UHC eliminates some OON non-emergency coverage

July 13, 2021

As part of a new policy update, UnitedHealthcare will no longer cover non-emergency services members receive from out-of-network facilities outside their service area, effective July 1.

The policy, which primarily affects affects residential treatment facilities, inpatient rehabilitation and other non-hospital-based services, will deny coverage for members who receive non-emergency services in an out-of-network facility that is outside of their service area. UHC defines a coverage area as the state a member lives in, in addition to the surrounding states.

The update applies to both inpatient and outpatient care. UHC said it plans to extend the policy to every member enrolled with out-of-network benefits by mid-2022.

This change comes at a time when UHC recently incurred significant pushback from patient advocates after announcing a separate policy that would have allowed the payer to retroactively deny emergency department visits it deemed non-emergent. However, UHC later announced it will not implement this change until after the Public Health Emergency has expired.

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