United Healthcare Choice Plus
Visit UHC’s COVID-19 Resource Center (new window)
You will have $0 cost-share (copayments, deductibles or co-insurance) on FDA-authorized COVID-19 vaccines as noted below, no matter where you get the vaccine and including when 2 doses are required. In fact, you shouldn’t receive a bill for the FDA-authorized COVID-19 vaccine.
· Plans through Employers and Individual health plans, including Student Resources, Short Term Limited Liability and Exchange plans: Members will have $0 cost-share at both in-network and out-of-network providers through the national public health emergency period.
· Medicare plans: Members will have $0 cost-share at both in-network and out-of-network providers through Dec. 31, 2021.
· For Medicaid members in UnitedHealthcare Community Plans: Members will have $0 cost-share for both in-network and out-of-network providers through the national public health emergency period. State variations and regulations may apply during this time. Please review the UnitedHealthcare Community Plan website and your state’s site for the latest information. If no state-specific guidance is available, UnitedHealthcare plan guidelines will apply.
If you get the COVID-19 vaccine during a regular office visit, your visit will be covered according to your plan benefits.
Be sure to follow the vaccination instructions, which you will receive when you get the vaccine. Current FDA-authorized COVID-19 vaccines require a second dose. You will need to get both doses in the required time frame to have protection from COVID-19. To help slow the spread of the disease, it’s important you continue to wear a face mask, physically distance from those who don’t live with you and wash your hands regularly.
Please visit https://www.uhc.com/health-and-wellness/health-topics/covid-19/vaccine (new window) for the most up-to-date information regarding COVID-19.
The United Healthcare (UHC) Choice Plus plan is a PPO plan that allows you to see any doctor in their network – including specialists – without a referral. United Healthcare has a national network of providers; however, you may use any licensed provider you choose.
There are two levels of coverage under the plan. Your level of coverage is determined each time you receive care, depending on whether you use a network or non-network provider. Your out-of-pocket costs under both levels of coverage may include office visit copayments, deductibles and coinsurance.
- Medical Plan Summary (new window) (2020)
- Medical Plan Summary (new window) (2021)
- Summary of Benefits and Coverage (new window)
- Medical Plan Summary for those living outside U.S. (new window) (2020)
- Medical Plan Summary for those living outside U.S. (new window) (2021)
- Summary of Benefits and Coverage for those living outside U.S.
- Pharmacy Benefit Summary – CVS Caremark (new window) (2020)
- Pharmacy Benefit Summary – CVS Caremark (new window) (2021)
- Participating CVS Caremark Pharmacy Locator Tool
In-Network: This level of benefits applies when you use a physician, specialist or other provider who is a member of the United HealthCare Choice Plus network. By utilizing In-Network providers, you will pay lower copayments, deductibles and coinsurance than you will using Out-of-Network providers. Please note that there is no penalty for seeking specialist care without a referral, thus providing more freedom and easier access to care.
Out-of-Network:This level of benefits applies when you use a provider who is not a member of the United HealthCare Choice Plus network. You will be covered, but you will pay higher copayments, deductibles, and coinsurance than you will using In-Network providers. In addition, you are responsible for any amounts incurred in excess of the “covered charges”. “Covered charges” are pre-determined usual, customary and reasonable charges for a particular service. Covered charges may vary from one geographical area to another. Additionally, Out-of-Network providers may require you to pay for services at the time of service and you will have to file a claim with the Plan in order to be reimbursed.
Finding a Doctor
The United Healthcare Choice Plus network is a national network of providers. To locate a medical provider, go to UHC’s on-line directory, or contact UHC member services by phone at 1-888-332-8885.
Mental Health/Substance Abuse
The Plan provides inpatient, intermediate and outpatient care. There is a network of United providers (United Behavioral Health), but you may go to any provider. Benefits are paid differently, depending on whether you use network or non-network providers. Please note that out-of-network benefits will be paid according to predetermined covered charges and you will be responsible for remaining balances.
Prescription Drug Plan
Participants in the United Healthcare Choice Plus plan will also be enrolled in a prescription drug plan insured by CVS Caremark. You will receive two ID cards – one for medical services from UnitedHealthcare and one for prescription drug coverage from CVS Caremark. You can fill prescriptions at CVS retail locations or at the more than 68,000 network pharmacies including independent and chain locations.
Find a participating network pharmacy using the CVS Caremark Pharmacy Locator. Participating pharmacies include CVS, Rite Aid, Walgreens, Safeway, Giant, Harris Teeter and many more.
Filing a Claim
When you use a network provider, that provider will submit your claim to United Healthcare on your behalf. United will pay the provider as determined by plan rules and send you an Explanation of Benefits (EOB) which details for you the total amount billed by the provider, the amount that United paid, and the amount for which you are liable. Your provider will send you an invoice for the amount for which you are liable (if any).
When you use a non-network provider, your provider may require you to pay the full bill at the time the service is rendered. You should then submit a copy of your invoice to United Healthcare, along with a claim form. United will reimburse your for any amount determined to be payable by the Plan.