For certain conditions, UnitedHealthcare partners with top-ranked facilities across the country, called Centers of Excellence (COEs), to ensure you are getting quality care from leading practitioners. Beginning January 1, 2018, the Plan will pay 100% of eligible charges after you’ve met your deductible for certain spine or joint surgeries if you enroll in UnitedHealthcare’s Spine and Joint Solution (SJS) program, connect with and use a COE.
In addition to the financial benefit, enrolling in the SJS program will partner you with a nurse who can:
- Help answer questions on your treatment plan or surgery
- Discuss options to manage your pain and care before and after surgery
- Determine other testing or consultation needs
As part of the SJS program, members will connect with 2nd.MD to receive an expert medical second opinion confirming the appropriateness of their treatment plan.
Eligible procedures include:
- Total hip and knee replacements
- Spine disc surgery
- Spine fusion surgery
COEs for Other Specialized Conditions
UnitedHealthcare members also have access to COEs for cancer treatment, gastric bypass surgery, infertility treatment, and substance and alcohol use treatment. Cigna members have access to COEs for substance and alcohol abuse treatment, along with other specialized services. If you are expecting a specialized surgery or treatment, call UnitedHealthcare or Cigna to ask about COEs for your service.