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UnitedHealthcare Community Plan of Virginia - Cardinal Care - Lookup Tools

Primary Care Provider
As a member of UnitedHealthcare Community Plan of Virginia - Cardinal Care Plan, one of the first things you will want to do is to choose a Primary Care Provider (PCP). Your PCP will provide and coordinate all your healthcare, including referrals to specialists, with the exception of emergencies, mental health and women’s healthcare.

Each covered family member may choose a different PCP within UnitedHealthcare Community Plan of Virginia - Cardinal Care Plan. If you do not choose a PCP, we may select one for you, which you can change later.

Please feel free to call our Member Services line, at 1-844-368-7151 (TTY: 711) and we will be happy to help you find or change your PCP.

To find a Primary Care Provider (PCP) or a Specialist in our network, please use our search below or download a directory. You'll find complete information, including names, addresses, specialties, new patient’s availability and languages spoken.

If you would like us to provide you with a printed version at no cost, please call us, at 1-844-368-7151 (TTY: 711).

Find a provider (Opens in a New Tab)

Provider Directories

Find a drug

Search for covered drugs

Preferred Drug List (PDL)

The PDL is a list of covered prescription drugs, and drugs needing prior authorization for enrollees. Prior authorization is when your doctor has to call us before giving you the prescription to see if we will cover it.

Download UnitedHealthcare Community Plan of Virginia - Cardinal Care Plan Preferred Drug List (PDL)

*Preferred Drug List is subject to change

90 day supply drug list

Virginia Medicaid has a new policy allowing coverage of up to a 90-day supply for many drugs as of October 1, 2021. The list of drugs by the Department of Medical Assistant Services (DMAS) includes many medications which members often receive for long term therapy. Members will be eligible for this policy after filling two 31-day supply fills in the past 120 days. This new 90-day list does not include all drugs. Drugs posted at the Virginia Medicaid Pharmacy Services website may be covered for 90 days. If the medication is not on the list, a maximum of 31-day supply will be applied. Some medications may have other edits, please see the searchable formulary.

COVID 19 test kit reimbursement request form

Pharmacy Direct Member Reimbursement Form

Use this form to get refunded if you paid retail cost for your covered prescription drug(s).

Search for a Behavioral Health provider

Mental health is as important as physical health. That's why we have coverage for both. This includes:  

  • Comprehensive evaluation and assessment services 
  • Mental health, addiction, and recovery treatment 
  • Medication management 
  • Person-centered care planning and coordination 
  • You or a loved one may experience a mental health crisis and need extra support.  Benefits include: 
  • Short-term crisis response programs 
  • Referral and linkage to other community-based services 
  • Mental health case management 
  • Your child may also benefit from specialized care.  Services for qualifying members include:  
  • Home-based or community-based assessment and treatment 
  • Treatment foster care case management 
  • Therapeutic day treatment 
  • Residential treatment and therapeutic group homes 

Dental care is managed by DMAS. The Dental Benefits Administrator, DentaQuest, provides dental services for adults and children. For more information, call 1-888-912-3456, TTY 1-800-466-7566 or visit  dmas.virginia.gov/dental

Find a pharmacy

Find a UnitedHealthcare Community Plan of Virginia - Cardinal Care network pharmacy below.  

Search for a pharmacy near you. 

Enrollment information

UnitedHealthcare Community Plan of Virginia - Cardinal Care plan specialists can answer questions.

Call us:
1-844-752-9434 / TTY: 711

8 am to 8 pm, local time, Monday - Friday

Enroll in plan (Opens in a New Tab)
Get the details

Visit the Virginia Department of Medical Assistance Services (DMAS) site or on the DMAS' broker site for more information on eligibility and enrollment.

Virginia Department of Medical Assistance Services (DMAS)

Virginia DMAS Enrollment Site for Brokers

Member information

Already a member of UnitedHealthcare Community Plan of Virginia - Cardinal Care? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Member website 

Do you have other format needs?

Call us today to let us know if you need information in a different format. We offer our materials in other languages, large print, audio files, and Braille at no charge. Call the Member Services number on the back of your card. We will send it to you within five (5) business days at no charge. 

 


Individual & Family ACA Marketplace Plans Disclaimer
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The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. By responding to this offer, you agree that a representative may contact you.

*To qualify for a $0 monthly premium, you must meet household income requirements for Advanced Premium Tax Credits.

**$0 cost-share for network periodic oral evaluation 2 times per consecutive 12 months. Adult dental benefit coverage is limited to a $1,000 benefit maximum per plan year. Coverage for routine vision exam and eyewear is limited to once every 12 months. If you opt to receive vision care services or vision care materials that are not covered benefits under this plan, a participating vision care provider may charge you their normal fee for such services or materials. Coverage may not be available on all plans or in all states. For costs and complete details of coverage, contact your insurance agent or the company, as applicable.

Last Updated: 09.30.2024 at 05:02 PM CDT

Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.