UnitedHealthcare benefit plans for exchanges - Chapter 4, 2021 UnitedHealthcare Administrative Guide

Plan Names:

  • Value Gold
  • Value Plus Silver
  • Value Silver
  • Value Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Value Gold
  • Balance Gold
  • Value Silver
  • Balance Silver
  • Value Bronze
  • Balance Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Balance Gold
  • Balance Plus Silver
  • Balance Silver
  • Value Silver
  • Balance Bronze
  • Value Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Value Gold
  • Value Silver
  • Balance Plus Silver
  • Balance Bronze
  • Value Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Value Gold 
  • Balance Plus Silver
  • Balance Silver
  • Value Silver
  • Value Bronze
  • Saver Balance Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Value Gold
  • Balance Silver
  • Balance Plus Silver
  • Value Silver
  • Balance Bronze
  • Value Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

Plan Names:

  • Cascade Select Gold
  • Cascade Select Silver
  • Cascade Select Bronze

PCP Required: Yes

Referral Required: Yes, for the member to have coverage

Prior Auth Required: Yes

Out-of-Network / Area Coverage: No*

*Except for emergency services and related authorized admissions.