Optimum Choice United Healthcare | HealthSoul

Optimum Choice United Healthcare

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Overview of Optimum Choice United Healthcare

OCI HMO
OCI is a referral-based plan in which members work closely with a primary care physician (PCP) for appropriate, cost-effective care. With a strong, local network, OCI offers lower premiums than traditional health plan options. If services are delivered outside of our local network, the plan will not cover the cost except in an emergency. The OCI network in Delaware, Maryland, Virginia, West Virginia or Washington, D.C. includes more than 33,000 doctors, 200 hospitals and 3,500 retail pharmacies.

Added plan details
A PCP is required to help coordinate your care and guide you through the health care system. You must choose a network primary care physician (PCP) when you enroll. Your PCP’s name will be printed on your health plan ID card.
There's no coverage if you go out-of-network.
You’ll need a referral from your PCP before seeing another network physician or specialist. Your physician should seek prior authorization for things like surgeries and most lab and radiology services, even when performed in your doctor's office.
You must visit network locations.
For PCP appointments, see the PCP printed on your ID card.
For lab and radiology appointments, go to the locations in the counties printed on your ID card. Your radiology facility is assigned based on your PCP's county, and your lab facility is assigned based on the county in which you live.

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