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UnitedHealthcare Doctors in Carlisle, PA

435 in-network providers across 47 specialties and 20 plans

435 Providers
47 Specialties
UnitedHealthcare’s Pennsylvania network spans 63,724 providers. Carlisle accounts for 1% of that. The largest UnitedHealthcare footprint in Pennsylvania is in Philadelphia (10,361 providers).
Showing 241260 of 435 providers·
GG
Gail Gustafson, NP
Nurse Practitioner
Pinnacle Health Cardiovascular Institute Inc
205 S Front St, Carlisle, PA 17104· 17.6 mi away
29 years experience · Other
UnitedHealthcare✓ Medicare12 plans

About UnitedHealthcare Coverage in Carlisle

UnitedHealthcare operates 20 distinct plans in Carlisle, PA, with a combined in-network roster of 435 doctors across 47 medical specialties. Among the five largest insurers we track in Carlisle, UnitedHealthcare ranks #4 by provider count, the leader is Aetna with 618 in-network doctors. Use this page to confirm a specific provider is in-network, understand which UnitedHealthcare plans have the widest reach in Carlisle, and compare coverage against other major insurers before scheduling care.

UnitedHealthcare sells EPO, POS, HMO, MA plan types in Carlisle. A PPO (Preferred Provider Organization) lets you see any provider without a referral; out-of-network care is covered but you pay a higher share. An HMO (Health Maintenance Organization) requires you to pick a primary-care doctor and get referrals for most specialist care, usually in exchange for lower premiums. An EPO (Exclusive Provider Organization) is in-network only, like an HMO, but skips the referral requirement. A POS (Point of Service) plan blends HMO-style in-network with PPO-style out-of-network options. Your plan name is on your member ID card.

UnitedHealthcare is a Medicare Advantage carrier in Carlisle with 12 plans available to seniors, listed below with star ratings and premiums. UnitedHealthcare does not currently sell ACA marketplace plans in PA; commercial coverage shown above comes through employer groups.

Data is sourced from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Last refreshed May 29, 2026. Networks change between filings, so even when a doctor appears here we recommend calling their office with your member ID to confirm current network status before your visit.

Plan Type Mix in Carlisle

UnitedHealthcare organizes its Carlisle network into several plan types, each with different rules about which doctors you can see and what referrals you need. The bars below show the unique-provider share of the 435-doctor network that offers plans of each type.

A high PPO share means most UnitedHealthcare doctors in Carlisle accept the insurer’s broader preferred-provider plans. these give you maximum choice and don’t require referrals to specialists. A high HMO share signals a tighter gatekeeper model: lower premiums but you usually need your primary-care doctor to refer you before a specialist will bill. EPO and POS bars sit between those two on both flexibility and cost.

Because individual doctors typically participate in multiple UnitedHealthcare plan types at once, these percentages don’t sum to 100%. the same provider can appear as both PPO and OAP coverage. What the chart tells you is which plan categories have meaningful depth in Carlisle.

Network size435UnitedHealthcare providers in Carlisle
HMO
283435
65%
EPO
286435
66%
POS
286435
66%
Other
182435
42%
Other
1435
0%

Percentages don’t sum to 100% because most doctors participate in several plan types simultaneously.

UnitedHealthcare Plans in Carlisle

UnitedHealthcare contracts with doctors at the network level in Carlisle. Each network below is a contract; your specific plan (printed on your member ID) maps to one of them.

Plan / NetworkTypeDoctors

NEXUSACO OA EPO

EPO

285

NEXUSACO OA POS

POS

285

Choice EPO

EPO

283

Choice HMO

HMO

283

Choice Plus POS

POS

283

Core EPO

EPO

283

Select EPO

EPO

283

Select Plus POS

POS

283

Charter EPO

EPO

282

Core POS

POS

281

Navigate EPO

EPO

280

Doctors Plan EPO

EPO

255

UnitedHealthcare Medicare Advantage Plans in Carlisle

12 UnitedHealthcare Medicare Advantage plans available to seniors in Carlisle. Each plan combines Medicare Parts A, B and usually D (prescription drugs) into one product, with star ratings and monthly premiums shown.

Star ratings (1-5) reflect overall plan quality measured by CMS. a 4-star plan generally indicates above-average member experience and care coordination. Premiums shown are the monthly cost on top of the standard Medicare Part B premium.

