Navigating the landscape of health insurance can often bring up questions about networks, providers, and administrators. If you are a member of the City and County of Broomfield health plan, you might be wondering about the relationship between UMR and United Health Care, especially in the context of your UnitedHealthcare Choice Plus Network administered by UMR. Let’s clarify this connection and what it means for your healthcare benefits.
UMR, or United Medical Resources, is indeed associated with UnitedHealth Group. However, it’s crucial to understand their specific roles. UMR operates as a third-party administrator (TPA) for self-funded health plans. This means that while UMR is part of the UnitedHealth Group family, it functions independently in managing the administrative aspects of your health plan on behalf of your employer, the City and County of Broomfield.
Think of it this way: UnitedHealthcare provides the network – the UnitedHealthcare Choice Plus Network – which is a broad network of doctors, hospitals, and healthcare facilities. UMR, on the other hand, is the entity that handles the day-to-day operations of your specific health plan using this network. This includes processing claims, managing benefits information, and providing customer service for plan members.
Accessing Your Benefits and Network
Upon enrollment, you should receive a UMR ID card, typically within 2-3 weeks of your coverage start date. This card is your key to accessing healthcare services within the UnitedHealthcare Choice Plus Network. For immediate access or to review your plan details, you can log in to the UMR member portal. It’s usually accessible 7-10 business days after your coverage becomes effective. The UMR portal allows you to view your ID card, explore your benefits, track claims, and find in-network providers.
Finding Healthcare Providers
Your health plan utilizes the UnitedHealthcare Choice Plus Network. This extensive network ensures you have access to a wide range of healthcare professionals. To find doctors, hospitals, and other providers within your network, you should specifically search within the UnitedHealthcare Choice Plus Network. This ensures that you receive in-network benefits, which typically result in lower out-of-pocket costs.
Vision Care
Your vision benefits are also administered through UMR and utilize the UnitedHealthcare Choice Plus Network for in-network routine vision care. In-network, you typically have a copay for eye exams and refractions, with coverage for hardware varying. Out-of-network benefits for vision exams are also available with a maximum coverage amount.
Pharmacy Benefits with Express Scripts
For prescription medications, your plan utilizes Express Scripts, Inc. (ESI) through RxBenefits as the pharmacy benefit manager (PBM). Express Scripts works within the UMR United Health Care Plus Choice Network. You can manage your prescriptions, review medication costs, find pharmacies, and understand your plan details by registering at Express-Scripts.com. Some medications may require prior authorization, which can be initiated by contacting RxBenefits or your prescribing physician.
Regenexx and UMR
Your plan also includes access to Regenexx, an innovative alternative to elective orthopedic surgeries. Regenexx utilizes your body’s natural healing agents, and most in-house services are covered at 100%. This is an example of specialized benefits offered within your UMR administered plan.
Key Takeaways
- UMR is part of UnitedHealth Group: Yes, UMR is under the umbrella of UnitedHealth Group.
- UMR is a Third-Party Administrator: UMR manages the administration of your health plan for the City and County of Broomfield.
- UnitedHealthcare Choice Plus Network: Your plan utilizes this network for access to doctors and facilities.
- Accessing Information: Use the UMR portal for plan details and Express Scripts for pharmacy benefits.
Contact Information for UMR
If you have any questions or need assistance, you can contact UMR directly:
- Customer Service: 800.826.9781
- Website: www.umr.com
- Submit Medical Claims to: PO Box 30541 / Salt Lake City, UT 84130
Understanding the relationship between UMR and UnitedHealthcare helps you effectively utilize your health benefits and access the care you need. Remember to use your UMR ID card and online resources to manage your healthcare effectively.
