What you’re getting
Whichever you choose – either Choice EPO or ChoicePlus PPO – you’re signing up for quality care that goes where you go, and the extra support you need to get the most from your plan. With UnitedHealthcare, you get:
- A national network of over 1.7 million providers and 6,700+ hospitals, so you can choose from a robust network of health care professionals and sites1
- A local network of 35,000+ providers1 and every hospital in Maryland
- A vision network with 156,000 vision provider access points nationwide, including Warby Parker, GlassesUSA, Costco and Visionworks, plus most national retail locations
- Specialist visits without a referral, saving you time when a concern won’t wait
- Mental health benefits, including virtual behavioral health visits and digital tools that make it easier to get help anywhere
- 24/7 Virtual Visits plus virtual primary and virtual specialty care, giving you access to urgent or routine care around the clock – from doctors on myuhc.com® or the UnitedHealthcare app – anywhere you are
- Condition management and wellness programs, to help you get – and stay – healthier
Support above and beyond
You’ll get the information and advocacy to help you get the most of your health and wellness benefits:
- 24/7 Nurse Support lets you chat with a registered nurse anytime, day or night, for answers or guidance
- If you have a device – computer, tablet or smartphone2 – you can see a doctor or behavioral health specialist through virtual care
- ExpressExam lets you renew your eyewear prescriptions virtually, at no additional cost: take an online exam at1800contacts.com/uhc, then a certified ophthalmologist reviews it. If approved, your prescription will be ready to use within hours.
- Advocacy for families who have children with complex medical needs offers one-stop support from a dedicated advisor, removing barriers and easing access to care
- Rally® helps make it fun to take action for better health – physical, mental, and emotional – and may just earn you rewards
- Real Appeal® is a digital program that helps guide, support and inspire you on your path to healthy weight management
- OnePass Select™ fitness discount program gives you the flexibility to choose from several membership tiers and a nationwide network of fitness locations – plus offers home grocery delivery
- Quit For Life® provides 1-on-1 support from a Quit Coach® to help you give up tobacco
- Members who complete wellness plan activities can save money, with $0 copays on PCP and behavioral health office visits and 24/7 Virtual Visits, plus reduced copays on specialist visits
- The Optum Store offers a large selection of health & wellness and over-the-counter (OTC) products. Just look for the HSA/FSA badge next to eligible products – and make the most of your flexible savings account (FSA) funds
All your health plan info in one place
The UnitedHealthcare secure member website, myuhc.com, is your personalized health plan hub, letting you search for care or see your plan information at a glance – on a smartphone, tablet or computer.
- Easy care search for a provider, clinic, hospital or lab based on location, specialty, cost, services and more – plus, see how other patients rated them
- Cost estimator that lets you estimate treatment costs before deciding where to go
- Current claim information – whether claims history or their status right now – along with the ability to track, personalize and manage your claims
- Benefit information and plan materials, including your Explanation of Benefits (EOB)
- Options for replacing or printing a lost health plan ID card
- Wellness tools, along with tips on healthier living and how to use your benefits to your best advantage
- Care reminders, from when to schedule checkups and treatments to suggestions on immunizations, well visits, routine tests or lab work
- 24/7 Virtual Visits plus virtual primary and specialist Care access, right from your member site
Options that fit the way you live
Get a closer look at the distinctive benefits of the Choice EPO and ChoicePlus PPO plans.
Choice EPO Plan
With the Choice EPO Plan, you won’t have to meet a deductible before the plan begins to pay; you just have to choose a provider from the UnitedHealthcare national network. That means immediate savings, as long as you stay in the network – out-of-network providers are not covered by the plan.3
- Preventive care is covered at 100% when you use a network provider
- For other care, you’ll be responsible for a copay4
- Coverage from our robust nationwide network means quality care and one less stress when you travel
- Premium Care Physicians are screened to meet or exceed national standards for quality and local benchmarks for cost effectiveness
- Premium providers are listed on myuhc.com® and the UnitedHealthcare app (just look for the two blue hearts!)
