Know more about NexusACO plans
Starting Jan. 1, 2023, more members will have access to the UnitedHealthcare NexusACO® plans. Here’s some information about NexusACO to help as you care for these members.
Tiered benefits
UnitedHealthcare NexusACO is a commercial tiered benefit plan designed to encourage members to seek care from Tier 1 health care professionals. Tier 1 includes featured Accountable Care Organizations (ACOs) in selected geographic areas and UnitedHealth Premium® Care Physicians in areas around the country where an ACO is not featured.
Learn more about UnitedHealthcare NexusACO.
Because members may have a higher level of benefits when they see Tier 1 providers, we encourage primary care providers (PCPs) to refer members to Tier 1 specialists. Tier 1 providers are identified in the UnitedHealthcare Provider Directory with the Tier 1 symbol.
NexusACO features
There are 2 types of NexusACO benefit plans:
- NexusACO R plans require referrals
- NexusACO OA plans do not require referrals
For both NexusACO plans:
- Members must choose a PCP to manage their overall care
- Members may have lower copays and/or co-insurance for services rendered by Tier 1 providers
- Standard prior authorization and notification requirements apply
- Submit referrals using the Referrals tool on the UnitedHealthcare Provider Portal
Questions?
If you have questions, please contact your UnitedHealthcare provider advocate.
