UnitedHealthcare has outlined several updates to its Medicare Advantage plans for 2026, including new referral requirements and changes to supplemental benefit eligibility.
1. Most HMO and POS plans will require referrals.
Beginning Jan. 1, 2026, members enrolled in UnitedHealthcare Medicare Advantage HMO and POS plans will need a referral from their primary care provider before seeing certain specialists in outpatient, office, or home settings. PCPs must submit the referral to UnitedHealthcare prior to the specialist visit. This requirement also applies when members use the National Network while traveling. Learn more 2026 Medicare Advantage Referral Requirements Guide
2. Special Needs Plans will require qualifying conditions for select benefits.
Starting Jan. 1, 2026, new and existing members in Chronic Special Needs Plans (C-SNPs) and Dual Special Needs Plans (D-SNPs) must have a qualifying chronic condition to access benefits such as healthy food or utility assistance. Providers may be contacted to verify the member’s eligibility. See 2026 Medicare Advantage, CSNP & DSNP Plan Overview Course for more information.
UnitedHealthcare has released detailed referral guidelines and training resources for providers ahead of these upcoming changes.
Resources: 2026 Medicare Advantage plan updates