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UnitedHealthcare Navigate

UnitedHealthcare Navigate benefit plans offer members access to a network of care providers that reflects the unique health care access needs of their communities. A primary care physician (PCP) coordinates member care among the various care providers they may be seeing to drive personalized member wellness.

Key Features

  • PCP Requirement  - Members are required to choose a network PCP from the Navigate network.
  • PCP Referrals to Network Specialists - PCPs generate electronic referrals to network specialists within the Navigate network when necessary.
  • Notification Requirements and Prior Authorization - Required for select services as referenced in the Advance Notification section in the Physician, Health Care Professional, Facility and Ancillary Administrative Guide.

Benefit Plans
In most cases, when non-emergency specialist services are rendered without a referral from a PCP, Navigate does not offer coverage and Navigate Balanced and Navigate Plus include a higher cost share for members. To identify the member's benefit plan, reference the bottom right corner of their health care ID card or confirm when verifying eligibility.

Plan Models Network Provider
with Referral
Network Provider Without Referral Non-network Provider*
Navigate Network benefits No coverage* No coverage
Navigate Balanced Network benefits Lower level benefit No coverage
Navigate Plus Network benefits Lower level benefit Non-network benefit
* Except for emergency services and related admissions
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