October 20, 2022

Updates to Individual Exchange plans for 2023

New states, plan details and a self-paced interactive guide

On Jan. 1, 2023, we’re launching UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans, in 4 new states. We’ll continue to offer these plans in the 14 existing states where we currently offer them.

New states

  • Kansas
  • Mississippi
  • Missouri
  • Ohio

Existing states

  • Alabama
  • Arizona
  • Florida
  • Georgia
  • Illinois
  • Louisiana
  • Maryland
  • Michigan
  • North Carolina
  • Oklahoma
  • Tennessee
  • Texas
  • Virginia
  • Washington

Prepare for the new plans

To help ensure your practice is ready to see Individual Exchange plan members in 2023, visit to learn more about the plans and access:

  • State-specific information
  • The new 2023 Individual Exchange plans self-paced interactive guide
  • Policies, coverage determination guidelines and prior authorization/notification and referral requirements

Please also prepare by:

  • Verifying your network participation by signing into the UnitedHealthcare Provider Portal at
  • Sharing information with your staff about your participation and the requirements for referrals and prior authorization/notifications
    • In most states,* these plans require a referral from an in-network primary care provider (PCP) for a member to see a specialist**
  • Modifying your business processes to recognize referral-required plans, if applicable
  • Noting that members must select a PCP to help coordinate their care, or we’ll assign them a PCP after 30 days
    • Physicians may also submit PCP change requests for members
  • Confirming that your staff have access to submit referrals and check referral statuses
  • Noting that we’ll conduct site of service medical necessity reviews for any procedures/codes in our UnitedHealthcare Individual Exchange Medical & Drug Policies and Coverage Determination Guidelines***
  • Verifying and updating your demographic information using the My Practice Profile tool at


Visit or contact your provider advocate.

*Except for Alabama, Kansas, Louisiana, Missouri, Mississippi, North Carolina, Oklahoma and Tennessee
**In Maryland and Virginia, we’ll offer some plans that require referrals and other plans that don’t require referrals.
***Except for Texas
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