UHC Provider Directory 2019 - Medicare & More

[Pages:2334]2019 PROVIDER DIRECTORY

List of network doctors and specialists

AARP? MedicareComplete? SecureHorizons? Essential (HMO) AARP? MedicareComplete? SecureHorizons? Plan 1 (HMO) AARP? MedicareComplete? SecureHorizons? Plan 2 (HMO) Texas Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, Van Zandt and Wise Counties

Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. For more information, please contact UnitedHealthcare Customer Service at:

Toll-free 1-800-950-9355, TTY 711

8 a.m. - 8 p.m. local time, 7 days a week



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This directory is current as of September 10, 2018

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Your plan

PROVIDER DIRECTORY

Introduction

This directory provides a list of your plan's network providers.

This directory is for the plans and service area listed on the cover. It is not a complete list of

network providers available to you. You can search for a network provider and print a directory

online, which is updated weekly and available 24 hours a day, 7 days a week.

For the most up-to-date information about the plan's network providers in your area:

Visit or call UnitedHealthcare Customer Service toll-free at 1-800-950-9355, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare. Providers are prohibited from discriminating against any member, with regard to quality of service or accessibility of services, on the basis of race, ethnicity, national origin, religion, sex, age, mental or physical disability or medical condition, sexual orientation, claims experience, medical history, evidence of insurability, disability, genetic information, or source of payment. This information is available for free in other languages. Please call UnitedHealthcare Customer Service toll-free at the number listed above. Esta informaci?n est? disponible sin costo en otros idiomas. Llame a nuestro Servicio al Cliente de UnitedHealthcare al n?mero gratuito indicado arriba. This document may be available in an alternate format such as Braille, larger print or audio. Please call Customer Service at the toll-free phone number listed above. The provider network may change at any time. You will receive notice when necessary.

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Introduction

Introduction

This directory provides a list of the plan's network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage.

What is a primary care provider?

A primary care provider (PCP) is the health care professional who provides most of your care.

Your PCP can help you: ? Make smart lifestyle choices to help improve and maintain your health ? Get preventive care and health screenings ? Better understand your medical conditions ? Coordinate any specialist care to help avoid duplicate and expensive tests ? Manage your prescriptions and identify possible harmful interactions

Select a primary care provider (PCP)

You will need to choose one of our network providers to be your primary care provider (PCP). PCPs are listed in the Primary Care Provider section of this directory. The term PCP will be used throughout this directory.

If you choose a PCP who is not taking new patients, UnitedHealthcare may assign you to a different PCP. If this happens, you can switch to another PCP who is accepting new patients.

Your PCP plays an important role in your health care and we want you to be comfortable with the provider you choose. If you want to switch providers, call UnitedHealthcare Customer Service tollfree at 1-800-950-9355, 8 a.m. - 8 p.m. local time, 7 days a week. TTY users should call 711.

Referrals from your PCP

Your PCP can handle most routine health care needs. If you need to see a network specialist or other network provider, you may need to get a referral from your PCP. Your PCP will make a referral based on your health situation. They may or may not refer you to a particular specialist in this directory who you want to see. Generally, your PCP will provide follow-up care, as needed. Please see the Evidence of Coverage for information about access to specialists.

This directory provides a list of skilled nursing facilities in your plan's network. Contact your PCP for a referral to a network skilled nursing facility.

The network providers listed in this directory have agreed to provide you with your health care coverage. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. Check your Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up for optional supplemental riders before making appointments for dental, vision or hearing services.

If I need emergency or urgent care

A medical emergency is when you, or any other ordinary person with an average knowledge of health and medicine, believe that you have symptoms that require immediate medical care to

Introduction prevent death, loss of a limb, or loss of function of a limb. The medical symptoms may be an illness, injury, severe pain, or a medical condition that is quickly getting worse.

If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service area from the nearest available provider. Emergency services are also covered whether a provider is in our network or not. You or someone else should call and tell us about your emergency care, usually within 48 hours.

