About UnitedHealthcare Coverage in Carthage
UnitedHealthcare operates 16 distinct plans in Carthage, TN, with a combined in-network roster of 40 doctors across 12 medical specialties. Among the five largest insurers we track in Carthage, UnitedHealthcare ranks #4 by provider count, the leader is Medicare with 52 in-network doctors. Use this page to confirm a specific provider is in-network, understand which UnitedHealthcare plans have the widest reach in Carthage, and compare coverage against other major insurers before scheduling care.
UnitedHealthcare sells EPO, POS, PPO plan types in Carthage. 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 sells consumer plans through two channels in Carthage: 12 ACA marketplace plans on healthcare.gov and 8 Medicare Advantage plans for seniors. Both are listed below with metal tiers, plan types, and star ratings where applicable.
Data is sourced from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Marketplace plans come from the CMS Qualified Health Plan Public Use File. Medicare Advantage plans come from the CMS MA Landscape File. Last refreshed August 12, 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 Carthage
UnitedHealthcare organizes its Carthage 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 40-doctor network that offers plans of each type.
A high PPO share means most UnitedHealthcare doctors in Carthage 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 Carthage.
Percentages don’t sum to 100% because most doctors participate in several plan types simultaneously.
UnitedHealthcare Plans in Carthage
UnitedHealthcare contracts with doctors at the network level in Carthage. Each network below is a contract; your specific plan (printed on your member ID) maps to one of them. For consumer plan names, see the section below.
Choice EPO
EPO
19
Choice HMO
HMO
19
Choice Plus POS
POS
19
Doctors Plan EPO
EPO
19
Navigate EPO
EPO
19
NEXUSACO OA EPO
EPO
19
NEXUSACO OA POS
POS
19
Select EPO
EPO
19
Select Plus POS
POS
19
Core EPO
EPO
13
Core POS
POS
13
Charter EPO
EPO
12
UnitedHealthcare ACA Marketplace Plans Available in Carthage
12 UnitedHealthcare plans sold on healthcare.gov for Carthage. These are the consumer plan names you’ll see during open enrollment, with metal tier (Bronze/Silver/Gold/Platinum) and plan type (PPO/HMO/EPO/POS).
Bronze plans have lower monthly premiums and higher out-of-pocket costs; Gold and Platinum have higher premiums but lower copays. Your plan choice affects which UnitedHealthcare doctors above are in-network. the network labels above map to one or more of these plans.
UHC Gold Advantage (Virtual Urgent Care, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Gold Copay Focus (Virtual Urgent Care, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Gold Standard (No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Silver Advantage (Virtual Urgent Care, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Silver Copay Focus (Virtual Urgent Care, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Silver Standard (No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Bronze Standard (No Referrals)
Network: Individual Exchange Benefit Plan Network
UHC Bronze Essential (No Referrals)
Network: Individual Exchange Benefit Plan Network
Source: CMS Qualified Health Plan Public Use Files (PY 2026). ACA marketplace plans only. Does not include employer-group or Medicare plans.
UnitedHealthcare Medicare Advantage Plans in Carthage
8 UnitedHealthcare Medicare Advantage plans available to seniors in Carthage. 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.
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 Carthage network spans 12 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 Carthage, 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 Carthage 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 Carthage 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.
Top Hospitals Serving UnitedHealthcare Patients in Carthage
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.
Highpoint Health-riverview With Ascension Saint Th
Carthage, TN
Highpoint Health-sumner With Ascension Saint Thoma
Gallatin, TN
Vanderbilt Wilson County Hospital
Lebanon, TN
Tristar Hendersonville Medical Center
Hendersonville, TN
Macon Community Hospital
Lafayette, TN
Williamson Medical Center
Franklin, TN
Coverage Compared in Carthage
Side-by-side provider counts for the five largest commercial and government insurers tracked in Carthage. 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 Carthage provider list with the same filters, plan breakdown, and hospital affiliations that you’re seeing here.
Nearby Cities with UnitedHealthcare Coverage
Cities closest to Carthage 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-Carthage options are likely more plentiful.
Frequently Asked Questions
Common questions about UnitedHealthcare coverage in Carthage
How do I find an UnitedHealthcare in-network doctor in Carthage, TN?
UnitedHealthcare has 40 in-network providers across 12 medical specialties in Carthage. This list is compiled from federally-mandated CMS Transparency in Coverage filings, last verified August 12, 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 Carthage?
UnitedHealthcare sells 3 distinct plan types in Carthage: EPO (18 doctors), POS (18 doctors), PPO (18 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.
What UnitedHealthcare ACA marketplace plans cover Carthage?
UnitedHealthcare sells 12 consumer plans on healthcare.gov for Carthage, TN, including UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals), UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals), UHC Bronze Essential (No Referrals) and 9 others. Available plan types are EPO. These plans appear on healthcare.gov during open enrollment (typically November to January) and through special enrollment periods after qualifying life events.
What metal tiers does UnitedHealthcare offer in Carthage?
UnitedHealthcare's ACA marketplace presence in Carthage spans 4 metal tiers: Expanded Bronze (3), Bronze (1), Gold (4), Silver (4). Metal tiers describe the cost-sharing balance, not provider quality. Bronze plans have the lowest monthly premiums but you pay more per visit. Silver plans are eligible for federal cost-sharing reductions if your income qualifies. Gold and Platinum plans cost more monthly but reduce out-of-pocket costs for specialist visits, hospital stays, and prescriptions.
Does UnitedHealthcare offer Medicare Advantage in Carthage?
Yes. UnitedHealthcare offers 8 Medicare Advantage plans in Carthage for 2026, with plan types including HMO-POS, HMO-POS C-SNP, HMO-POS D-SNP. The average CMS star rating across these plans is 3.8 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 Carthage?
AARP Medicare Advantage from UHC TN-0006 (HMO-POS) (HMO-POS) holds UnitedHealthcare's top CMS star rating in Carthage at 4.0 of 5, with a $63 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 Carthage?
Yes. 2 of UnitedHealthcare's 8 Medicare Advantage plans in Carthage 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 Carthage accept UnitedHealthcare?
Hospitals where UnitedHealthcare doctors most commonly practice in Carthage include HIGHPOINT HEALTH-RIVERVIEW WITH ASCENSION SAINT TH, HIGHPOINT HEALTH-SUMNER WITH ASCENSION SAINT THOMA, VANDERBILT WILSON COUNTY HOSPITAL, TRISTAR HENDERSONVILLE MEDICAL CENTER. 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 Carthage?
UnitedHealthcare's Carthage network is largest in Nurse Practitioner (16), Family Practice (6), Physician Assistant (5). 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 Carthage?
UnitedHealthcare ranks #4 of 5 major insurers tracked in Carthage by provider count, with 40 doctors. Medicare leads at 52 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 Carthage.
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 August 12, 2026.
What if my doctor isn't listed here?
This list reflects UnitedHealthcare's submitted network data as of the last federal filing on August 12, 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 Carthage provider list was last refreshed August 12, 2026. Doctor and network data come from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. ACA marketplace plan data comes from the CMS Qualified Health Plan Public Use File for plan year 2026. 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 Carthage UnitedHealthcare members.
Common health topics
Common medications
Common procedure costs
Data freshness
Last verified August 12, 2026 · Source: CMS Transparency in Coverage federal filings · Refresh cadence: monthly