24th Annual JPMorgan Healthcare Conference

January 10, 2006

2

Forward-Looking Statements

Certain matters discussed in this presentation and oral statements made from time to time by representatives of the Company may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 and the Federal securities laws. Although Universal American believes that the expectations reflected in such forward-looking statements are based upon reasonable assumptions, it can give no assurance that its expectations will be achieved. Forward-looking information is subject to certain risks, trends and uncertainties that could cause actual results to differ materially from those projected. Many of these factors are beyond Universal American's ability to control or predict. Important factors that may cause actual results to differ materially and could impact Universal American and the statements contained in this presentation can be found in Universal American's filings with the Securities and Exchange Commission, including quarterly reports on Form 10-Q, current reports on Form 8-K and annual reports on Form 10-K. For forward-looking statements in this presentation, Universal American claims the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. Universal American assumes no obligation to update or supplement any forward-looking statements, whether as a result of new information, future events or otherwise.

The discussion in this presentation of Universal American Financial Corp.’s financial performance includes financial measures that are not derived from generally accepted accounting principles, or GAAP. Information regarding these non-GAAP financial measures is available in our quarterly earnings press releases in the Investor Relations section of Universal American Financial Corp.’s website at www.uafc.com.

3

Rapidly Growing Senior Health Opportunity

Beneficiaries - Coverage Type MMA OpportunityU.S. Over 65 Population

35,061

40,243

54,632

71,453

0

20,000

40,000

60,000

80,000

2000 2010 2020 20305%

10%

15%

20%

25%

Age 65+ Percent of Total Population

Fastest growing demographic segment

Reducing employer-sponsored post-retirement benefits and

increasing incidence of Government-backed programs

Emplo yer Spo nso red

29%

Other2%

M edicare A dvantage

13%

M edigap23%

B o th Emplo yer

& M edigap5%

F F S Only14%

M edicaid14%

Source: Medicare Current Beneficiary Survey (MCBS) 2002 Access to Care File.

• Increased private sector role in Medicare

• Immediate increase in funding for Medicare Advantage

• Expanded managed care program options

• Prescription drug coverage –Part D

Private sector Medicare coverage opportunity expected to increase from $50 billion in 2005 to $130

billion by 2007

(in thousands)

4

Comprehensive Portfolio of Senior Market Products

Pre-MMA

Medicare Supplement/SelectSenior Acute Care and Dental

Senior Health, Long Term Care and ElderCare (non-risk)Third-Party Products – Medicare Supplement and Long Term Care

Post-MMA

Heritage Health: TexasPrivate Fee-for-Service“231” plans (special needs)

Prescription Drug Plan

Medicare Advantage

Medicare Part D

Senior Administrative Services

Senior Market Health Insurance

5

$73

$108

$145

$105

$123

58%69%

64%60%

40%

15%

12%41%

31%

36%

27%

28%

19%

$0

$20

$40

$60

$80

$100

$120

$140

$160

2002 2003 2004 YTD Q3'04

YTD Q3'05

Senior Market Health Medicare Advantage

All other products

Premier Distribution Network

Unique Distribution Capabilities Leveraging Distribution by Increasing Productivity($ in millions)

• Nationwide access via quality network of career and independent agents

– 1,700 career agents in 40 states

– 25,000 independent agents in 35 states

• Combination of distribution capabilities with strong branding initiatives

– Senior Solutions® portfolio of senior health market products

– 114 Senior Solutions® centers in 35 states

• Leveraging distribution capabilities for Medicare Advantage opportunity

New Business Written

17%

CAGR: 41%

6

Senior Market Health Insurance

Business Overview Historical Performance($ in millions)

• Medicare Supplement

– 299,000 policies

• Medicare Select

– Network of 284 hospitals in 21 states

• Part D – Prescription Drug Plan

• Other Products

– Senior Dental

– Acute Care

• Policyholder distribution

– 11% urban and 89% non-urban

$104.9

$268.1

$355.3

$264.9

$293.2

$8.6$27.7 $35.4

$24.2 $20.8

$0

$100

$200

$300

$400

2002 2003 2004 YTD Q32004

YTD Q32005 *Net Premium Income Before Taxes

* YTD Q3 ’05 includes pre-tax Part D expenses of $1.1 million

A leading Medicare Supplement/Select business with significant expansion opportunities forms the backbone of the Company’s senior market platform