Urgently needed services is a non-emergency, unforeseen medical illness, injury, or condition, that requires immediate medical care. When out of the service area, urgent care may be obtained from the first available provider whether the provider is in our network or not. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. If you obtain routine care from out-of-network providers neither Medicare nor your Plan will be responsible for the costs.

If you get a bill

There may be times when you get a bill from a provider for the full cost of medical care you have received. If you get a bill, contact UnitedHealthcare. In many cases, you should send this bill to UnitedHealthcare instead of paying it. We will look at the bill and decide whether the services should be covered. If we decide they should be covered, we will pay the provider directly. Please see your Evidence of Coverage for more information.

If you're on Medicare and Medicaid

If you're a Qualified Medicare Beneficiary (QMB), your doctor may not bill you for deductibles, copays or coinsurance for Medicare-covered services, except for Part D prescription drug copays. Please show your UnitedHealthcare member ID card and your state-issued Medicaid member ID card when you see the doctor or use other plan services. This will help ensure you're billed for the correct amount.

Accessing your mental health benefits

To access your mental health benefits, call the toll-free mental health number on your UnitedHealthcare member ID card. When you call, a representative will check your eligibility and get basic information about you and your situation. Depending on the help you need, a clinician may talk with you and recommend a provider and treatment plan. If you prefer, your PCP may call and arrange a referral for you. Your personal information will be kept strictly confidential.

Organ transplant services

Your plan has a nationwide network of facilities that perform organ transplants (including the heart, lung, liver, intestine, kidney, bone marrow and/or pancreas). Solid organ transplants must be performed at a facility that is currently Medicare-approved for your specific type of transplant. The plan's hospital network for organ transplant services is different than the network shown in the "Hospitals" section of this provider directory. Some hospitals in the plan's network for other medical services are not in the plan's network for transplant services. The complete list of Medicare-approved facilities in your plan's network may change throughout the year. For information on network facilities for transplant services, please call UnitedHealthcare Customer Service toll-free at 1-800-950-9355, TTY 711.

Introduction

What is the service area for your plan?

Your service area is listed below.

AARP? MedicareComplete? SecureHorizons? Essential (HMO) Texas - Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, Van Zandt, and Wise counties

AARP? MedicareComplete? SecureHorizons? Plan 1 (HMO) Texas - Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, Van Zandt, and Wise counties

AARP? MedicareComplete? SecureHorizons? Plan 2 (HMO) Texas - Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, Van Zandt, and Wise counties

How do you find network providers in your area?

Network providers in your area are listed in the following sections of this directory. To find a provider using this directory, turn to the Table of Contents on the next page and see where each section begins. Go to the section of the type of provider you are looking for. Once you are in that section, locate the city you live in. Under each city you will find a list of providers in alphabetical order.

You may have more providers to choose from if the service area shown above is larger than the service area shown on the front of this directory. You can also search online at , which is updated weekly and available 24 hours a day, 7 days a week.

If you have questions about your plan or require assistance in finding a PCP, please call our UnitedHealthcare Customer Service Department toll-free at 1-800-950-9355, TTY 711. Or visit .

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Table of Contents

Contracting Medical Group/IPA or Network..................................................................................................................5 Austin Market..................................................................................................................................................5 Houston Market...........................................................................................................................................11 North Texas Market.................................................................................................................................... 29 North Texas Specialty Physicians.........................................................................................................833 North Texas Specialty Physicians (PCP).............................................................................................896 San Antonio Market................................................................................................................................. 921 Wellmed Dallas PCP................................................................................................................................932

Skilled Nursing Facility Care.............................................................................................................................................. 937 Dental............................................................................................................................................................................................... 947

Dental.......................................................................................................................................................... 947 Vision............................................................................................................................................................................................. 2129

Vision........................................................................................................................................................ 2129 Index...............................................................................................................................................................................................2219

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