New Individual Exchange plans are coming soon

See what’s new in 2022

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UnitedHealthcare Individual Exchange plans offer more options

See what’s new in 2022

Explore now

New Individual Exchange plans are coming soon

See what’s new in 2022

Explore now

UnitedHealthcare Individual Exchange plans offer more options

See what’s new in 2022

Explore now

Claims and Payments

Eligibility and Benefits

Policies and Protocols

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Latest UnitedHealthcare Provider News

New clinical pharmacist-led medication optimization program

Last Modified | 10.27.2021

UnitedHealthcare is excited to introduce our Comprehensive Medication Management (CMM) program, a patient-centered, interactive review of current medications that may include prescription and non-prescription medications, as well as herbal supplements.

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09/2021: Texas: Maternal level-of-care reimbursement

Last Modified | 10.22.2021

Effective Dec. 1, 2021, we will reimburse maternal services for Medicaid members to hospitals that align with the level-of-care designations assigned by the Texas Health and Human Services Commission (HHSC).

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09/2021: Tufts Freedom Health Plan policy update

Last Modified | 10.22.2021

Tufts Health Freedom Plan policy update for Massachusetts, Maine, New Hampshire, Vermont and Rhode Island.

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09/2021: Southeast and Central: Medical PRAs won’t be mailed after November

Last Modified | 10.22.2021

Starting Dec. 10, 2021, UnitedHealthcare provider remittance advice (PRAs) for medical claims will no longer be mailed to in-network providers and facilities in the following states: ND, SD, NE, KS, OK, TX, MN, IA, MO, AR, LA, WI, IL, MI, IN, OH, KY, TN, NC, SC, MS, AL, GA, FL. View in the portal, through Optum Pay or EDI.

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09/2021: States Added to Medical Review for Self-administered Drugs

Last Modified | 10.22.2021

UnitedHealthcare® Commercial plans add eleven states to medical review process for self-administered drugs that should be billed through the member pharmacy benefit.

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