7

Senior Market Health3rd Quarter Results

• Higher Medicare Supplement Loss Ratios

– 71.9% for Q3 ‘05, 290 bps above expectations

– Impacted results by $.03 per share (after-tax)

– Caused by higher-than-anticipated Part B (outpatient doctor) and SNF utilization

• Increase in Medicare Supplement Lapsation

– Non-cash Deferred Acquisition Cost write-off of $2.6 million (pre-tax), or $.03 per

share (after- tax)

– Largely caused by departure of 3 sales managers who replaced business with other

carriers

8

Medicare Advantage

Business Overview Membership

• Medicare Advantage – HMO product– 24,800 members as of December 2005 (est.)

– Physician-centric organization

– Operates eight networks in Southeast Texas

• Private Fee-for-Service product– 5,100 members as of December 2005 (est.)

– Expansion » 2005: 258 counties in 7 states

» 2006: 152 counties in 6 states

• Strong growth opportunities– Internal network expansion

– Contiguous counties and new markets

– Special Needs Products» Initial members enrolled in August 2005

Annualized Revenues

$238.9

$36.1

$172.4

$276.4

$162.8

$9.6

SNP$1.4

$0

$50

$100

$150

$200

$250

$300

Dec-04 12/30/2005EHealthplan Private FFS SNP

($ in millions)

18,82224,800

20,227

30,000

5,100

1,405

SNP100

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Dec-04 12/30/2005EHealthplan Private FFS SNP

Acquisition of Heritage created a platform from which to build a broader Medicare Advantage and Private Fee-for-Service franchise

48%

60%

9

Prescription Drug Plan(Part D)

• Potential market: 24 million beneficiaries translating into $36 billion opportunity– Includes Medigap, fee-for-service and dual eligibles

• Strategic alliance with PharmaCare, a subsidiary of CVS Inc.

– Industry leading PBM

– Preferred marketing relationship in 5,400 CVS stores

• Distribute through UAFC field force

• Filed in 32 regions

• Dual eligibles/LIS: auto-assignment

• Limited Risk Exposure– Shared risk with PharmaCare

– Risk-adjustors

– Specific stop-loss

– Government participation through risk corridors

• Estimated $11 million to be expensed in 2005 for development

10

Senior Administrative Services

Business Overview Historical Performance (1)

($ in millions)

• Third party administrative services for the senior market with industry leading clientele

• Products offered:– Outsourcing for senior insurance products

– LTC specialist – underwriting, case management

– Non-insured products – Nurse Navigator(SM)

• ElderCare competencies:– Senior specialized 24/7 customer contact center

– 1,500 geriatric care managers

– 50 on-staff RN case managers

– 5,000 LTC provider network in all 50 states

$43.2

$48.5

$56.7

$42.0$44.2

$10.5$13.1

$15.3

$11.2 $11.1

$0

$10

$20

$30

$40

$50

$60

2002 2003 2004 YTD Q3'04

YTD Q3'05*

Revenues EBITDA

Lowers operating costs and provides recurring third-party fee revenue

* YTD Q3 ’05 includes pre-tax Part D expenses of $1.3 million

1. Includes Affiliated and Non-Affiliated.

11

Insurance Product Offerings

• Limited risk, high profit fixed benefit accident and health products

• Distributed through career agency sales forces in U.S. and Canada

• Opportunity to move self-employed customers to senior products over time

$62.2

$41.1

$24.0

$57.3

$0

$15

$30

$45

$60

$75

12/2002 12/2003 12/2004 09/2005

Complementary product offering with stable profitability and strong cash flow

($ in millions)

Historical Performance

($ in millions)

Life / AnnuitySpecialty Health – Self-Employed

• Low-face amount, simplified issue senior whole life products

• Distributed through the career and independent agent channels

• Single and flexible premium deferred annuities focused on the senior and retirement markets (De-emphasized in 2004)

Annual Life Premium in Force

$130.8 $132.0

$25.6 $24.4 $26.3 $20.3 $19.2

$172.1$162.3 $174.8

$0

$40

$80

$120

$160

$200

2002 2003 2004 YTD Q3'04

YTD Q3'05Revenue Income Before Taxes

12

Proven Acquirer

Disciplined Acquisition Approach

• Acquired 11 insurance companies, 4 blocks of business and 3 administrative companies since 1991

