UnitedHealthcare Tiered Benefit plans are built on traditional UnitedHealthcare health plans and include additional features that can help both members and employers save money.
UnitedHealthcare Tiered Benefit plans feature lower copays and/or co-insurance when members seek care from a Tier 1 care provider for their primary care physician (PCP), specialist, or hospital inpatient or outpatient services.
- Physicians included in the Tier 1 status include PCPs and specialists with the UnitedHealth Premium® designation for quality and cost efficiency and physicians participating in UnitedHealthcare NexusACO® in certain markets.
- Some plans also reduce member cost share for utilizing free-standing facilities for certain radiology, labs or outpatient surgeries.
Products with UnitedHealthcare Tiered Benefit Plans
Any one of our commercial products listed below may feature tiered benefits; UnitedHealthcare NexusACO is offered as a tiered benefit plan only. Some Medicare Advantage plans may also include tier benefits.
- UnitedHealthcare Choice and UnitedHealthcare Choice Plus
- UnitedHealthcare Charter, UnitedHealthcare Charter Plus and UnitedHealthcare Charter Balanced
- UnitedHealthcare Core and UnitedHealthcare Core Essential
- UnitedHealthcare EDGE®
- UnitedHealthcare Navigate®, UnitedHealthcare Navigate Plus® and UnitedHealthcare Navigate Balanced®
- UnitedHealthcare NexusACO
- UnitedHealthcare Options PPO
- UnitedHealthcare Select and UnitedHealthcare Select Plus
Tools & Resources