Guide to United Healthcare Supplemental Coverage

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Guide to Using Your UHC Dental, Vision, and Hearing

Setting Up Your UHC Dental, Vision, and Hearing Account

  1. Go to the UnitedHealthcare Website:

  2. Create an Account:

    • If you don’t have an account yet, click “Create Account” and follow the prompts.

    • You’ll need your UHC Golden Rule Dental or Vision policy number and other personal information like your date of birth, email address, and home address.

  3. Choose Your Username and Password:

    • Select a username and a strong password that you can remember.

  4. Set Up Security Information:

    • Choose security questions and answers for added account protection in case you forget your login credentials.

  5. Log in to Your Account:

    • Once you’ve completed registration, log in with your username and password.

Filing a Claim for UHC Dental, Vision, and Hearing

  1. Log in to Your UHC Account:

  2. Navigate to the "Claims" Section:

    • After logging in, locate the “Claims” section in your dashboard or menu, and select either the Dental or Vision claims option.

  3. Provide Required Information:

    • For Dental Claims:

      • Date of service

      • Procedure codes (if applicable)

      • Dentist’s name, address, and contact info

      • Copy of the dental bill or itemized receipt

    • For Vision Claims:

      • Date of service

      • Name of the vision provider (optometrist/ophthalmologist)

      • Type of service (eye exam, glasses, contacts, etc.)

      • Receipt or statement showing payment or charges

  4. Submit Your Claim:

    • Once you’ve entered the necessary details, submit your claim online.

  5. Track Your Claim:

    • You can monitor the status of your claim directly in your UnitedHealthcare account. UHC will notify you if further information or documentation is required.

How UHC Dental, Vision and Hearing Plans Work

  1. Primary Health Insurance First:

    • Your primary health insurance generally covers a broad range of medical services, including hospital stays, surgeries, and doctor visits, but does not cover routine dental or vision care (unless specific conditions or exceptions apply, like certain surgeries or treatments).

  2. Dental and Vision Plans as Supplemental Coverage:

    • Dental: UHC Golden Rule Dental covers preventive care like cleanings, exams, and fillings, as well as major procedures like root canals, crowns, and dentures.

    • Vision: UHC Golden Rule Vision helps cover the cost of routine eye exams, eyeglasses, and contact lenses.

  3. How Payments Work:

    • Dental: The plan covers a percentage of costs based on the type of dental care (e.g., preventive care, restorative care, or major services). If you go to an in-network dentist, you'll pay less. If you go out-of-network, you might need to pay more upfront and get reimbursed.

    • Vision: The vision plan covers services like eye exams and helps pay for eyewear, typically offering a fixed allowance for glasses or contacts. It also offers discounts for LASIK surgery and other vision treatments.

  4. Example:

    • Dental Care:

      • Total bill for a procedure: $1,200

      • Primary Health Insurance: Covers $800 (leaving $400 balance)

      • UHC Golden Rule Dental: Pays 80% of the $400 balance = $320

      • Your Payment: You pay $80 out-of-pocket.

    • Vision Care:

      • Eye exam cost: $150

      • UHC Golden Rule Vision: Covers $100 of the cost

      • Your Payment: You pay $50 for the exam. If you purchase glasses, the plan may cover a portion of the cost, depending on your specific coverage.

  5. Coordination of Benefits:

    • The dental and vision plans are typically not coordinated with your primary health insurance. They act as separate standalone benefits.

    • If you have secondary insurance, the dental or vision plan may coordinate with other policies (like another dental or vision plan) to cover additional expenses.

Tips for Maximizing Your UHC Dental, Vision, and Hearing Plan Benefits

  1. Use In-Network Providers: UHC has a network of preferred dentists and vision providers. Using in-network providers often results in lower costs and better coverage.

    Search In-Network Providers Here

  2. Review Your Coverage: Make sure to read your plan details to know what’s covered (e.g., routine checkups, glasses, contacts, etc.) and the reimbursement rates.

  3. Take Advantage of Preventive Care: Both dental and vision plans often offer coverage for routine checkups (e.g., cleanings, eye exams) with little to no cost to you.

  4. Maximize Your Vision Benefits: If you need glasses or contacts, use your annual allowance to help reduce out-of-pocket costs. Check if there are discounts for additional glasses or upgrades (e.g., lens coatings).

  5. Submit Claims on Time: File claims as soon as possible to ensure faster reimbursement. Keep copies of all your receipts and documents for reference.

  6. Know Your Plan’s Limitations: Understand the limits of your dental and vision benefits, including the number of visits per year, coverage limits, and exclusions. For example, some dental plans may not cover orthodontics or cosmetic dental work.

Frequently Asked Questions (FAQ)

  1. Q: How long does it take for a dental or vision claim to be processed?

    • Claims are generally processed within 10-15 business days, depending on the complexity. You can track your claim status via your online account.

    Q: Are orthodontic services covered under the dental plan?

    • Orthodontics may or may not be covered, depending on your specific policy. Check your benefits summary to confirm if this service is included in your coverage.

    Q: Can I file a claim for out-of-network dental or vision providers?

    • Yes, but if you use out-of-network providers, you may have to pay the full amount upfront and submit a claim for reimbursement. In-network providers typically result in lower out-of-pocket costs.

    Q: Are contact lenses and glasses covered?

    • Yes, UHC Golden Rule Vision generally covers a portion of the cost of eyeglasses or contact lenses, often with an annual allowance. Check your policy for details on limits and allowances.

