Find information regarding the response to recent storms at UHCprovider.com/disaster.
The following Commercial Health Plans are offered in Georgia. Open the section below to view more information.
The All Savers® Alternate Funding Plans are self-funded health plans that can help employees pay everyday health care expenses before they meet their deductible. Employers can also purchase UnitedHealthcare dental and vision plans and fully insured group life insurance.
Members with All Savers Plans have access to the UnitedHealthcare® Choice, UnitedHealthcare Choice Plus and UnitedHealthcare Core networks with the exception of Mayo Clinic facilities.
All Savers Insurance Company (ASIC) is a UnitedHealthcare company.
To check member eligibility and claims status for a patient enrolled in an All Savers Plan, go to provider-allsavers.optum.com/.
The Heritage and UnitedHealthcare of the River Valley family of health plans allow members to go to any network provider. The member will pay two different copayment amounts based on the services received.
There is out-of-network coverage for emergency services only.
Surest is a UnitedHealthcare company that administers health plans without deductibles or coinsurance. Members have access to the nationwide UnitedHealthcare and Optum® Behavioral Health networks and can check costs and care options in advance.
If you participate in UnitedHealthcare commercial plans, you automatically participate in Surest benefit plans at the existing commercial reimbursement rates per your participation agreement.
A small number of members have the Surest Flex plan, which includes the feature of flexible coverage. For a fixed list of plannable tests, procedures or treatments, the member must activate coverage at least 3 business days in advance of the service, or the member may not have coverage for the service.
Claims: Please send claims to us electronically using Surest Payer ID 25463 or by mail to Surest, P.O. Box 211758, Eagan, MN 55121. Include the subscriber ID and rendering address on the claim to help us confirm the copay/member price. Check the status of your claims in the UnitedHealthcare Provider Portal.
Eligibility and benefits: To check member eligibility and benefits, visit the provider portal or call Surest Provider Services at 844-368-6661. If you’re requesting information about a dependent, we’ll need the subscriber ID.
Variable copays: You can receive variable copay information through electronic data interchange (EDI) 270/1 transaction responses. For more information, see the 270/271 EDI Surest guide and Digital Solutions page.
For more information, please visit UHCprovider.com/surest.
The UnitedHealthcare Choice and Choice Plus health plans allow members to choose a physician or specialist from the UnitedHealthcare Choice networks but do not need a referral to receive benefits.
Preventive care, including immunizations and preventive exams and health screenings, is covered at 100 percent in our UnitedHealthcare Choice and UnitedHealthcare Choice Plus networks.
UnitedHealthcare Choice Advanced health plans allow members to choose a physician or specialist in the UnitedHealthcare Choice networks and do not need a primary care physician or referral to receive benefits. There is out-of-network coverage for emergency services only.
UnitedHealthcare Choice Advanced members have lower copays and/or greater coinsurance when they use Tier 1 UnitedHealth Premium® Care Physicians.
UnitedHealthcare Choice Advanced and UnitedHealthcare Choice Advanced Plus build on Choice and Choice Plus plans with additional features for both members and employers.
UnitedHealthcare Core health plans allow members to choose a network physician or specialist without a referral (open access). The UnitedHealthcare Core network is narrowed in some states.
An array of health and wellness resources are available to members including the Online Health Assessment, Personal Health Record and Online Health Coaching modules.
UnitedHealthcare EDGE health plans allow members to choose a network physician or specialist but don’t need a referral (open-access).
Some UnitedHealthcare EDGE plans provide access to network and non-network care providers so members can seek care from any care provider they choose, but at a lower co-insurance/deductible level for network care providers.
By seeking care from Tier 1 care providers, members can maximize their in-network benefits based on UnitedHealthcare’s evaluation.
UnitedHealthcare EDGE plans provide medication benefit coverage through a four-tier pharmacy plan. UnitedHealthcare EDGE plans include health and wellness programs, services and discounts from UnitedHealth Wellness®.
The UnitedHealthcare Navigate health plans encourage members to use their primary care provider (PCP) to coordinate care across a wide spectrum of health services and enter electronic referrals to network specialists. The UnitedHealthcare Navigate network is narrowed in some states.
Changes to PCP selection are permitted once per month. Changes submitted on or before the 31st of the month will be effective on the first day of the following month.
The UnitedHealthcare NexusACO suite of products offers cost-saving opportunities to members when they seek care providers from a select group of Accountable Care Organizations (ACO) nationwide. There is out-of-network coverage for emergency services only.
All UnitedHealthcare NexusACO members are required to select a primary care provider (PCP) within the network to provide their preventive care, treat chronic conditions, manage medications and enter specialist referrals.
Changes to PCP selection are permitted once per month. Changes submitted on or before the 31st of the month will be effective on the first day of the following month.
UnitedHealthcare Options PPO health plans allow members to choose a network physician or specialist without a referral (open-access).
UnitedHealthcare Options PPO offers two levels of coverage: a higher level of benefits for in-network services, and a lower level of benefits for non-network services, with somewhat higher deductibles and coinsurance.