UnitedHealthcare Nursing Home Plans are Institutional Special Needs Plans (ISNPs) that provide individualized, closely monitored care to members who reside in contracted nursing homes. These plans help coordinate care through Optum nurse practitioners and physician assistants on behalf of UnitedHealthcare. UnitedHealthcare Nursing Home Plans do not require referrals for specialty care.
Health Maintenance Organization (HMO) plans have a defined network of contracted physicians and hospitals to provide member care. Generally, members must use these providers to receive benefits for covered services, except in emergencies.
Point of Service (HMO-POS) plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost.
Preferred Provider Organization (PPO) plans offer members access to a network of contracted physicians and hospitals, but also allow them the flexibility to seek covered services from outside of the contracted network, usually at a higher cost.
UnitedHealthcare offers Medicare Advantage Special Needs Plans (SNPs) that combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional benefits and services designed to meet the unique needs of identified Medicare consumer populations.
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.
UnitedHealthcare provides Special Needs Plan (SNP) care providers access to SNP beneficiaries' Health Risk Assessments (HRAs) and Individualized Care Plans (ICPs) in a variety of ways including mailing, faxing, uploading to the portal or placing Individualized Care Plans in the SNP beneficiary's physical and/or electronic chart.
Care providers should be reviewing the SNP beneficiary's Individualized Care Plans and participating with the SNP Interdisciplinary Care Team to coordinate the beneficiary's care. Special Needs Plan care providers can register online at UHCprovider.com to begin accessing and reviewing SNP beneficiary Individualized Care Plans via the Care Conductor tool under Clinical & Pharmacy in the menu > Clinical Tools.