Why Stay In-Network?

Quality
UnitedHealthcare is committed to providing you and your family with access to a broad network of physicians, health care facilities and many other health care professionals. We are equally committed to providing this access to care in a way that is affordable, both to you and your employer.

One of the ways we deliver on this commitment is by negotiating significant discounts with a broad network of over 420,000 physicians and 3,700 facilities nationwide.

Costs
If your benefit plan covers out-of-network care, you may choose to seek care outside UnitedHealthcare's network without a referral. However, you should know that this care will result in a higher deductible and copayment for you than receiving those same services from a network physician or facility. Your benefit plan only pays a portion of non-network charges and it is your responsibility to pay the remainder - the amount above the allowed amount, which you are required to pay, may be significant and does not apply to your Out-of-Pocket Maximum.

Before deciding where to receive your care, we recommend you review and understand your financial responsibility if you choose to go outside the network.

Understand the costs associated with your health care choices.
Access the Treatment Cost Estimator on myuhc.com to help estimate the costs associated with your treatment options. If you are currently receiving care from a non-network physician or health care facility, you can reduce your financial responsibility by seeking those same services from a network physician or health care facility.

Learn More

Network Value: How Reimbursement and Financial Responsibility Compare

The following examples are based on average billed charge amounts and are provided to illustrate that your financial responsibility when you seek care from a physician or hospital in the network is considerably lower than it is when you seek these same services from outside the UnitedHealthcare network.

Example 1: Physician Office Visit Claim	In-Network	Non-Network
Billed Charge Amount	$250	$250
Eligible Expense (Amount UnitedHealthcare Pays)	paid per contract	$140
Difference	$0	$110 *
Copay/ 30% Non-Network Coinsurance	$20	$42
Your Financial Responsibility	$20	$152
Example 2: Hospital Outpatient Claim	In-Network	Non-Network
Billed Charge Amount	$1,000	$1,000
Eligible Expense (Amount UnitedHealthcare Pays)	paid per contract	$550
Difference	$0	$450 *
Copay/ 30% Non-Network Coinsurance	$20	$165
Your Financial Responsibility	$20	$615
Example 3: Hospital Inpatient Claim	In-Network	Non-Network
Billed Charge Amount	$12,000	$12,000
Eligible Expense (Amount UnitedHealthcare Pays)	paid per contract	$6,600
Difference	$0	$5,400 *
Copay/ 30% Non-Network Coinsurance	$500	$1,980
Your Financial Responsibility	$500	$7,380
* This amount does not apply to Out-of-Pocket maximum

These examples represent average billed charges for these service categories. They are not intended to be an exact calculation of claim payment and individual financial responsibility that may result from the services you receive. The amounts will vary depending on the actual services you receive, your specific benefit plan and copay and/or coinsurance design and changes to Medicare reimbursement methodology. We encourage you to get more information on potential physician and facility charges by using the Treatment Cost Estimator at myuhc.com.