UnitedHealthcare Medicare Advantage Referral Requirement – What Patients Need to Know

Starting January 1, 2026, most members enrolled in UnitedHealthcare Medicare Advantage HMO and HMO-POS plans will be required to obtain a referral from their Primary Care Provider (PCP) before receiving specialist care.

👉IMPORTANT FOR EXCELSIOR PATIENTS:
Orthopedic services DO require a PCP referral under this new requirement.

To ensure a smooth transition and prevent delays or denied claims, our office will begin requiring referrals now for applicable services.

For certain specialist visits, your PCP must submit a referral to UnitedHealthcare before your appointment. While UnitedHealthcare will not deny claims for missing referrals until May 1, 2026, referrals will be required moving forward.

If a referral is not obtained, your appointment may be cancelled.  Please call your primary care to ensure a referral has been submitted.

Beginning referrals ahead of time helps:

🔗 For additional details directly from UnitedHealthcare, visit:
https://www.uhcprovider.com/en/resource-library/news/2025/referral-req-specialist-services-medadv.html

If you have questions or need assistance, please contact our office at 716 250-9999 — we’re here to help!