Do you have a United Healthcare ACA individual health plan with a network that requires a PCP (Primary Care Provider)??
Here are 3 helpful tips:
See the PCP first:
Your PCP is the main doctor who takes care of you – the one who coordinates care and makes referrals to specialists, if needed.
You need to see your PCP even if you are undergoing treatment with a different doctor or specialist today.
The PCP will need to make a referral to continue treatment.
Remember: if you get care from a doctor, hospital or clinic outside the network, care will not be covered, and you'll have to pay the full cost.
Get a referral to see a network specialist:
When a PCP determines care from a specialist is needed, the PCP must submit a referral. A referral is a note sent electronically from the PCP to UnitedHealthcare. If you are On-Exchange (meaning you are getting a subsidy from Healthcare.gov), you can see the electronic referrals from your PCP on www.myuhc.com under the Physicians & Facilities tab ( If you are an Off-Exchange clients you can view referrals on www.MyUHOne.com).
Remember: If care is received without a referral on file, it will not be covered, and you will have to pay the full cost. So it is important to see their PCP first.
Of course, no referral is needed for emergency care, and your client can go to any facility.
Need to change PCP?
Here's how:
The front of your health plan ID card shows the name of your PCP. If you did not pick a doctor when you enrolled, UHC matched you with one in your area.
If you want to change your PCP: Your insurance broker, Dave Trout can request the change or you can make the change on your own.
–On-Exchange clients can visit www.myuhc.com and select "Find a network doctor or hospital" to search for a provider.
Then you can make the change online, or call the toll-free member phone number on their ID card.
–Off-Exchange clients can visit www.myuhone.com and select "Find A Doctor" to search for a provider.
Then you can call the toll-free customer service phone number on your ID card to make the change.
When changing a PCP, keep in mind that the change will not be immediate.
The effective date for a PCP change is similar to effective dates for ACA plans:
Changes made on or before the 15th of the month will apply the first of the following month.Changes made after the 15th will apply the first of the second month following the request.
Work with your PCP to take advantage of your plan's network savings and find the best care!
Here are 3 helpful tips:
See the PCP first:
Your PCP is the main doctor who takes care of you – the one who coordinates care and makes referrals to specialists, if needed.
You need to see your PCP even if you are undergoing treatment with a different doctor or specialist today.
The PCP will need to make a referral to continue treatment.
Remember: if you get care from a doctor, hospital or clinic outside the network, care will not be covered, and you'll have to pay the full cost.
Get a referral to see a network specialist:
When a PCP determines care from a specialist is needed, the PCP must submit a referral. A referral is a note sent electronically from the PCP to UnitedHealthcare. If you are On-Exchange (meaning you are getting a subsidy from Healthcare.gov), you can see the electronic referrals from your PCP on www.myuhc.com under the Physicians & Facilities tab ( If you are an Off-Exchange clients you can view referrals on www.MyUHOne.com).
Remember: If care is received without a referral on file, it will not be covered, and you will have to pay the full cost. So it is important to see their PCP first.
Of course, no referral is needed for emergency care, and your client can go to any facility.
Need to change PCP?
Here's how:
The front of your health plan ID card shows the name of your PCP. If you did not pick a doctor when you enrolled, UHC matched you with one in your area.
If you want to change your PCP: Your insurance broker, Dave Trout can request the change or you can make the change on your own.
–On-Exchange clients can visit www.myuhc.com and select "Find a network doctor or hospital" to search for a provider.
Then you can make the change online, or call the toll-free member phone number on their ID card.
–Off-Exchange clients can visit www.myuhone.com and select "Find A Doctor" to search for a provider.
Then you can call the toll-free customer service phone number on your ID card to make the change.
When changing a PCP, keep in mind that the change will not be immediate.
The effective date for a PCP change is similar to effective dates for ACA plans:
Changes made on or before the 15th of the month will apply the first of the following month.Changes made after the 15th will apply the first of the second month following the request.
Work with your PCP to take advantage of your plan's network savings and find the best care!
