Important Update for Patients with UnitedHealthcare Medicare Advantage Plans
What’s Changing?
Beginning May 1, 2026, patients with a UnitedHealthcare Medicare Advantage plan will be required to obtain a referral from their primary care provider (PCP) before receiving specialty care. This referral requirement applies to:
- Orthopedic care
- Neurosurgical care
- Spine care
- Pain management
- Other specialty medical services
This requirement applies regardless of whether care is provided by Tier 1 Institute or another specialty practice.
Tier 1 Institute Remains In-Network
Tier 1 remains dedicated to providing top-tier, high-quality care to our patients. With that mission in mind, Tier 1 will continue to be in-network with UnitedHealthcare Medicare Advantage plans.
However, in order to be seen by one of our physicians, your primary care provider must submit a referral to UnitedHealthcare for approval.
Planning Ahead for Medicare Coverage
If you are reviewing or considering Medicare plan options in the future and prefer plans that do not require referrals for specialty care, we encourage you to contact our office for guidance and assistance.
Our Commitment to You
The team at Tier 1 remains committed to your care. We will continue to advocate on your behalf and work diligently to ensure you receive the high-quality specialty care you need and deserve.
If you experience any difficulty obtaining a referral, our team is ready to help advocate for you and guide you through the process.
If you have questions or need assistance, please contact us at 931-526-9518.
UnitedHealthcare Medicare Advantage Referral Requirement – FAQs
Who is responsible for submitting the referral?
Your primary care provider (PCP) must submit the referral request to UnitedHealthcare on your behalf for approval.
What should I do if I am having trouble with a referral?
If you experience any difficulty obtaining a referral, our team is ready to help advocate for you and guide you through the process. Please contact us at 931-526-9518.
Can Tier 1 Institute submit a referral for me?
No. UnitedHealthcare requires referrals to be submitted by your primary care physician.