Last update: May 13, 2021, 10:45 a.m. CT
Temporary Provision Exceptions for Individual and Fully Insured Group Market Health Plans
UnitedHealthcare is updating a number of temporary provisions around originating site requirements and cost share waivers that were established as part of the COVID-19 response. Full details of the changes are available in the Summary of COVID-19 Dates by Program guide and on the COVID-19 Telehealth pages.
Some states have established state-specific rules, regulations and emergency periods that apply to Individual and fully insured Group Market health plans. These may vary from federal regulations. (Implementation for self-insured customer benefit plans may vary.)
We’ve collected the following information about differences that may apply in your state. Rules, regulations and other guidance are subject to change, so be sure to check with the appropriate state regulatory agency for the latest information. If no state-specific rules are noted, UnitedHealthcare guidelines will apply.
Illinois, Indiana, Iowa, Kentucky, Minnesota, Missouri, North Dakota, Oklahoma, South Dakota
Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont, West Virginia
Alaska, Arizona, California, Colorado, Montana, Nevada, New Mexico, Oregon, Washington
State-specific telehealth coverage and reimbursement rates may differ for Medicaid. We will administer benefits and make reimbursements in accordance with federal and state-specific Medicaid regulations and guidelines. Please refer to your state’s website, if applicable. For Medicare, please find details on the COVID-19 Telehealth pages.
The benefits and processes described on this website apply pursuant to federal requirements and UnitedHealthcare national policy during the national emergency. Additional benefits or limitations may apply in some states and under some plans during this time.
We will adjudicate benefits in accordance with the member’s health plan.
Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.