UnitedHealthcare PPO/EPO

UnitedHealthcare Non-Medicare PPO and EPO 

These plans are only available to qualified Retirees with dependents where one or more member(s) is eligible for Medicare and the other member(s) is not eligible for Medicare. The non-Medicare eligible member(s) may choose to have the UHC Non-Medicare PPO or EPO plans. 

UnitedHealthcare Non-Medicare PPO 

This plan allows you to choose any healthcare provider. When you obtain care from in-network providers, the plan pays higher benefits, your out-of-pocket expenses are less, and claims are submitted for you by your doctor. If you obtain care from an out-of-network provider, the plan pays lower benefits and you may be required to pay for services directly and submit your own claims. PPO's don't assign a Primary Care Physician, so you have more responsibility for coordinating your own care.

Exclusive Provider Organization (EPO)

EPO plans allow members to get care and treatment from in-network providers for a fixed copay. UHC offers two EPO plans for SFHSS members. UHC Doctors Plan EPO has a narrow network of providers for members who live in certain zip codes in the greater San Francisco Bay area. You will need to select a Primary Care Physician (PCP) to coordinate your care. The UHC Select Network EPO has a broader network of providers throughout California. You do not need to select a PCP and will need to coordinate your own care. You can self-refer to specialists as long as they are in the UHC Select Network in California. 

Learn more at the UHC SFHSS website here. 

Attention

The UnitedHealthcare Group Medicare Advantage (PPO) Plan will be discontinued as of December 31, 2024. Starting January 1, 2025, the Blue Shield Medicare PPO plan will take its place. Members enrolled in the UnitedHealthcare Medicare Advantage PPO plan in 2024 will be automatically transitioned to a corresponding Blue Shield plan unless an election was made to change or waive their benefits during this past Open Enrollment in October. 

Link to the Blue Shield MAPD information would be found here.