How Can I Find Healthcare Providers Who Accept UnitedHealthcare Medicare Plans?
This article was updated on: 08/27/2017
You may be familiar with Medicare Health Maintenance Organization (HMO) plans; they usually require you to get your care from a network provider or fill your prescriptions within the plan’s pharmacy network. UnitedHealthcare offers a variety of Medicare health plans. Here’s what you need to know about finding and using providers in a UnitedHealthcare Medicare plan network.
Why does UnitedHealthcare Medicare use a provider network?
Private insurance companies like UnitedHealthcare that are contracted with Medicare to provide benefits look for ways to control costs to keep benefits affordable for their enrollees. They negotiate low payment rates with network providers for Medicare covered services; in some cases, these rates are lower than the providers would charge you if you weren’t covered by United Healthcare Medicare plans.
UnitedHealthcare Medicare Preferred Provider Organizations (PPOs) may encourage you to use these network providers by offering lower copayments, coinsurance amounts, and/or deductibles if you get your health care within the network. HMOs might require you to use network providers only (except for medically necessary emergency care).*
Your UnitedHealthcare Medicare plans provider network might include primary care providers, medical and surgical specialists, pharmacists, hospitals, outpatient facilities, labs, and/or imaging centers. Depending on the plan you choose, you may even have dental, vision, and hearing care providers in your plan network.
How do I find providers in the UnitedHealthcare Medicare plans network?
One of the easiest ways to find providers in your plan network if you’re already a UHC member is to register for a free UnitedHealthcare “” account through the member portal and use the online tools to search for providers. You’ll need your plan ID card to register.
If you aren’t registered, or are searching for providers as part of your research before enrolling in a plan, you can use the search tool on the UnitedHealthcare website.
If you are looking for a pharmacist in your UnitedHealthcare Medicare Advantage or Medicare Part D Prescription Drug Plan network, that’s easy, too — you can use the .
What happens if I don’t use a UnitedHealthcare Medicare network provider?
Using network providers may save you money. Your UnitedHealthcare Medicare network provider typically must accept your copayment or coinsurance amount as payment in full for your share of your medical care. If you go out-of-network for your health care, you may be billed the full cost of your care, or your plan may pay a smaller percentage toward your Medicare covered services.
Choosing a network provider may also save you time. In some cases, you may be required to get prior authorization from your plan before it will cover out-of-network care.
Check out the UnitedHealthcare profile page to get a glimpse into the company and its various coverage options. To compare Medicare plan options right now, click the Find Plans button on this page. To speak with a licensed insurance agent, call 1-844-847-2659, TTY users 711; Monday through Friday, 8AM to 8PM ET.
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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