UnitedHealthcare HMO Plans
Network 1, Network 2, and Alliance
HMOs allow you to receive comprehensive coverage at set prices,
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
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 could pay out of your own pocket.
Prescription Coverage: Prescriptions will be managed by Express Scripts. UHC HMO members will receive an ID card from UHC for medical and an ID card from Express Scripts for prescription drug benefits.
Note: Review the comparison charts below for copays, annual out-of-pocket maximums, and a list of medical groups.
Per Pay Period Cost
|Employee Only||Employee +1
||Employee + 2 or more|
UnitedHealthcare Performance HMO Network 1
UnitedHealthcare Performance HMO Network 2
UnitedHealthcare SignatureValue Alliance HMO
- Traditional Medical Plans Comparison Chart
- UnitedHealthcare Network Comparison Chart
- UnitedHealthcare HMO Evidence of Coverage
- UnitedHealthcare Performance HMO Network 1 Schedule of Benefits
- UnitedHealthcare Performance HMO Network 2 Schedule of Benefits
- UnitedHealthcare Signature Value Alliance HMO Schedule of Benefits
- Out-of-Area Dependent
- VEBA Advocacy
- VEBA Resource Center
Contact the Provider
- Group Numbers
- UHC HMO Network 1: 685700-WBU
- UHC HMO Network 2: 685700-WCA
- UHC Alliance HMO: 685710-WBA
CoSD/VEBA Advocacy Center: 888-276-0250
Express Scripts 800-918-8011
- Group Numbers
- UHC HMO Network 1: MVISDD133
- UHC HMO Network 2: MVISDD233
- UHC Alliance HMO: MVISDAH33