Update to UnitedHealth Premium® program for select specialties
- North Carolina
- North Dakota
- New Hampshire
- New Jersey
- New Mexico
- New York
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
- Fully Insured and Self-Funded
- Plan Design
In an effort to help provide greater access to Tier 1 physicians to UnitedHealthcare members, specialties that are currently not evaluated as part of the UnitedHealth Premium® program, such as Dermatology, Neonatology, Ophthalmology and Podiatry, will be elevated to Tier 1 status for NexusACO® members only – effective Jan. 1, 2021.
This elevation will take place for specialty providers located outside of the NexusACO service area only. NexusACO service areas will be evaluated one at a time over the coming months and changes will take place if needed.
Out-of-scope specialty types
The following specialty types will be out-of-scope when the Tier 1 elevation of non-evaluated specialties becomes effective:
- Specialty types that are already evaluated as part of the Premium program
- Specialty types that submit or bill claims for non-tiered services (e.g., mental health providers, chiropractors, etc.)
Provider directory display
These specialties will be identified in the provider search on myuhc.com® by the Tier 1 blue dot icon, as shown below. Tier 1 status will be visible on Oct. 1, 2020.
For more information please contact your UnitedHealthcare representative.
The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com®. You should always visit myuhc.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. You should also discuss designations with a physician before choosing him or her. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for detailed program information and methodologies.
Tier 1 providers may be subject to change, visit myuhc.com® for the most current information or call the number on your health plan ID card.