Membership in the UnitedHealthcare NexusACO benefit plans is growing. Starting Jan. 1, 2019, even more members will have access to the UnitedHealthcare NexusACO products.
UnitedHealthcare NexusACO is an accountable care organization (ACO) focused tiered product. Nationally, ACOs in certain markets have been selected to be included in Tier 1 for the UnitedHealthcare NexusACO benefit plans. While UnitedHealthcare NexusACO members can receive benefits for services from all UnitedHealthcare NexusACO participating care providers, the members may have higher out-of-pocket costs when getting care from UnitedHealthcare NexusACO participating care providers who are not in Tier 1.
Health Plan Key Features
UnitedHealthcare NexusACO includes two benefit plans - NexusACO R and NexusACO OA - and both require that the member select a primary care physician (PCP).
- NexusACO R requires referrals
- NexusACO OA doesn’t require referrals Refer to the member ID card to identify the member’s benefit plan. The ID card will also show if a referral is required. Standard prior authorization and notification requirements, listed in UnitedHealthcare Administrative Guide, apply.
Tier 1 care providers will have the Tier 1 graphic by their name in the UnitedHealthcare NexusACO care provider directory. If you’re not sure if you’re a NexusACO Tier 1 care provider, you can check at UHCprovider.com > Menu > Find a Care Provider > NexusACO Care Provider Directory