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We offer a variety of low-cost plans for individuals and families to help them get and stay healthy. Our plans cover adults, children, people with disabilities and those who are expecting.
A monthly notice of recently approved and/or revised Medical Policies and Medical Benefit Drug Policies is provided below for your review. We publish a new announcement on the first calendar day of every month.
The appearance of a health service (e.g., test, drug, device, or procedure) in the Medical Policy Update Bulletin does not imply that UnitedHealthcare provides coverage for the health service. In the event of an inconsistency or conflict between the information provided in the Medical Policy Update Bulletin and the posted policy, the provisions of the posted policy will prevail.
Last Published 05.01.2025
Last Published 06.01.2025
Last Published 07.01.2025
Last Published 07.01.2025
Become part of a network of health care professionals and facilities committed to helping people live healthier lives and making the health care system better for everyone. Select the appropriate service line below for instructions. If you don’t see your specialty, please choose other.
NexusACO Referral Requirements Quick Reference Guide
The UnitedHealthcare NexusACO benefit plans offer UnitedHealthcare commercial members a tailored network of accountable care organization (ACO) care providers. In areas where UnitedHealthcare NexusACO doesn’t have a featured ACO, UnitedHealth Premium® Program designated providers will be included as participating Tier 1 care providers.
Charter, Navigate and Navigate Now Referral Requirement Quick Reference Guide
UnitedHealthcare® Charter, Navigate and NavigateNOW benefit plans offer UnitedHealthcare commercial members a customized, more-focused network of healthcare professionals. Some plans require referrals.
Important Concepts in Integration: Coordination of Care
Members may receive services from more than one practitioner. Coordination of Care among practitioners is a best practice, as well as a vital contribution to integrating a member’s physical and behavioral health needs.
Home Health and SNF High-Performing Provider Initiative Lists
High-Performing Skilled Nursing Facility and Home Health Provider Initiative Lists
Each United Commercial HMO provider group must receive the provider group's AMP Commercial HMO performance report which shows provider's eligibility for incentive, performance in four appropriate resource use metrics, incentive calculation, and incentive amounts.
Each United Commercial HMO provider group must receive the provider group's AMP Commercial HMO.
Each United Commercial HMO provider group must receive the provider group's AMP Commercial HMO performance report which shows provider's eligibility for incentive, performance in four appropriate resource.
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Home and community support services are resources that provide care in individual homes and throughout communities as well as some Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, including:
Each United Commercial HMO provider group must receive the provider group's AMP Commercial HMO performance report which shows provider's eligibility for incentive, performance in four appropriate resource use metrics, incentive calculation, and incentive amounts (if achieved) the provider group can anticipate receiving by 2/28/23.
| Required documentation |
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| If your request is declined |
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| If your credentialing is approved, your request will remain on file for a period of 1 year. We will reach out to you if our network needs change. You may submit another request 1 year from the date we declined your request. |
July 17, 2025
Review the latest UnitedHealthcare prior authorization, medical policy, pharmacy, reimbursement, laboratory and policy and protocol updates.
July 14, 2025
UnitedHealthcare Community Plan of New Jersey health care professionals are urged to check the NJPMP database before prescribing medication.
July 03, 2025
Sign up annually during the enrollment period to be eligible for the Attendant Compensation Enhancement Program (ACEP).
June 25, 2025
The Division of Medicaid will offer free training to provide information related to Medicaid and managed care programs.
June 18, 2025
Certain CPT codes associated with pharmacogenetic testing will no longer be covered or require prior authorization.
May 20, 2025
Help patients and other health care professionals find your practice faster by updating your demographic data.
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AARP Medicare Advantage from UHC plans cover features and benefits in addition to those included in Original Medicare. Members in some areas may have different plans from which to choose. The plans often include an integrated Medicare Part D prescription drug benefit.
State |
2nd language |
3rd language |
4th language |
5th language |
6th language |
7th language |
|---|---|---|---|---|---|---|
Arizona |
Spanish |
Vietnamese |
Arabic |
Chinese |
Persian |
- |
Florida |
Spanish |
Creole |
- |
- |
- |
- |
Hawaii |
Chinese |
Ilocano (Filipino) |
Korean |
Vietnamese |
Tagalog |
- |
Indiana |
Spanish |
- |
- |
- |
- |
- |
Kansas |
Spanish |
- |
- |
- |
- |
- |
Kentucky |
Spanish |
- |
- |
- |
- |
- |
Louisiana |
Spanish |
Vietnamese |
Arabic |
- |
- |
- |
Maryland |
Spanish |
Vietnamese |
- |
- |
- |
- |
Michigan |
Arabic |
Spanish |
Bengali |
- |
- |
- |
| Minnesota | Spanish |
Hmong |
Karen |
Somali |
- | - |
Mississippi |
Spanish |
- |
- |
- |
- |
|
Missouri |
Spanish |
- |
- |
- |
- |
- |
Nebraska |
Spanish |
Arabic |
Vietnamese |
- |
- |
- |
New Jersey |
Spanish |
Korean |
Arabic |
- |
- |
- |
New York |
Spanish |
Chinese |
Russian |
Korean |
French |
Haida |
| North Carolina | Spanish |
Arabic |
Russian | Vietnamese | - | - |
Ohio |
Spanish |
Nepali |
Arabic |
Somali |
Swahili |
Burmese |
Pennsylvania |
Spanish |
Arabic |
Cambodian |
Russian |
- |
- |
Rhode Island |
Spanish |
Portuguese |
- |
- |
- |
- |
Tennessee |
Spanish |
- |
- |
- |
- |
|
Texas |
Spanish |
Vietnamese |
- |
- |
- |
- |
Virginia |
Spanish |
Arabic |
Vietnamese |
Amharic |
Persian |
Urdu |
Washington |
Spanish |
Russian |
Vietnamese |
Ukrainian |
Chinese |
Korean |
Wisconsin |
Spanish |
Hmong |
Arabic |
Burmese |
Somali |
Chinese |
To learn more about the Medicare Advantage plans offered in your area, visit UHC.com/medicare and enter your ZIP code.
To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on the Plan Information and Forms page of UHC.com/medicare.
What matters most to you? Managing time? Saving money? Simplifying workflow? Whatever your priority, we offer a variety of digital solutions that can help you complete your tasks quicker and more efficiently.
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