Surest out-of-network service area update
Last modified: April 5, 2024
Update: Content updated with specific service area information
Beginning April 1, 2024, we’re updating the out-of-network service area for Surest™ benefit plans with out-of-network (OON) benefits.
For out-of-network services that are non-emergent, sub-acute inpatient and outpatient, the updated service area will include only the member's state of residence and immediate bordering states. Accordingly, Surest benefit plans will exclude coverage for those types of services that members receive outside of the updated service area. The exclusion will apply to medical and behavioral health services, including those that members receive in the following settings:
- Residential treatment facilities
- Partial hospitalization/day treatment programs
- Inpatient rehabilitation facilities
- Skilled nursing facilities
What you need to do
Refer members to in-network providers within the member's service area. If you refer to OON providers, your patients could be responsible for higher out-of-pocket costs.
What you need to know
These medical and behavioral health services are already subject to prior authorization. Starting April 1, 2024, we’ll deny prior authorizations if the prior authorization request is outside the updated service area.
Questions?
Call UnitedHealthcare Provider Services for Surest at 844-368-6661, 7 a.m.–5 p.m. CT, Monday–Friday.
PCA-1-24-00370-UHN-NN_04052024
