Will My Doctor Accept My UnitedHealthcare Medicare Plan?

At a glance

  • $0 premium plans available in some areas
  • Many plans offer prescription drug coverage and vision and dental benefits
  • 4.9 million people are enrolled in a UnitedHealthcare Medicare Advantage Plan1

Whether or not your doctor will accept your UnitedHealthcare Medicare plan depends on what Medicare plan you have and if your doctor is in your plan network.

UnitedHealthcare networks include 1.3 million physicians and other health care professionals and around 6,250 hospitals and other facilities in the U.S.2

Each type of UnitedHealthcare Medicare plan has different network requirements. Before seeking medical care or services, check with your provider to find out if they accept the terms and conditions of your UnitedHealthcare Medicare plan.

UnitedHealthcare Medicare Advantage Plans

According to the Kaiser Family Foundation, 25 percent of all Medicare Advantage plan beneficiaries in 2018 were members of a Medicare Advantage plan from UnitedHealthcare.3

If you have a UnitedHealthcare Medicare Advantage plan, you may have network restrictions that affect what doctors, hospitals and other providers you can see for covered care. Network restrictions depend on which type of Medicare Advantage plan you have.

Health Maintenance Organization (HMO)

A UnitedHealthcare Medicare HMO plan features a localized network of providers. You are typically required to seek medical care from an in-network provider, except for urgent care, emergency room care and renal dialysis that is out-of-network.

Preferred Provider Organization (PPO)

A UnitedHealthcare Medicare PPO plan also includes a local network of providers, but beneficiaries may also receive care from providers outside of the network. Any covered care you receive outside of your plan network may come with higher out-of-pocket costs.

Point-of-Service (POS)

A UnitedHealthcare Medicare POS plan works similarly to an HMO plan but typically allows you to receive certain medical services outside of the local plan network. Out-of-network care will typically come with a higher cost.

Private Fee-for-Service (PFFS)

A Medicare PFFS plan from UnitedHealthcare gives you the flexibility to see any Medicare-eligible doctor or hospital for your medical care, as long as they agree to accept the plan’s terms and conditions.

UnitedHealthcare Medicare Prescription Drug Plans

Medicare Part D prescription drug plans from UnitedHealthcare offer coverage for many common generic and brand name drugs. You may also be able to get additional savings by filing your prescriptions at a plan-preferred retail pharmacy.

The pharmacy network will vary based on your plan.

UnitedHealthcare Medicare Supplement Insurance Plans

UnitedHealthcare Medicare Supplement Insurance plans are accepted by any doctor who participates in Medicare. Plan availability can vary by state, so you may want to speak with a licensed insurance agent to learn more about what plans are available where you live.

Enrolling in a UnitedHealthcare Medicare Plan

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