Tag: UnitedHealthcare (UHC)
UHC AARP Plans as of June/23/2026
YOU SHOULD ALWAYS CHECK NETWORK PARTICIPATION, DO NOT SKIP THIS STEP.
Please read this article closely. It could save you time, money, and headaches.
CMS assigns every Medicare Advantage organization a five-character contract number, sometimes called an H-code. That contract number represents the legal agreement between the insurance company and the federal government. A single insurer might hold several contract numbers. Not every contract number starts with “H.” CMS uses different letters for different plan types:
- H: Local plans, including most HMOs and local PPOs
- R: Regional PPO plans that cover a wider geographic area
- S: Stand-alone prescription drug plans (Part D only)
- E: Employer-sponsored Medicare Advantage and Part D plans
When comparing Medicare Advantage plan ID cards, it’s important to compare apples to apples.
However, the 5 digit contract number alone is not always enough. For example:
- AARP Medicare Advantage CareFlex from UHC-44 (HMO-POS) has contract number H0609.
- AARP Medicare Advantage Extras from UHC TX-27 (HMO-POS) also has contract number H0609.
Although these plans share the same contract number, they are different plans.
To accurately identify a member’s plan, compare the entire 11-character Plan ID, not just the H number. Using the full Plan ID helps ensure you are reviewing the correct plan and its associated benefits and network.
Please, Do Not Skip Verification
UHC disclaimer: Oxford Data refresh date: 06/16/2026, all other lines of business: 6/15/2026
To check your participation status with employer-specific plans, please contact your Advocate or Network Account Manager.
CONFIDENTIALITY NOTICE: Information accompanying this facsimile is considered to be UnitedHealthcare’s confidential and/or proprietary business
information. Consequently, this information may be used only by the person or entity to which it is addressed. Such recipient shall be liable for using and
protecting UnitedHealthcare’s information from further disclosure or misuse, consistent with applicable contract and/or law. The information you have received
may contain protected health information (PHI) and must be handled according to applicable state and federal laws, including, but not limited to HIPAA.
Individuals who misuse such information may be subject to both civil and criminal penalties. If you believe you received this information in error, please
contact the sender immediately.
If you would like this list in excel format, please contact POET office.
Remember these are Government Contracts and are subject to change.
UHC Provider Webinar February 26, 2026
- Learn about digital tools to simplify workflow
- Explore UHC plans
- Hear Policy Updates
UHC December Monthly Overview
Key changes for our Medicare Advantage plan
- In 2026, most UnitedHealthcare Medicare Advantage health maintenance organization (HMO) and point of service (POS) plans are referral plans. You can check plan referral requirements online.
- Starting Jan. 1, 2026, most members enrolled in UnitedHealthcare Medicare Advantage HMO/POS plans will be required to obtain a referral from their primary care provider (PCP) before accessing certain specialist services in outpatient, office or home settings. Referrals must be submitted by the PCP to UnitedHealthcare prior to the specialist visit. This also applies when members of HMO/POS plans are traveling and accessing the National Network. Learn more in our 2026 Medicare Advantage Referral Requirements Guide.
- Effective Jan. 1, 2026, new or existing members of UnitedHealthcare SNPs, including Chronic Special Needs Plans (C-SNP) and Dual Special Needs Plans (D-SNP), need a qualifying chronic condition to access benefits that cover healthy food and/or utilities. Providers may be contacted by UnitedHealthcare to verify a member has at least one qualifying condition to receive benefits. See 2026 Medicare Advantage, CSNP & DSNP Plan Overview Course for more information.
UHC November Update
A list of recently approved, revised, and/or retired Medical Policies and/or Medical Benefit Drug Policies is provided below for your reference. For a comprehensive summary of the latest updates, refer to the Medical Policy Update Bulletin: November 2025.
UHC “Check by Member” Authorization Tool
UHC says they have a smarter way to check prior authorization requirements.
Our upgraded Check by Member tool is now the most accurate and reliable way to confirm prior authorization requirements.
- Personalized results based on member-specific data
- Same trusted source as our phone advocates
- Instant answers with no hold time
TRS 2025-2026 Plan Year
Products for 2025-2026 Plan Year
Please be aware the Retiree Plans are Calendar Year
Health Plan Representatives Updated 8/4/2025
The Health Plan Representatives List has been updated. This is a good tool to print and have close by when you have an issue.
The biggest change for claims issues will be HealthSpring (HCSC) formerly Cigna MA. Here is how:
- Email ALL claims issues to [email protected]
2. HealthSpring has supplied the spreadsheet that MUST be used. A link is provided below, or you may call POET, we will be glad to email you an electronic copy.
Only the columns with Red Lettering, need to be filled out by the Physician’s office.
4. Always feel free to copy [email protected] if you would like POET to be in the loop.
5. If you have a time sensitive, special, or just an issue you would like to discuss with POET, please call (936) 637-7638.
Check Your Gold Card Eligibility
Last fall, UHC introduced the first national Gold Card program, reducing prior authorizations in favor of advance notification for provider groups consistently adhering to evidence-based care guidelines. They are happy to announce that in the 2nd year of the program, starting Oct. 1, 2025, additional provider groups will be eligible.
On Sept. 1, UHC will publish details on how to determine if your provider group has qualified for the program.
Check your Gold Card eligibility status starting Sept. 1
Provider groups can view their Gold Card program status in the UnitedHealthcare Provider Portal.
Renewing Oct. 1, 2025, the program simplifies the prior authorization process for qualifying providers and eligible services. Qualifying providers will need to submit advance notification, which confirms eligibility and network status, but no clinical information will be requested. We’ve updated the program protocol for the renewal period.
Visit our national Gold Card program page in September for detailed instructions on how to identify Gold Card status and access to an interactive guide that can help you navigate our resources.
UHC July Overview
Policy and protocol updates
Medical policy updates
Medical policy updates for July 2025 for the following plans: Medicare, Medicaid, Exchanges and commercial.
Reimbursement policy updates
See the latest updates for reimbursement policies.
Specialty Medical Injectable Drug program updates
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members.
Pharmacy and clinical updates
Access upcoming new or revised clinical programs and implementation dates for UnitedHealthcare plans
Recent Comments