UnitedHealthcare EDGE®

November 14, 2017

The EDGE product line for Small Business is a distinct combination of medical and outpatient pharmacy designs designed to address a target segment of small-to-mid size business purchasers with up to 300 employees seeking an innovative, lower priced alternative.

The UnitedHealthcare EDGE Small Business plans are built on UnitedHealthcare Choice and Choice Plus plans, with additional features that can help both members and employers save money.  By seeking care from Premium Care physicians, members can get an even higher level of quality care and in-network benefits.

Like Choice and Choice Plus, EDGE small business plans are open-access plans where members have the freedom to choose from any health care professional in the UnitedHealthcare network, including specialists, without a referral or choosing a primary care physician.   Some EDGE Plans provide access to both network and non-network providers, so members can seek care from any provider they choose, but at a lower co-insurance/deductible level for network providers.

Members can get better coverage when using:

  • Network providers
  • Tier 1 providers (this may include Premium Care Physicians)

The key features that distinguish the product include:   

  • Use of a tiered benefit structure for office copayments and professional medical and surgical service coinsurance.
  • Embedded deductible
  • Per-occurrence deductible for inpatient hospital and outpatient surgical
  • Lab/x-ray with coinsurance separate from outpatient visit copayment