Starting January 1, 2026, most members enrolled in UnitedHealthcare Medicare Advantage HMO and HMO-POS plans will be required to obtain a referral from their Primary Care Provider (PCP) before receiving specialist care.
👉IMPORTANT FOR ALLERGY PATIENTS:
Allergy services DO require a PCP referral under this new requirement.
To ensure a smooth transition and prevent delays or denied claims, our office will begin requesting referrals now for applicable services.
What This Means for You
For certain specialist visits, your PCP must submit a referral to UnitedHealthcare before your appointment. While UnitedHealthcare will not deny claims for missing referrals until May 1, 2026, referrals will be required moving forward.
Why We’re Starting This Process Now
Beginning referrals ahead of time helps:
- Avoid appointment delays
- Prevent claim denials
- Ensure continuity of care into 2026
🔗 For additional details directly from UnitedHealthcare, visit:
https://www.uhcprovider.com/en/resource-library/news/2025/referral-req-specialist-services-medadv.html
If you have questions or need assistance, please contact our office — we’re here to help!