• Increasingly focused criteria

– Strategic: Senior market

– Financial: Favorable price, optimal financing, need for accretion

– Discipline to walk away

• Efficient transaction execution

– Extensive due diligence

– Immediate and thorough integration

Recent Acquisition History

• Heritage Health Systems (May 2004)

– Entry into Medicare Advantage

– Acquired for $98 million at 4.8x run rate EBITDA

• Pyramid Life (March 2003)

– Career senior market distribution

– Acquired for $58 million at 8.6x GAAP Net Income

13

2006 Guidance

• Earnings of $1.30 to $1.38 per diluted share, excluding realized gains– excludes stock option expense of approximately $.03 per share

• Revenues of approximately $1.375 to $1.525 billion– 50% to 60% increase

Segment

Senior Market Health Insurance 400$ 425$ Part D 280 330 Senior Managed Care - Medicare Advantage 400 460 Specialty Health Insurance 170 180 Life Insurance and Annuity 95 105 Senior Administrative Services 75 85 Corporate/Eliminations (45) (60)

Total Revenue 1,375$ 1,525$

($ in millions)Revenue Range

14

2006 Guidance(continued)

• Medicare Advantage– Projected 2006 net new enrollment

» HMO Plans: 11,000» PFFS: 6,500

– Gross additions of approx 4,050 members in December for January 2006 enrollment» Includes HMO Plans: 2,350, PFFS: 1,700» Excludes lapsation

– EOY 2006: 47,500 total members• Part D

– Enrollment of approximately 525,000 members by 2006 year-end» As of January 6, 440,000 members enrolled, including 350,000 auto-enrollees

– Projected profits of approximately 4% of Part D net premium» Significant operational and financial risks, as previously disclosed

• Medicare Supplement – Loss Ratio:

» 2006 projected loss ratio between 71.0% and 72.0%» 4th quarter 2005 loss ratio of approximately 71.7%

– Lapsation» 2006 projected lapsation consistent with recent 2005 experience » 4th quarter 2005 consistent with 3rd quarter 2005

15

Management Team

Richard Barasch Chairman & Chief Executive Officer 24 17

Gary Bryant Chief Operating Officer 25 21

Robert Waegelein Chief Financial Officer 21 15

Ted Carpenter CEO of Heritage Health Systems, Inc. 38 5

Gary Jacobs President of CHCS Services, Inc. 26 9

Jason Israel COO of CHCS Services, Inc. 26 3

Neil Lund Chief Actuary 31 4

Fred Rook Chief Information Officer 22 2

Lisa Spivack General Counsel - Corporate 11 1

William Cushman VP, Financial Reporting 17 6

Name PositionYears inIndustry

Years withUHCO

16

Financial Highlights

17

Building Shareholder Value

Total Revenue (1) Senior Health Lives

20

253

312335

305315

27332

0

100

200

300

400

500

12/2002 12/2003 12/2004 09/2005

Senior Market Health Lives Medicare Advantage Lives

(in thousands)

$337

$521

$725

$520

$686

$0

$100

$200

$300

$400

$500

$600

$700

$800

2002 2003 2004 YTD Q3'04

YTD Q3'05Total Revenue

(in millions)

CAGR: 47%32%

Robust revenue growth and solid senior membership base

1. Excludes Realized Gains / Losses.

18

Building Shareholder Value

Net Income (1) and ROE (1) Earnings Per Share (1)

(in millions)

$33

$42

$57

$40

$46

13.9%

14.8%

16.6% 16.3%

14.2%

$0

$10

$20

$30

$40

$50

$60

2002 2003 2004 YTD Q3'04

YTD Q3'05 *

11.0%

12.0%

13.0%

14.0%

15.0%

16.0%

17.0%

Net Income ROE

$0.62

$0.76

$1.01

$0.72$0.78

$0.00

$0.20

$0.40

$0.60

$0.80

$1.00

$1.20

2002 2003 2004 YTD Q3'04

YTD Q3'05*

CAGR: 28%

8%

Strong profitability and earnings growth

1. Excludes Realized Gains/ Losses.

* YTD Q3 ’05 includes after-tax Part D expenses of $1.2 million, or $.02 per share