Plan NameTypeStar RatingPremium / MOOP
UHC Nursing Home Plan EX-F002 (PPO I-SNP)SNP
PPO I-SNP★★★★★ 4.5$33/moMOOP $9,250
AARP Medicare Advantage from UHC PA-0002 (HMO-POS)
HMO-POS★★★★☆ 4.0$0/moMOOP $6,700
AARP Medicare Advantage from UHC PA-0007 (PPO)
PPO★★★★☆ 4.0$42/moMOOP $5,900
AARP Medicare Advantage from UHC PA-0008 (PPO)
PPO★★★★☆ 4.0$60/moMOOP $4,900
AARP Medicare Advantage from UHC PA-0011 (PPO)
PPO★★★★☆ 4.0$0/moMOOP $6,700
AARP Medicare Advantage Giveback from UHC PA-12 (PPO)
PPO★★★★☆ 4.0$0/moMOOP $8,900
AARP Medicare Advantage Patriot No Rx PA-MA01 (HMO-POS)
HMO-POS★★★★☆ 4.0MOOP $6,700
UHC Complete Care PA-17 (HMO-POS C-SNP)SNP
HMO-POS C-SNP★★★★☆ 4.0$0/moMOOP $6,700
UHC Dual Complete PA-S001 (PPO D-SNP)SNP
PPO D-SNP★★★★☆ 4.0$33/moMOOP $9,250
UHC Dual Complete PA-S002 (HMO-POS D-SNP)SNP
HMO-POS D-SNP★★★★☆ 3.5$7/moMOOP $9,250
UHC Dual Complete PA-S3 (HMO-POS D-SNP)SNP
HMO-POS D-SNP★★★★☆ 3.5$19/moMOOP $9,250
UHC Dual Complete PA-V001 (HMO-POS D-SNP)SNP
HMO-POS D-SNP★★★★☆ 3.5$30/moMOOP $6,700

Source: CMS Medicare Advantage Landscape File. Star ratings reflect overall plan performance per CMS quality measures. Premiums shown are monthly Part C+D consolidated.

Top Specialties Accepting UnitedHealthcare

UnitedHealthcare’s Carlisle network spans 47 distinct medical specialties. The mix reflects where the insurer has negotiated the deepest physician contracts. primary-care specialties and behavioral health tend to dominate, with surgical and sub-specialty networks typically narrower.

Click any specialty below to see a filtered list of just those in-network providers in Carlisle, including ratings, locations, years of experience, and contact information. For specialties with fewer than 10 in-network providers, you’ll likely want to check nearby cities too. the section further down on this page has your geographic options.

Physician Experience in UnitedHealthcare’s Carlisle Network

Years since medical school graduation is a reasonable proxy for experience, though it doesn’t capture fellowship training, subspecialty certifications, or years spent in specific clinical settings. For UnitedHealthcare’s Carlisle network the breakdown below gives a quick sense of whether you’re picking from a predominantly early-career roster or one weighted toward veteran practitioners.

A network heavy on early-career doctors (0–5 years) often means lower wait times for new patients and exposure to the latest training, while veteran providers (30+ years) typically bring deeper pattern recognition for unusual presentations. A balanced distribution. roughly one-quarter in each bucket. is a healthy signal that the insurer has depth at every career stage, not just new graduates filling out its directory.

Median21years of experience
1,538 UnitedHealthcare providers in Carlisle with graduation-year data
Early career0–5 yrs
63providers
4%
Established6–15 yrs
530providers
34%
Senior16–30 yrs
565providers
37%
Veteran30+ yrs
380providers
25%

Telehealth Coverage in Carlisle

44 of 435 UnitedHealthcare in-network providers (10%) offer telehealth visits in Carlisle. Video appointments are typically covered for follow-ups, medication refills and adjustments, mental-health sessions, dermatology triage, and low-acuity primary care.

Availability and reimbursement still vary by state regulation and specific plan. Psychiatry, behavioral-health, and primary-care telehealth is near-universal at this point; procedural specialties (cardiology, orthopedics) typically offer video visits for pre-op consults and post-op follow-up but not initial diagnostic visits. Call the office with your UnitedHealthcare member ID to confirm your plan covers the visit type you need.

Top specialties offering telehealth in Carlisle

Top Hospitals Serving UnitedHealthcare Patients in Carlisle

Hospitals with the most UnitedHealthcare-network physicians practicing there. Large affiliation counts indicate that UnitedHealthcare has a durable relationship with the facility, which typically means smoother prior-authorizations for admissions, lab work, and follow-up care coordinated under one roof.

Hospital coverage is a separate contract from physician coverage. your UnitedHealthcare plan may cover a doctor who admits at Hospital X but classify the hospital itself as out-of-network, leaving you with a surprise facility bill. Before scheduling anything inpatient or procedural, call both the doctor’s office and the hospital billing line with your member ID to confirm both sides are in-network for the specific plan you hold.

Coverage Compared in Carlisle

Side-by-side provider counts for the five largest commercial and government insurers tracked in Carlisle. These numbers show raw network breadth. they don’t adjust for quality, specialty mix, or your specific plan’s tier structure, but they’re a useful first filter when choosing a carrier at open enrollment.

If UnitedHealthcare’s provider count looks limited for your needs, the alternatives below may fit better. Click any row to open that insurer’s Carlisle provider list with the same filters, plan breakdown, and hospital affiliations that you’re seeing here.

Aetna618Medicare547Cigna511
UnitedHealthcareThis page435
Humana152

Nearby Cities with UnitedHealthcare Coverage

Cities closest to Carlisle where UnitedHealthcare has an in-network provider base of meaningful size. Useful if you’re willing to drive a short distance for a hard-to-find specialist, have two offices to choose between, or are planning a move inside the region.

