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With the UnitedHealthcare Retiree Advantage Plan (PPO), a Preferred Provider Organization (PPO) plan, you can see doctors and other health care providers that are in and out of our network at the same cost share as long as they participate in Medicare and are willing to bill the plan.
A network doctor or health care provider is one who contracts with UnitedHealthcare to provide services to Medicare-eligible members.
An out-of-network doctor or health care provider does not have a contract with UnitedHealthcare.
You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. Accepting the plan means the doctor is willing to treat you and bill UnitedHealthcare.
We will be happy to contact your doctor on your behalf to explain how the plan works. Usually, that is all that is needed.
If a doctor or hospital refuses to directly bill UnitedHealthcare, they may ask that you pay the full allowable amount. In that case, you can pay the doctor and then submit your claim to UnitedHealthcare. You will be reimbursed for the cost of the claim less your copay.
Disclaimer
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.