How the UnitedHealthcare Plans Work
Covered Health Services
The healthcare service, supply or pharmaceutical product is only a covered health service if it is considered Medically Necessary. See "Medical Plan Definitions" to understand how the Plan defines a covered health service. The fact that a physician or other provider has performed or prescribed a procedure or treatment does not mean that it is a covered service under the Plan.
The following explains information you need to know about how the UnitedHealthcare plans work, and how using participating or non-participating providers impacts your benefits.
Both the UHC Choice and Value PPO plans work the same way, use the same network of providers and cover the same services. The differences are the employee costs for coverage, the deductibles and the out-of-pocket maximums.
The UHC Basic and Premium HSA medical plans work similarly in that they use the same network of providers and cover the same services. However, there are differences in the employee costs, deductibles, co-insurance and out-of-pocket maximums. In addition there are no co-pays with the HSA plans.