The Patriot V QPOS Plan offered by the Fund provides you with in-network (referred) services coordinated by your participating Primary Care Physician (PCP). The Plan offers participants the options of going directly to out-of-network (self-referred) providers or facilities without a referral.
When you self-refer, you will be subject to the applicable self-referred deductible and coinsurance benefits levels and maximums.
The Patriot V Plan covers routine Wellness and Preventive Care provided by your PCP.
You may also obtain pediatric dental services and gynecological exams from participating providers without a referral from your PCP. If you choose to access care without a referral, you must obtain authorization prior to receiving self-referred care for certain services. Failure to precertify may result in a reduction of benefits
UnitedHealthCare (UHC) is the medical Third Party Administrator "TPA" for the North Jersey Municipal Employee Benefits Funds MA plans Only.
For more than two decades, UnitedHealthCare has strived to improve the health care experience, help individuals take a more active role in their own health and well-being and to make health care services more accessible for all Americans.
Members of the NJMEBF have access to myuhc.com. You can find information about your medical benefits, locate a physician* in your network using UHCs customized online hospital and physician directory, check eligbility information and more. Other great features include: