What is UnitedHealthcare

TL;DR:

UnitedHealthcare is the insurance arm of UnitedHealth Group, the largest U.S. health company.
Plans include employer, Marketplace, Medicare, Medicaid, and travel options.
For 2026, many UHC Medicare HMO/POS plans require PCP referrals for specialists.
Members can buy international travel medical coverage from UnitedHealthcare Global.
Check networks, referrals, and extras before you enroll or renew.

UnitedHealthcare, often called UHC, is the health insurance business of UnitedHealth Group. It sells and administers health plans for employers, individuals, Medicare, and state Medicaid programs in the United States. UnitedHealth Group also owns Optum, a separate services arm for pharmacy benefits, data, and care delivery. This scale makes UnitedHealth Group the largest health care company by revenue in the U.S., with UHC as its core insurance brand.

If you live outside the U.S., UHC is still relevant. Its UnitedHealthcare Global unit offers travel medical policies and assistance services for people who live or travel abroad. These plans are separate from U.S. domestic health insurance and are priced and regulated differently in each country.

The main plan types at a glance

UnitedHealthcare sells several plan families. Names vary by state and employer.

Employer plans. Offered through companies, often with large provider networks and wellness extras.
Individual and family plans. Purchased on HealthCare.gov or state Marketplaces. Networks and benefits differ by metal level.
Medicare. Medicare Advantage HMO, PPO, and special needs plans, plus Part D drug plans and Medicare Supplement (Medigap).
Medicaid and CHIP. Managed care plans that contract with state programs.
Travel medical. Short term international medical and evacuation coverage from UnitedHealthcare Global.

Key 2026 update for Medicare members

Starting January 1, 2026, most UnitedHealthcare Medicare Advantage HMO and POS plans require a referral from your primary care provider before you see many specialists. If you travel and use UHC’s National Network under these plans, the referral rule still applies. PPO plans are usually not affected. Always check your plan’s Evidence of Coverage to confirm.

How UHC networks work

The lowest costs come from in-network doctors and hospitals that have contracts with UHC. Out-of-network care can be limited or not covered at all, especially in HMO plans. During emergencies, hospitals must stabilize you, but billing can be complex if the facility or physicians are out of network. Disputes between providers and insurers do occur, which can affect what a hospital is paid for out-of-network emergency services.

What affects your cost

Three ideas drive what you pay each year:

Premium. The amount you pay each month.
Cost sharing. Deductibles, copays, and coinsurance when you use care.
Network rules. Referrals and prior authorization for certain tests, drugs, and procedures.

Large insurers, including UHC, use prior authorization to manage cost and safety. Federal and state rules change often. Medicare programs may add or change prior authorization pilots that affect how care gets approved in some states. Ask your doctor’s office how they handle approvals and how long they take.

Benefits you may see

UnitedHealthcare plans can include extras beyond basic medical coverage. Availability depends on plan type and state.

Virtual visits with telehealth providers.
Pharmacy benefits through Optum.
Wellness perks like gym credits or care management programs.
Medicare extras such as allowances for over-the-counter items, healthy food cards, and utilities in certain plans. Program rules for these allowances change over time.

UnitedHealthcare Global and travel medical coverage

If you need coverage while traveling abroad, UHC’s travel medical plans can pay for emergency care, evacuation, and assistance services. These plans are not major medical insurance. They are short term, priced by age, trip length, and destination, and often exclude preexisting conditions unless you meet time-sensitive purchase rules. Always read benefit limits and evacuation terms.

Recent context you should know

UnitedHealth Group’s 2024 Change Healthcare cyberattack disrupted claims across the U.S. market. The company reported significant costs tied to the incident and continues security work. When you enroll, keep your contact details current and set up online accounts so you receive outage or security notices quickly.
How to choose a UHC plan in five steps

List your must-have doctors and drugs. Search for each on the UHC website or call the plan to confirm they are in network and covered.
Match the plan type to your style. HMO costs are often lower but require referrals, PPO offers more flexibility at a higher price.
Estimate your total annual cost. Add premium plus your expected copays and coinsurance for visits, tests, and drugs.
Check rules that affect access. Look for referral or prior authorization requirements, especially for imaging, infusions, specialty drugs, and elective procedures.
Review extras. Telehealth, dental, vision, hearing, over-the-counter credits, and travel coverage can tip the balance.

Quick comparison table

Feature	HMO	PPO	POS	Medigap	Travel medical
Use of referrals	Often required, 2026 MA HMO usually yes	Usually no	Often yes	Not applicable	Not applicable
Out-of-network coverage	Usually no, except emergencies	Yes, higher cost	Limited	Follows Original Medicare	Emergency only
Typical premium	Lower to moderate	Moderate to higher	Moderate	Higher than MA, but stable use of any Medicare provider	Priced per trip
Best for	People with a local PCP and stable network	People who want more choice	Those who like PCP coordination	People who want broad Medicare access	Short term global trips

Referral and network rules depend on your exact plan and state. Always confirm with the plan before you enroll .

Common questions

Is UnitedHealthcare the same as UnitedHealth Group?
No. UnitedHealth Group is the parent company. UnitedHealthcare is its insurance arm, and Optum is its services arm.

Do UHC plans work outside the U.S.?
Most U.S. plans cover emergency care for short trips but do not pay for routine care abroad. For real protection overseas, consider a travel medical plan from UnitedHealthcare Global or another dedicated travel insurer.

What if my hospital is out of network during an emergency?
Hospitals must stabilize you, but billing with an out-of-network facility can be complicated. Know your plan’s rules, and call member services after you are stable.

What changed for Medicare in 2026 at UHC?
Many HMO and POS members now need PCP referrals for certain specialists, including when using the National Network while traveling. Check your plan’s documents.

Why it matters

Picking the right plan can save you money, time, and stress. UnitedHealthcare’s size brings broad networks and many plan options, but rules like referrals and prior authorization can affect access. A 10-minute check of networks, drug lists, and approval rules before you enroll can prevent surprise bills later.