Effective January 1, 2026, United Healthcare (UHC) will require most members enrolled in UHC Medicare Advantage HMO and HMO-POS plans to obtain a referral from their primary care provider (PCP) before accessing certain specialist services in outpatient, office or home settings.
UHC will not deny claims for lack of referral on plans with new referral requirements for dates of service through April 30, 2026.
Even with a referral, claims can still be denied if required prior authorization is not obtained. Read the notice here.