UnitedHealthcare HMO Plans

HMO's allow you to receive comprehensive coverage at set prices, called copays.

Doctors/Other Medical Care Providers:  You can only use doctors, hospitals, and pharmacies that participate in the HMO network.  Doctors who participate in the HMO network are called in-network providers. There is no coverage if you go to out-of-network providers, except for emergency services.

Annual Deductible: You don’t need to pay an annual deductible before the plan begins to pay for a portion of covered medical services.

Copays: When you receive medical care, you pay a set dollar amount called a copay.

Annual Out-of-Pocket Maximum:  The HMO plans include an annual out-of-pocket maximum. This is the maximum amount you must pay out of your own pocket.

Note: Review the comparison chart below for copays, annual out-of-pocket maximums and annual deductible limits.

Per Pay Period Cost
 

  Employee
   Only 
 
Employee
   Plus 1
 
Employee
Plus 2 or more
 

UnitedHealthcare Performance HMO Network 1
 
$323.21 $646.33 $914.51

UnitedHealthcare Performance HMO Network 2
 
$410.36 $820.60 $1,161.10

UnitedHealthcare Signature Value Alliance HMO
 
$310.67 $621.25 $879.03


Resources

Traditional Medical Plans Comparison Chart

UnitedHealthcare HMO Evidence of Coverage

UnitedHealthcare Performance HMO Network 1 Schedule of Benefits 

UnitedHealthcare Performance HMO Network 1 Summary of Benefits and Coverage

UnitedHealthcare Performance HMO Network 2 Schedule of Benefits

UnitedHealthcare Performance HMO Network 2 Summary of Benefits and Coverage

UnitedHealthcare Signature Value Alliance HMO Schedule of Benefits

UnitedHealthcare Signature Value Alliance HMO Summary of Benefits and Coverage

Express Scripts Pharmacy ID Cards

UHC Network Comparison Chart


Contact the Provider

UnitedHealthcare Website

UnitedHealthcare - Find a Doctor

If you would like to designate a Primary Care Physician, please contact UnitedHealthcare Member Services.

Member Services Phone Number: (888) 586-6365
COSD/VEBA Advocacy Center: (888) 276-0250 

UnitedHealthcare Performance HMO – Network 1
Group # 251129

UnitedHealthcare Performance HMO – Network 2
Group #251132

UnitedHealthcare Alliance HMO
Group #251135

Express Scripts Website

Express Scripts Phone Number: 800-282-2881
 

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