Welcome to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans.
Here, you can access a variety of resources to help you work with us as you care for members who have these state-specific plans.
Interactive guide
Access this self-paced guide for everything you need to know about our Individual Exchange plans
Quick reference guide
Get answers about working with the plans in our quick reference guide
Actions you can take in the Provider Portal
Verify your participation
Check if you’re in-network for an Individual Exchange plan
Update patient information
Provide accurate patient information to help make claims processing faster
Submit a referral
Refer your patients to a specialist within minutes
Submit or check claims
Review a claim’s status or send us a new claim with ease
Check eligibility
Confirm patient eligibility and review information about their benefits
Helpful links
Prior Authorization
- Advance Notification and Clinical Submission Requirements
- To access the Prior Authorization Request Form, select your state below
- Cardiology Prior Authorization and Notification
- Radiology Prior Authorization and Notification
State-specific plan information
Rocky Mountain Health Plans administers Colorado Individual Exchange plans
Individual Exchange plans will be available in Kansas effective Jan. 1, 2023.
Maryland Health Connection administers Maryland Individual Exchange Plans
UnitedHealthcare Navigate® administers Massachusetts Individual Exchange plans.
Massachusetts Navigate Quick Reference Guide
Massachusetts Navigate Frequently Asked Questions
Massachusetts Prior Authorization Form for Prescription Benefits
Individual Exchange plans will be available in Mississippi effective Jan. 1, 2023.
Mississippi Prescription Drug List (PDL)
Mississippi Prior Authorization Form for Prescription Benefits
Individual Exchange plans will be available in Missouri effective Jan. 1, 2023.
Sierra Health and Life administers Nevada Individual Exchange plans.
UnitedHealthcare Compass administers New York Individual Exchange plans.
New York Compass Quick Reference Guide
Individual Exchange plans will be available in Ohio effective Jan. 1, 2023.
Washington Healthplan Finder administers Washington Individual Exchange Plans
Washington Prescription Drug List (PDL)
Washington Prior Authorization Form for Prescription Benefits
