The UnitedHealthcare Medicare Advantage plans cover features and benefits in addition to those included in Original Medicare. Members in some areas may have different plans from which to choose. The plans often include an integrated Medicare Part D prescription drug benefit.
- UnitedHealthcare Sync (PPO)
Health Maintenance Organization (HMO) plans have a defined network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not need referrals for specialty care.
Preferred Provider Organization (PPO) plans offer members access to a network of contracted physicians and hospitals, but also allow them the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Members do not need a referral for specialty care.
PPO plans are available as either local PPO (certain counties within a state) or regional PPO (RPPO) offerings. RPPOs serve a larger geographic area - either a single state or a multi-state area. RPPOs offer the same premiums, benefits and cost-sharing requirements to all members in the region.
Tools and Resources - UnitedHealthcare® Medicare Advantage Plans
- HouseCalls Program Overview
- Medicare Advantage Plans - Benefit Plan Name Overview
- Medicare Advantage Chiropractic and Acupuncture Coverage – Quick Reference Guide
- Medicare Advantage Copayment Guidelines
- Medicare Advantage Durable Medical Equipment (DME) Frequently Asked Questions
- Medicare Advantage Home Health Services Frequently Asked Questions
- Medicare Advantage Member Rights and Responsibilities
- Medicare Advantage Non-Contracted Provider Dispute and Appeal Rights
- Medicare Advantage Non-Contracted Provider Claim Payment Dispute Request Form
- Medicare Advantage Preventive Screening Guidelines
- Optum Behavioral Health Referral Process
- Readmission Review Program Clinical Guidelines
- Readmission Review Program Frequently Asked Questions
- UnitedHealthcare Administrative Guide
- Medicare Advantage Drug Formulary - UHCMedicareSolutions.com (enter zipcode and select plan)
UnitedHealth Passport® Travel Benefit (Note: UnitedHealth Passport is only available in specific UnitedHealthcare branded plans in CT, FL, MN and NY. Please check the front of the member ID card for the Passport logo to verify that a plan has Passport.)
To learn more about UnitedHealthcare Medicare Advantage plans offered in your area, please visit UHCMedicareSolutions.com and enter your ZIP code.
To learn more about Medicare Part D prescription drug coverage or to access related forms, please review the materials available on UHCMedicareSolutions.com under Our Plans > Medicare Advantage Plans > What Do I Need to Know? > Medicare Advantage Plan Information and Forms.