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Benefit Awareness News | April 2016

Help avoid cost surprises

A doctor and a patient

Choosing a doctor, hospital, lab or facility from your plan’s network is a great way to reduce your out-of-pocket costs.

Some medical plans require you to choose a network primary care provider (PCP). Your PCP gets to know you and coordinates your care with other doctors and providers in the network.

How referrals work
Let’s say you have a chronic ear infection that needs specialty care. Your PCP connects you with other doctors that are in your health plan’s network.

This is called a referral. If you have a UnitedHealthcare plan that requires a referral, your PCP will send it to us before you call the specialist.

When you make the appointment, be sure to check that the specialist has received the referral. You can see if your PCP submitted an electronic referral on myuhc.com®. Go to the “Physicians & Facilities” tab.

Not sure if your plan requires referrals? Check your health plan ID card to see if it has the words “Referrals Required.”

You don’t need a referral to see a gynecologist (OB-GYN) or a mental health professional as long as they are in your network and service area. For emergency services, you may use any emergency provider.

Quality care and cost savings
No matter what plan you have, you should always select network providers. When you go outside the network, you’ll likely end up paying more for the same services. Sometimes lots more.

In fact, if your plan doesn’t cover out-of-network services, you could owe the entire cost!

You can log in to myuhc.com to make sure your provider is in the network.

LightbulbWhat to do next
To find a network doctor or PCP, go to myuhc.com. Or call the member number on your health plan ID card, TTY 711.

Watch a short video to learn more about the network and referrals:

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Just Plain Clear®: What is a network?

Network: The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.

Need more definitions? Check out justplainclear.com. It has thousands of health care and insurance terms defined in plain, clear language.

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