Contact UnitedHealthCare of Arizona: 800-985-2356

Health Care Terms

A quick look at some key healthcare terms that may be helpful to you

Continuity of Care

Continuity of care is a term used to address the issue of “quality of care” over time. Typically, health plans will allow patients to continue to see their health care provider if they consider it critical to the consistency of their treatment. The health plan will usually take into account the patient’s current medical condition and the availability of in-network specialty physicians to whom the care can be transferred. The state of Arizona has specific requirements for insurance companies to provide Continuity of Care. This information can be found at www.azleg.gov.

In-Network

Health plans contract with a wide range of doctors, as well as specialists, hospitals, labs, radiology facilities and pharmacies. These are the providers in your “network.” Each of these providers has agreed to accept your plan’s contracted rate as payment in full for services. That contracted rate includes both your insurer’s share of the cost, and your share. Your share may be in the form of a co-payment, deductible or co-insurance.

Out-of-Network

Health plans contract with a wide range of doctors, as well as specialists, hospitals, labs, radiology facilities and pharmacies. These are the providers in your “network.” Each of these providers has agreed to accept your plan’s contracted rate as payment in full for services. That contracted rate includes both your insurer’s share of the cost, and your share. Your share may be in the form of a co-payment, deductible or co-insurance.

Open Enrollment

Out-of-network providers are not under contract with your insurance plan to provide services. In many cases, you can still see those providers, however, your plan may not cover out-of-network care at all, or it may require higher co-pays, deductibles and co-insurance for out-of-network care. Your costs for out-of-network care also depend on your type of plan.

Insurance Exchange

The Arizona Health Insurance Exchange is the new marketplace established by the federal government for health insurance policies. Uninsured, under-insured and the self-insured Arizonans are eligible to purchase health insurance plans through the exchange.