UnitedHealthcare HMO

Group Number: 010931

Customer Service Telephone: 1-800-825-9355

Customer Service Hours: Mon-Fri, 7 a.m. - 9 p.m. CST

Website: www.myuhc.com

The HMO plan offers a network of doctors, specialist, and hospitals within a geographic area.  When you receive service from a network provider, you pay a copay for covered service(s) with no additional deductible or co-insurance.  If you go to a non-network provider, except for emergency care, any service(s) provided will not be covered.  A prescription drug plan (Administered by OptumRx) is offered with the HMO plan.   Prescription drugs must be included on the plan formulary in order to be covered.

What is a Service Area?

All retirees and covered dependent(s) must reside within the UnitedHealthcare service area.  The service area is the State of Oklahoma.  If retiree and/or covered dependent(s) move out of the service area, contact Employee Benefits within 31 days.

What is a Primary Care Physician (PCP)?

Each family member may choose a Primary Care Physician (PCP) from one of the doctors listed in UnitedHealthcare's provider directory. You can search for providers on www.myuhc.com.

Members may change their PCP up to once a month by contacting a UnitedHealthcare customer service representative. PCP changes will take effect the first of the following month. For example, if a member calls September 30th the PCP change will take effect on October 1st. Also, members do not have to stay within a certain network of physicians. For example, if your PCP is with Mercy and you wish to see a St. Anthony specialist, you may. Additionally, if you are with a Mercy PCP and want to move to a St. Anthony PCP the next month, you may. 

What are Copays?

A copay is the amount you're required to pay directly to the provider each time you use medical services. There is no deductible or co-insurance on the HMO plan. For example, you pay a small copay each time you visit the doctor's office. Under UnitedHealthcare HMO, you should only have to pay the specified copay amount for covered services. You will not be billed for additional amounts on covered services. 

Do I need a referral for Specialty Care (Specialist)?

Members do not have to have a referral to see a specialist as long as the specialist is contracted with UnitedHealthcare HMO.