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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!


Trout Insurance Services

Monday-Friday
8:30am-6pm & by Appointment


​Visit: 29 N Main St
Weaverville, NC 28787
     
Mail: PO Box 1414     
Weaverville, NC 28787  
Ph: 828.279.4681

Fax: 1.888.221.4842
​
contact@troutinsurance.com
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Trout Insurance is a Full Service Independent Insurance Agency Based in WNC. 
Stay current with relevant insurance news. Newsletters usually send out about 1-2 times per month. We will never share your address. ​ 

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  • Coverage
    • Home & Auto Insurance
    • ACA-2021
    • Health Insurance 2021
    • Medicare
    • AARP - Hartford
    • Life Insurance
    • Income Protection >
      • Disability Insurance
      • Long-Term Care
      • Critical Illness
      • Annuities
    • Dental, Vision, Accident
    • Health Insurance 2020
    • Employee Benefits
    • Business Owners >
      • Employee Benefits
      • Group Health Insurance
      • Commercial Property & Liability
      • Business Overhead Expense Disability
      • Disability for Business Owners
      • Critical Illness
    • Short Term Health
  • About Us
    • Our Story
    • Dave Trout >
      • DT Landing
    • Jessica Cody >
      • JC Landing
    • Jeremy Sheridan >
      • JS Landing
    • Jennifer Trout
    • Jan Trout
    • John Phillips >
      • JP Landing
    • Steve Dillingham
  • Reviews
  • Resources
    • Insurance Partners
    • Lost Subsidy
    • 2019 Verification-a
    • Renewal 2020
    • Privacy Policy
    • BCBS Online Setup
    • APTC Income 2021 & Tax Form 1040
  • Community
    • Music on Main
    • Manna Fundraiser
    • Western Women's Business Center Conference
    • Mural on Main Street
    • Expanded Team- Next Generation
    • Back to School
    • Weaverology
  • Blog
  • Contact Us