19

Business Mix

($ in millions)

RevenueSenior Market Health Insurance 106.9$ 29% 271.6$ 49% 360.3$ 47% 296.9$ 41%Senior Managed Care - Medicare Advantage - - - - 93.5 12% 173.8 24%

Total Senior Health Products 106.9$ 29% 271.6 49% 453.9 59% 470.7 66%

Senior Administrative Services 43.2 12% 48.5 9% 56.7 7% 44.2 6%

Total Senior Business 150.1$ 41% 320.2 57% 510.5 66% 514.9 72%

Specialty Health Insurance 162.3 44% 172.1 31% 174.8 23% 132.0 18%Life Insurance and Annuities 56.8 15% 67.1 12% 84.5 11% 71.1 10%

Total Segment Revenue 369.3$ 100% 559.4$ 100% 769.8$ 100% 718.0$ 100%

Income Before TaxesSenior Market Health Insurance 8.6$ 15% 27.7$ 37% 35.4$ 36% 20.8$ 25%Senior Managed Care - Medicare Advantage - - - - 10.1 10% 21.6 26%

Total Senior Health Products 8.6$ 15% 27.7 37% 45.5 46% 42.4 51%

Senior Administrative Services 7.6 14% 11.0 15% 13.1 13% 9.5 11%

Total Senior Business 16.2$ 29% 38.8 52% 58.6 60% 51.9 63%

Specialty Health Insurance 25.6 46% 24.4 33% 26.3 27% 19.2 23%Life Insurance and Annuities 14.2 25% 12.0 16% 13.4 14% 11.7 14%

Total Segment Income Before Taxes 56.0$ 100% 75.2$ 100% 98.3$ 100% 82.9$ 100%

YTD Q320052002 2003 2004

FY FY FY

Increasing focus on senior health

20

Strong Balance Sheet

($ in millions) 12/31/04 03/31/05 06/30/05 09/30/05

AssetsCash & investments 1,378.3$ 1,382.3$ 1,466.6$ 1,562.2$ DAC 208.3 227.5 241.6 261.7 Intangible assets 136.0 134.3 127.6 125.7 Reinsurance balances 212.5 213.9 208.2 230.9 Other assets 82.0 89.5 93.4 91.8

Total Assets 2,017.1$ 2,047.5$ 2,137.3$ 2,272.3$ Liabilities & Equity

Policy and other liabilities 1,421.6$ 1,440.9$ 1,450.4$ 1,560.8$ Bank debt 101.1 99.8 98.4 97.1 Trust preferred securities 75.0 75.0 75.0 75.0

Total Liabilities 1,597.7$ 1,615.6$ 1,623.9$ 1,733.0$ Equity ex. AOCI 378.4$ 399.2$ 464.5$ 497.7$ AOCI 41.0 32.7 48.9 41.7

Total Equity 419.4$ 431.9$ 513.5$ 539.4$ - - - -

Total Liabilities & Equity 2,017.1$ 2,047.5$ 2,137.3$ 2,272.3$ - - - -

DAC to Equity 49.7% 52.7% 47.0% 48.5%Intangible Assets to Equity 32.4% 31.1% 24.8% 23.3%Debt / Total Capitalization [1] 18.2% 17.4% 15.4% 14.5%Debt + Trust Preferred / Total Capitalization [1] 31.8% 30.4% 27.2% 25.7%

[1] Total Capitalization = Debt + Trust preferred securities + Equity ex. AOCI

21

Ownership Profile

Shares% of Total

(in millions)

Capital Z 20.3 32.5%Institutional and Retail 34.0 54.5%Management and Directors 8.1 13.0%

Total 62.3 100.0%

Note: Based on fully diluted shares outstanding

As of 09/30/2005

22

Investment Highlights

• Leader in rapidly growing senior health market

• Comprehensive suite of products for the senior health market

• Premier national distribution network

• Leading Third Party Administrator with best-in-class execution capabilities

• Proven acquirer with a track record of successful integrations

• Experienced management team

• Robust growth outlook with multiple drivers

For more information, please contact:Investor Relations

(914) 934-5200-or-

Visit our website atwww.UAFC.com