The mileage figures are straight-line distances computed from average practice-address coordinates, not drive-time. Counts reflect each nearby city’s UnitedHealthcare network size. a small count doesn’t mean no coverage, just that your in-Carlisle options are likely more plentiful.

Frequently Asked Questions

Common questions about UnitedHealthcare coverage in Carlisle

How do I find an UnitedHealthcare in-network doctor in Carlisle, PA?

UnitedHealthcare has 435 in-network providers across 47 medical specialties in Carlisle. This list is compiled from federally-mandated CMS Transparency in Coverage filings, last verified May 29, 2026. Filter by specialty, plan type, gender, telehealth or experience above to narrow your search, then click any provider for full credentials and contact details. Always confirm coverage with your specific plan before scheduling.

What UnitedHealthcare plan types are available in Carlisle?

UnitedHealthcare sells 4 distinct plan types in Carlisle: EPO (286 doctors), POS (286 doctors), HMO (283 doctors), MA (1 doctors). PPO plans give you the broadest provider choice without referrals; HMO plans require a primary-care referral but typically have lower premiums; EPO plans skip the referral but stay in-network only; POS plans blend HMO in-network rules with PPO out-of-network options. Choose by reading what's printed on your member ID card and matching it to one of the rows in the Plans section above.

Does UnitedHealthcare offer Medicare Advantage in Carlisle?

Yes. UnitedHealthcare offers 12 Medicare Advantage plans in Carlisle for 2026, with plan types including PPO I-SNP, HMO-POS, PPO, HMO-POS C-SNP. The average CMS star rating across these plans is 3.9 of 5. Medicare Advantage (Part C) bundles Parts A and B with usually Part D prescription drug coverage, often adding dental, vision, and wellness benefits. Enrollment is open during the annual election period each fall.

What's the highest-rated UnitedHealthcare Medicare Advantage plan in Carlisle?

UHC Nursing Home Plan EX-F002 (PPO I-SNP) (PPO I-SNP) holds UnitedHealthcare's top CMS star rating in Carlisle at 4.5 of 5, with a $33 monthly premium. Star ratings reflect overall plan quality based on member experience, customer service, drug pricing, and clinical care measures. Plans rated 4 or higher generally indicate above-average performance.

Are there $0 premium UnitedHealthcare Medicare Advantage plans in Carlisle?

Yes. 4 of UnitedHealthcare's 12 Medicare Advantage plans in Carlisle carry a $0 monthly premium for 2026. Note that $0 premium plans still require you to pay the standard Medicare Part B premium each month, plus copays and deductibles when you use care. Compare each plan's MOOP (maximum out-of-pocket) limit to understand worst-case annual cost.

Which hospitals in Carlisle accept UnitedHealthcare?

Hospitals where UnitedHealthcare doctors most commonly practice in Carlisle include UPMC PINNACLE HOSPITALS, UPMC CARLISLE, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, UPMC MEMORIAL. This is inferred from physician affiliations rather than direct insurer-hospital contracts, so confirm hospital network status separately with both your UnitedHealthcare plan and the hospital's billing department before scheduling any inpatient or surgical procedure. Even when a doctor is in-network, the hospital where they admit may not be.

Which medical specialties have the most UnitedHealthcare providers in Carlisle?

UnitedHealthcare's Carlisle network is largest in Physician Assistant (78), Nurse Practitioner (56), Diagnostic Radiology (35). Primary care, behavioral health, and physical therapy tend to dominate insurer networks because high patient volumes drive deeper provider contracts. Surgical sub-specialties typically have narrower networks. Click any specialty in the section above to see a filtered list of those in-network providers.

How does UnitedHealthcare compare to other insurers in Carlisle?

UnitedHealthcare ranks #4 of 5 major insurers tracked in Carlisle by provider count, with 435 doctors. Aetna leads at 618 providers. Larger network size means more provider choice but doesn't guarantee that your specific doctor is in-network with any insurer. The Coverage Compared section above shows side-by-side counts for the top five carriers in Carlisle.

How do I verify a doctor is in-network with UnitedHealthcare?

Three steps: first match the doctor's name against this list, second call the provider's office with your member ID to confirm they currently accept your specific UnitedHealthcare plan, and third check UnitedHealthcare's own member portal for the most authoritative real-time status. Networks change between monthly federal filings; our data was last refreshed May 29, 2026.

What if my doctor isn't listed here?

This list reflects UnitedHealthcare's submitted network data as of the last federal filing on May 29, 2026. Doctors join and leave networks between filings, so a current in-network provider may be missing if they joined recently. Call the doctor's office to ask whether they currently accept UnitedHealthcare, then check UnitedHealthcare's own member portal for confirmation.

When was this UnitedHealthcare data last updated?

The UnitedHealthcare Carlisle provider list was last refreshed May 29, 2026. Doctor and network data come from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Refresh cadence: monthly for provider data, annually for marketplace and Medicare plans.

Related healthcare resources

Patient resources for Carlisle UnitedHealthcare members.

Data freshness

Last verified May 29, 2026 · Source: CMS Transparency in Coverage federal filings · Refresh cadence: monthly