- You have coverage for network services only, so if you see an out-of-network provider, you’ll have to pay out of pocket
- If you’re not yet a UnitedHealthcare member, you can find network providers easily with the online search tool (see the Resources)
ChoicePlus PPO Plan
With the ChoicePlus PPO option, you are covered for both network and out-of-network services. That means more flexibility; you’ll just pay coinsurance until you meet your out of pocket limit.
- Preventive care is covered at 100% when you use a network provider
- For other care, you’ll have a deductible to meet before the plan will start to pay; after that, you’ll be responsible for coinsurance with most services4
- Coverage from our robust nationwide network means quality care and one less stress when you travel
- Premium Care Physicians are screened to meet or exceed national standards for quality and local benchmarks for cost effectiveness
- Premium providers are listed on myuhc.com® and the UnitedHealthcare app (just look for the two blue hearts!)
- Out-of-network providers are also covered, but you may be charged more than with network providers
- If you’re not yet a UnitedHealthcare member, you can find network providers easily with the online search tool (see the Resources)
| State of Maryland benefits January 1–December 31, 2023 | UnitedHealthcare ChoicePlus PPO | UnitedHealthcare Choice EPO | |
|---|---|---|---|
| Network | Out of Network | Network Only | |
| Plan overview | |||
| Referrals | No | No | |
| National network | Yes | Yes | |
| Deductible | None | $250 Individual $500 Family | None |
| Coinsurance out of pocket limit | $1,000 Individual $2,000 Family | $3,000 Individual $6,000 Family | None |
| Copay out of pocket limit | $1,000 Individual $2,000 Family | None | $1,500 Individual $3,000 Family |
| Total annual medical out of pocket costs | $2,000 Individual $4,000 Family | $3,250 Individual $6,500 Family | $1,500 Individual $3,000 Family |
| Lifetime maximum | Unlimited | Unlimited | |
| Medical overview3 | |||
| Physician office visits | |||
| Primary care provider (PCP) | $15 copay | 70% after deductible | $15 copay |
| Specialist | $30 copay | 70% after deductible | $30 copay |
| Inpatient care | 90% | 70% after deductible | 100% |
| Outpatient care | 90% | 70% after deductible | 100% |
| Inpatient hospitalization | 90% | 70% after deductible | 100% |
| Outpatient facility | 90% | 70% after deductible | 100% |
| Maternity | 90% | 70% after deductible | 100% |
| Diagnostic lab and X-ray | 90% – Lab testing services related to diabetes, high blood pressure, heart disease, asthma and COPD are paid at 100% | 70% after deductible | 100% |
| Durable medical equipment | 90% | 70% after deductible | 100% |
| Emergency room (inside and outside the area) | 100% after $150 copay; copays are waived if admitted. (If criteria are not met for a medical emergency, plan coverage is 50% of allowed amount, plus the $150 copay.) | ||
| Behavioral health | $15 copay | 70% after deductible | $15 copay |
| Intensive outpatient services | 90% | 70% after deductible | 100% |
| Preventive care | |||
| Mammography | 100% | 70% | 100% |
| Immunizations, including annual flu shots (flu shots not covered out of network) | 100% | 70% after deductible | 100% |
| Well-child care | 100% | 70% after deductible | 100% |
| Annual physical exams | 100% | 70% after deductible | 100% |
| Physical/occupational/speech therapy | $30 copay | 70% after deductible | $30 copay |
| Acupuncture for chronic pain management | $30 copay | 70% after deductible | $30 copay |
| Chiropractic services | $30 copay | 70% after deductible | $30 copay |
| Hearing aids | 100% for basic-model hearing aids | 70% after deductible for basic-model hearing aids | 100% for basic-model hearing aids |
| Vision | |||
| For full vision benefit information, visit uhcmaryland.com You also have the added option of discounted services on laser vision correction surgery through Laser Vision Network of America. | |||
| Mental health services are covered under both plans. Mental health providers can be found at liveandworkwell.com. | |||