Washington - UnitedHealthcare Community Plan - Lookup Tools

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UnitedHealthcare Community Plan

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Primary Care Provider
As a member of UnitedHealthcare Community Plan, one of the first things you will want to do is to choose a Primary Care Provider (PCP). Your PCP will provide and coordinate all your healthcare, including referrals to specialists, with the exception of emergencies, mental health and women’s healthcare. Each covered family member may choose a different PCP within UnitedHealthcare Community Plan. If you do not choose a PCP, we will select one for you, which you can change later.

Please feel free to call our Member Services line, at 1-877-542-8997 (TTY: 711) and we will be happy to help you find or change your PCP.


To find a PCP or a Specialist in our network, please visit these online directories for complete information, including names, addresses, specialties, new patient’s availability and languages spoken. If you would like us to provide you with a printed version at no cost, please call us, at 1-877-542-8997 (TTY: 711).

Search for a Provider

Download Our Provider Directory - East (PDF 8.35 MB)
Download Our Provider Directory - West (PDF 46.58 MB)

Behavioral Health is as important as physical health. That’s why we have coverage for both.  You are eligible for behavioral health services, also called mental health services. Behavioral health services can help you with personal problems that may affect you and your family. These problems may be stress, depression, anxiety or using drugs or alcohol.


Your PCP might think your behavioral needs are better served through services covered by a Behavioral Health Organization at a Community Mental Health or Substance Use Disorder Services agency. If so, your PCP will send you there for an evaluation. If the evaluation results determine you need this level of service, you may continue to get your behavioral health care from the Agency.

Search for a Mental Health Clinician or Facility

Required care is 100% covered with no copay.  If you need behavioral health care, your PCP and UnitedHealthcare Community Plan can help coordinate your care.

We:

• Cover assessment for mental health services and treatment such as counseling, testing, and medications for addressing mental health symptoms.

• Cover lower and mid-level intensity treatment.

• Provide screening for substance use disorder and may make a referral to either a plan covered service or a community provider for further assessment.

For more information on services available, please refer to your Member Handbook (PDF 1.59 MB) .

Additional health resources can be found here. Find the balance, support and care you need to live the healthiest life possible.

You can also contact the Washington Recovery Help Line at 1-866-789-1511or visit https://www.warecoveryhelpline.org. 24-Hour Help for Substance Abuse, Problem Gambling & Mental Health.

 

Emergency and Urgent Care
The Emergency and Urgent Care List tells you what a real emergency is and provides a list of many urgent care centers that you can use. You can use these centers when you are sick or need medical care right away and your PCP is not available, but it's not a life-threatening situation. Urgent care centers are usually open in the evenings and on weekends.

Emergency rooms (ERs) are for major injuries or sudden sicknesses that may be life threatening and need medical care right away. In an emergency, you should call 911 or go to an ER immediately.

For more information your covered dental benefits contact: 
Health Care Authority/ProviderOne 1-800-562-3022

To find a provider that takes Apple Health visit: https://fortress.wa.gov/hca/p1findaprovider

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Find A Behavioral Health Clinician
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Find A Drug

Search for drugs covered by UnitedHealthcare Community Plan

The UnitedHealthcare Community Plan Preferred Drug List (PDL) is a list of covered prescription drugs, and drugs needing prior authorization for enrollees in Washington Apple Health. Prior authorization is when your doctor has to call us before giving you the prescription to see if we will cover it.

Preferred Drug List for Washington Apple Health (PDF 1.38 MB)


10/1/2017 PDL Update  (PDF 60.16 KB)
7/1/2017 PDL Update (PDF 134.94 KB)
4/1/2017 PDL Update (PDF 62.28 KB)
1/1/2017 PDL Update
(PDF 61.94 KB)

Direct Member Reimbursement (DMR) Form
(PDF 93.85 KB)


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Find A Pharmacy

Search for a UnitedHealthcare network pharmacy below.

Search for a Pharmacy

 

 

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Questions?

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Call Us:
1-877-542-8997
TTY: 711

Monday through Friday
8 am to 5 pm PT

Member Information

Member Website

Already a member? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Medical Benefits Book

More Resources

Member Page

View more news, updates and resources for members.

Member Information

Member Website

Already a member? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Member Benefits Book