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Exchange Plans Policies

These policies apply to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. We currently offer these plans in Alabama, Arizona, Florida, Georgia, Illinois, Louisiana, Maryland, Michigan, North Carolina, Oklahoma, Tennessee, Texas, Virginia, and Washington.

Beginning Jan. 1, 2023:

  • These medical and reimbursement policies will also apply to Kansas, Mississippi, Missouri, and Ohio.
  • These reimbursement policies will also apply to Colorado.

Medical policies

For all other states (including Massachusetts and New York), refer to our Commercial Policy Benefits Plans for Providers page.

Medical & Drug Policies and Coverage Determination Guidelines for UnitedHealthcare Individual Exchange Plans

Reimbursement Policies for UnitedHealthcare Individual Exchange Plans

More UnitedHealthcare Policies and Clinical Guidelines: