AI was front and center during recent earnings calls for UnitedHealth Group and Elevance Health, as leaders discussed their companies’ respective $1.5 billion and $1 billion tech investments. Both organizations, along with Centene, made Fortune‘s top companies for AI adoption in 2025, as well.
Payers have been experimenting with internal and member-facing capabilities, while grappling with health system AI use, as well. As insurers build upon their substantial investments and weigh how humans can stay “in the loop,” here is where that money is actually going.
Member navigation and digital experience
From chatbots to provider-matching tools, major insurers have been diving into use cases that aim to drive member experience.
Several major insurers — including UnitedHealthcare, Elevance, Aetna and Cigna — have launched virtual assistants for members. By the end of 2026, more than 20 million UnitedHealthcare members should have access to generative AI virtual assistant Avery. Elevance’s virtual assistant reached 22 million commercial members, and the company planned to broaden the assistant’s reach to Medicare. Aetna said it would roll out voice enablement with its generative AI assistant in early 2026.
Along with an AI-powered chatbot, Cigna also launched a “proprietary” provider-matching tool and redesigned its real-time cost-tracking resource, which breaks down deductibles, out-of-pocket costs and integrated bill payments. A claim submission feature allows members to upload bills, autofills details and fields updates. Those with employer-sponsored coverage can also access plan selection support to get a sense of healthcare costs and available providers.
Prior authorization and claims processing
As carriers double down on their commitment to reducing prior authorization, AI has become one means of doing so. The vast majority of surveyed health plan executives, 93%, expect AI to add value by automating prior authorizations, according to recent Deloitte research.
During Elevance’s latest earnings call, President and CEO Gail Boudreaux said the company’s Health OS platform and other AI tools have cut prior authorizations by almost 70%. Under Carelon, Health OS unifies provider data, lab results and pharmacy information, filling gaps that could otherwise prompt a denial. More than 60,000 Elevance associates can access this technology.
Internal automation
Across insurers of all sizes, internal automation has been a priority with AI deployment. Last year, former UnitedHealth Group CEO Andrew Witty said the company directed 26 million customer calls with AI agents and anticipated that AI would direct more than half of these calls by 2026.
Earlier this year, Humana deepened its relationship with Google Cloud to launch its AI-enabled Agent Assist, which aims to accelerate care-support personnel activities.
Beyond direct member interactions, Elevance employees use AI toolkit Spark to streamline workflows. The features help with manual task automation, including document analysis and contract processing.
Clinical decisionmaking and solutions
Recently, Optum’s Value Connect brought together clinical, operational and financial data into a single system for payers and providers in value-based arrangements. The platform can flag which members may need intervention. This year, Optum reported customers had 29% fewer emergency room visits, 28% fewer preventable hospital readmissions and more than a 20% improvement in care gap closure. Elevance’s Health OS also strives to bridge interoperability gaps.
Industry group AHIP recently shared how payers are putting AI to use in predictive risk modeling and research support to assist with care management.
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