United healthcare blue cross blue shield customer service

• No provider referrals necessary for in-network services

• Using an in-network providers will save you the most in out-of-pocket costs

• Coverage of preventive care services from in-network doctors at 100%

• Employee Assistance Program managed by Optum EAP

• Onsite customer advocate

• Premiums

• Preventive benefit coverage

• Annual deductible

• Coinsurance

• Out-of-pocket maximum

Medical coverage through UnitedHealthcare also covers most medications received directly from a provider or when in a medical facility. However, if your provider writes a prescription for medication, you need to fill written prescriptions at an Express Scripts (ESI) retail pharmacy or ESI mail. Express Scripts is the Prescription Benefit Manager for Sandia Total Health. To learn more about Express Scripts and if your prescription is covered, refer to the BCBSNM and UHC Prescriptions article. 

You can refer to the following documents to find more detailed information on your UHC plan:

• For a quick overview of how UHC manages your plan, you can refer to the Sandia Total Health (STH) UHC Member Guide.

• For details on how the plan works, you can refer to your Sandia Total Health Program Summary – UnitedHealthcare.

• For details on eligibility, events allowing enrollment and disenrollment, coordination of benefits, claims and appeals information, when coverage ends, continuation of group health coverage, and your rights under the Employee Retirement Income Security Act of 1974 (ERISA), you can refer to the Sandia Health Benefits Plan for Employees Summary Plan Description.

Sandia Total Health by UHC allows members to see any licensed provider, although benefits are greater when your care is received care from UHC-contracted In-network providers and In-network facilities. Sandia Total Health by UHC features two network options:

• In-network (Tier 1 & Tier 2): With Sandia Total Health, in-network (Tier 1 & Tier 2) services provide you with access and better negotiated rates to contracted providers and facilities nationwide. You receive a higher level of benefits and pay a lower deductible, coinsurance, and out-of-pocket maximum utilizing in-network providers than out-of network providers.

• Out-of-network: With Sandia Total Health, out-of-network services are covered, so you have the option of visiting any provider or facility. With a higher deductible, coinsurance, and out-of-pocket maximum, this is the most expensive healthcare option for you, but it also offers you freedom of choice for most services (same benefits are not covered out-of-network). Note: Deductible and coinsurance are calculated based on UHC’s allowed amounts for eligible services. If you see a non-contracted provider, you will be responsible for the difference between UHC’s allowable amount and the provider’s billed amount, in addition to the higher coinsurance, deductible, and out-of-pocket maximum costs.

To help you cover the costs of healthcare, Sandia Total Health offers you the following Health Reimbursement Account (HRA) and a voluntary Flexible Spending Account (FSA):

• Health Reimbursement Accounts: The HRA is a tax-free, Sandia-funded account you can use to help pay for eligible medical, prescription, dental, and vision expenses. Note: During claims processing, FSA funds will be applied to eligible expenses, if enrolled, first before you can access HRA dollars.

• Flexible Spending Accounts: The FSA is an employee-funded account you can use to help pay your deductible and other covered expenses. Note: During claims processing, FSA funds will be applied to eligible expenses first before you can access HRA dollars.

Note: the provider may bill you for the portion of each service due after your deductible, coinsurance, out-of-pocket maximum, and FSA and HSA funds have been applied to your claim.

To learn more about how you can earn HRA dollars to offset your healthcare costs, refer to the Virgin Pulse article.

Online search

You can find a new provider or check to see if your current doctor is a UHC in-network provider by:

• Members: Visiting My United Healthcare and registering. Then, following the tab “Provider Look-Up” to search all UHC in-network providers. When conducting your search select the “UnitedHealthcare Choice Plus Plan.”

• Non-UHC members: Visiting My United Healthcare selecting “Link & Tools” on the left side of the home page, selecting “Provider Look-Up,” selecting “UnitedHealthcare Choice Plus Plan,” and following the search options.

Finding a primary care provider (PCP)

The Presbyterian Customer Service Center is ready to assist you in finding a Presbyterian Medical Group (PMG) primary care or pediatric provider and setting up your first appointment. They can also assist you in changing to another PMG primary care or pediatric provider. You can call 505-923-7300 or call toll free 855-269-7737, Monday – Friday, 8:00 a.m. – 5:00 p.m. For more information, refer to the Primary Care Physician article.        

In non-emergency situations, help is a phone call or click away. UHC’s confidential Nurseline is available to you 24/7 and lets you to speak with an experienced registered nurse who can give you treatment advice and determine whether it’s necessary for you to see a doctor.

You can access the Nurseline by:

• Phone: 1-877-835-9855

• Via Live Nurse Chat: My United Healthcare (click the “Online Now” link from the “Ask A Nurse” section of the homepage)

You can access a board-certified doctor within minutes from your smartphone, tablet, or computer-anytime and anywhere for conditions such as: allergies, coughs, colds, ear infections, pink eye, seasonal flu, fever, rash, sinus problems, sore throats, urinary tract infections, and more. Virtual Visits are just $10 and FSA and/or HRA funds can be used. Click here to learn more information.

UHC customer advocate

UHC’s customer advocate can help you navigate your plan, understand how a claim was paid, answer Flex Spending Account and Health Reimbursement Account questions, navigate appeals, find a doctor, and use the cost estimator tool.

Contact our UHC Customer Advocate, Amanda Huber

• Hours are: 8:00 a.m. - 4:00 p.m., Monday-Friday 
• Phone: (952) 251-5434 (Please allow up to 2 business days for a return call)
• Email:

You may also contact UHC Customer Service (make sure to have your ID card available): Phone: 877-835-9855. Keep in mind that the hours are: Monday – Friday, 8:00 a.m. – 5:00 p.m. (MST) (closed Thanksgiving Day and Christmas Day).

Additional Resources

• Contact:
  • UHC Customer Service: 1-877-835-9855
  • HR Solutions

• Related Websites:
  • UHC Rally Connect (Find a Provider)
  • UHC Virtual Visits
  • My United Healthcare

• Related Documents:
  • Sandia Total Health Program Summary – UnitedHealthcare
  • Sandia Total Health (STH) UHC Member Guide
  • Sandia Health Benefits Plan for Employees Summary Plan Description
  • Get the Health4Me app
  • myClaims Manager at myuhc.com
  • myHealthcare Cost Estimator on myuhc.com

• Related Forms:
  • UHC Claim Submission / Withdrawal Request Form
  • UHC Health Claim Transmittal Form
  • UHC International Claims Transmittal Form

• Related Articles:
  • Primary Care Physician
  • BCBSNM and UHC Prescriptions
  • HRA
  • FSA
  • Virgin Pulse
  • UHC: Managing your FSA and HRA Accounts
  • Employee Assistance Program

This article is informational only, and coverage and benefits are determined solely in accordance with the applicable Plan documents.