    Q: Do I need a referral to visit an eye doctor or dentist?

    • No, for most dental and vision plans, you can see any provider you wish, though using in-network providers is recommended for maximum benefits.

  2. Contact Information

    If you need assistance or have questions, here’s how to reach UnitedHealthcare:

    • Customer Service Phone: 1-800-203-3459 (Dental)

    • Customer Service Phone: 1-800-638-3120 (Vision)

    • Website: www.uhone.com

Guide to Using Your UHC Hospital Indemnity Plan

Setting Up Your UHC Hospital Indemnity Plan Account

  1. Go to the UnitedHealthcare Website:

    • Visit the official website at UnitedHealthcare.

    • Click the “Sign In” button in the top right corner.

  2. Create Your Account:

    • If you don't already have an account, click “Create Account” and follow the instructions.

    • You will need your Golden Rule Hospital Indemnity policy number, date of birth, and other personal details to verify your identity.

  3. Set Up Your Username and Password:

    • Choose a username and a strong password to access your account.

  4. Complete Security Setup:

    • Set up security questions for account recovery in case you forget your login credentials.

  5. Log in to Your Account:

    • Once registered, log in with your username and password to manage your plan.

Filing a Claim for Hospital Indemnity Benefits

  1. Log in to Your UnitedHealthcare Account:

  2. Navigate to the Claims Section:

    • Once logged in, look for the "Claims" tab or option related to your Hospital Indemnity Plan.

  3. Enter Claim Information:

    • You’ll need to provide specific details about your hospitalization, including:

      • Date of admission and discharge

      • Hospital name and contact information

      • Reason for hospitalization (diagnosis, procedure)

      • A copy of the hospital bill or other supporting documentation

  4. Submit Your Claim:

    • After entering all necessary information, submit the claim directly online through your UnitedHealthcare account.

  5. Track Your Claim:

    • You can monitor the status of your claim through the same online portal. UnitedHealthcare will notify you if any additional information is needed.

How the UHC Hospital Indemnity Plan Works With Your Primary Health Insurance

  1. Primary Health Insurance First:

    • Your primary health insurance will pay for most of your medical expenses, including hospital stays, surgeries, doctor visits, and medications.

  2. Hospital Indemnity Plan Second:

    • The Golden Rule Hospital Indemnity Plan pays a fixed daily amount or lump sum benefit for hospitalization. This is paid directly to you, not to the hospital.

    • The plan is intended to help cover out-of-pocket costs that your primary insurance doesn't pay, like deductibles, co-insurance, or non-medical expenses.

  3. Benefit Example:

    • Hospital Bill: Total of $15,000

    • Primary Health Insurance Pays: $12,000 (leaving a balance of $3,000)

    • Golden Rule Hospital Indemnity Plan: Pays $250 per day for 5 days of hospitalization = $1,250

    • Remaining Balance: You owe $1,750 after both insurances contribute.

  4. Coordination of Benefits:

    • Your primary health insurance will typically pay first, and then the hospital indemnity plan will pay its fixed benefits.

    • When you file a claim with UnitedHealthcare, ensure you provide the details of your primary insurance to help coordinate the benefits between the two plans.

Tips for Maximizing Your Benefits

  • Review Your Coverage: Familiarize yourself with the benefits your hospital indemnity plan provides, such as the daily benefit amount, the maximum number of covered days, and any exclusions.

  • Use In-Network Providers: While the hospital indemnity plan doesn't require you to use in-network hospitals for benefits to apply, using in-network providers for your primary health insurance may lower your overall costs.

  • Submit Claims Promptly: File your claims as soon as possible to avoid delays. Keep your medical bills and supporting documents organized to make the claims process smooth.

  • Keep Track of Hospital Stays: If you have multiple hospitalizations, ensure you know the limits on the number of days your hospital indemnity plan covers. You may need to file separate claims for each hospitalization.

  • Use Benefits for Out-of-Pocket Costs: The payments from your hospital indemnity plan can help cover out-of-pocket costs like deductibles, co-insurance, and other medical or non-medical expenses.

Frequently Asked Questions (FAQ)

  1. How long does it take to process a claim?

    • Claims are typically processed within 10-15 business days. You can track your claim status via your UnitedHealthcare account.

    Q: Can I file a claim for outpatient services?

    • No, the Golden Rule Hospital Indemnity Plan typically only covers inpatient hospital stays. For outpatient services, you would need to use other insurance coverage or benefits.

    Q: Do I need to notify UnitedHealthcare before I go to the hospital?

    • No, you generally don’t need to notify UnitedHealthcare in advance of a hospital stay. However, if you are undergoing an elective procedure, it’s a good idea to check with UnitedHealthcare for any requirements.

    Q: What happens if I exceed the maximum number of covered days?

    • If your hospital stay exceeds the number of days your plan covers, you may be responsible for the additional costs. Check your policy for limits on the number of days or benefits provided.

    Q: Can I use the Golden Rule Hospital Indemnity Plan with a High Deductible Health Plan (HDHP)?

    • Yes, the hospital indemnity plan can be used alongside any primary health insurance, including HDHPs. It can help cover the high out-of-pocket costs associated with HDHPs, like your deductible and co-pays.

  2. Contact Information

    For assistance or questions, here’s how to reach UnitedHealthcare:

    • Customer Service Phone: 1-800-658-2105 (for Golden Rule plans)

    • Website: www.uhone.com

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