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UniCare is becoming Wellpoint
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Provider Tiering

As of July 1, 2023, UniCare is discontinuing tiering for specialists in the Total Choice plan (previously called Basic), and is introducing Primary Care Provider (PCP) tiering for the PLUS plan.

You can check provider tiers using Find Care.

How Tiering Is Determined

The tier placement for each group is based on the group’s contractual relationship with UniCare.

Member copays are determined by the tier placement of the group. Providers submitting claims from different and distinct groups will be subject to the copays associated with the tier of each of those groups. The copay for a visit will depend on which of those two physician groups billed for the services. For providers who work for more than one group, the group with the highest tier will determine the tier listed in Find Care.

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