United Healthcare Choice Plus

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.

Plan Summaries

Accessing Care

In-Network: This level of benefits applies when you use a physician, specialist or other provider who is a member of the UnitedHealthcare Choice Plus network. By utilizing in-network providers, you will pay lower copayments, deductibles and coinsurance than you will using out-of-network providers. There is no penalty for seeking specialist care without a referral.

Out-of-Network: This level of benefits applies when you use a provider who is not a member of the UnitedHealthcare Choice Plus network. You will still be covered under the plan, but you will pay higher copayments, deductibles and coinsurance than you would by using Choice Plus providers. In addition, you are responsible for any amounts that exceed 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 at the time of service and file a claim with UHC 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. In addition to filling prescriptions at CVS retail locations, you can utilize 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 UnitedHealthcare on your behalf. UHC 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 UHC 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).