agnostic collections carry the same runnable value as Postman without locking you to one client — the portable, forkable form of the same exercise.
Open, tool-agnostic API collections (OpenAPI-derived and Bruno).
UnitedHealthcare Interoperability API
OPEN COLLECTIONUnitedHealthcare Provider API
OPEN COLLECTIONPricing Plans 1
Pricing is part of the interface. Machine-readable plans tell you what a tier costs and includes before you commit — one of the six things the Kin Score reads for commercial clarity.
Published pricing tiers and plan structures.
Rate Limits 1
Rate limits are the difference between a demo that works and a production integration that doesn't fall over. Publishing them is an operational-transparency signal — and a hard requirement for any agent that plans its own throughput.
Documented rate limits and quota policies.
Unitedhealthcare Rate Limits
RATE LIMITSFinOps 1
Cost, billing, and metering signals let a buyer model the financial operations of an API before it's live. We profile them for the same reason we profile pricing: the money is part of the contract.
Cost, billing, and metering signals for API financial operations.
Unitedhealthcare Finops
FINOPSSemantic Vocabularies 2
JSON-LD contexts give the data shared meaning across APIs. We profile them because semantics are what let a machine reconcile 'customer' here with 'customer' somewhere else.
JSON-LD contexts and semantic vocabularies used across these APIs.
Spectral Rules 2
Governance rulesets we run against this provider's specs — the automated checks behind parts of the score. Profiling them makes the quality bar explicit and re-runnable, not a matter of opinion.
UnitedHealthcare API Rules
SPECTRALUnitedHealthcare API Rules
SPECTRALJSON Schema 13
Standalone JSON Schema definitions describe the data models behind the API. We profile them so the shapes are validatable on their own — useful long after a single request is forgotten.
Standalone JSON Schema definitions for this provider's data models.
UnitedHealthcare FHIR Bundle
JSON SCHEMAUnitedHealthcare FHIR Patient
JSON SCHEMAUnitedHealthcare Benefit Check Request
JSON SCHEMAUnitedHealthcare Benefit Check Response
JSON SCHEMAUnitedHealthcare Claim Inquiry Request
JSON SCHEMAUnitedHealthcare Claim Inquiry Response
JSON SCHEMAUnitedHealthcare Claim Pre-Check Request
JSON SCHEMAUnitedHealthcare Claim Pre-Check Response
JSON SCHEMAUnitedHealthcare Eligibility Request
JSON SCHEMAUnitedHealthcare Eligibility Response
JSON SCHEMAUnitedHealthcare Prior Auth Check Request
JSON SCHEMAUnitedHealthcare Prior Auth Check Response
JSON SCHEMAUnitedHealthcare Provider Demographics
JSON SCHEMAScroll within the panel for all 13 ·
JSON Structure 13
JSON Structure captures the data shapes in a form built for tooling — a complement to JSON Schema that keeps the model machine-legible.
JSON Structure definitions describing this provider's data shapes.
Interoperability Fhir Bundle Structure
JSON STRUCTUREInteroperability Fhir Patient Structure
JSON STRUCTUREProvider Benefit Check Request Structure
JSON STRUCTUREProvider Benefit Check Response Structure
JSON STRUCTUREProvider Claim Inquiry Request Structure
JSON STRUCTUREProvider Claim Inquiry Response Structure
JSON STRUCTUREProvider Claim Pre Check Request Structure
JSON STRUCTUREProvider Claim Pre Check Response Structure
JSON STRUCTUREProvider Eligibility Request Structure
JSON STRUCTUREProvider Eligibility Response Structure
JSON STRUCTUREProvider Prior Auth Check Request Structure
JSON STRUCTUREProvider Prior Auth Check Response Structure
JSON STRUCTUREProvider Provider Demographics Structure
JSON STRUCTUREScroll within the panel for all 13 ·
Examples 8
Real request and response payloads are what turn a spec from abstract into obvious — and they're one of the twelve things an agent needs to call an API correctly on the first try.
Example request and response payloads for these APIs.
Scroll within the panel for all 8 ·
Security Posture 2
Authentication, domain security, vulnerability disclosure, and trust-center signals — the evidence that a provider takes security seriously enough to document it. We profile it because you can't govern what you can't see.
Authentication, domain security, vulnerability disclosure, and trust-center signals.
Agentic Access 1
An x-agentic-access contract marks which operations are safe for an agent to run on its own and which need a human in the loop. It is the difference between an API an agent can use and one it can use safely.
Recommended x-agentic-access execution contracts for AI agents.
Resources
Every other property we hold for UnitedHealthcare — documentation, portals, status pages, policies, and corporate surface — grouped by the job it does, following the integrator's arc from getting started to running in production.
Agent Surfaces 1
MCP servers, agent skills, and machine-readable catalogs
Build 1
SDKs, sample code, and the tooling you integrate with
Access & Security 2
Authentication, authorization, and security posture
Company 1
The organization behind the API
← All providers · Data indexed from github.com/api-evangelist/unitedhealthcare · machine-readable index on apis.io