UnitedHealthcare

In short

Call the number on your member ID card and get the denial in writing, then appeal: most commercial plans follow the federal 180-day internal appeal and 4-month external review rules, and Medicare Advantage plans have their own Medicare steps. Appeal even when it feels pointless: federal investigators found that UnitedHealthcare overturned 99.7 percent of appealed Medicare Advantage denials for skilled nursing facility admission in June 2024. In California, grievances go through UnitedHealthcare's online form, then to the Department of Managed Health Care and Independent Medical Review.

How complaints actually go

• Members should sign in to their plan account or call the number on their health plan ID card; people without a card use the Contact UnitedHealthcare page. UnitedHealth Group's main number is (800) 328-5979. UnitedHealth Group contact
• Appeals, grievances and requests for ERISA plan documents can be filed online (Empire, UHC West, Oxford and other employer and individual plans; not behavioral health, dental or vision except individual family plans). UnitedHealthcare appeals and grievances form
• California: submit a grievance within 180 calendar days of the incident; UnitedHealthcare acknowledges within 5 calendar days and answers a standard grievance within 30 calendar days, or 3 calendar days if urgent. Members may also qualify for Independent Medical Review through the DMHC. UnitedHealthcare appeals and grievances form
• For other commercial plans, the federal rules give 180 days to file an internal appeal and 4 months after the final denial to ask for external review, which the insurer must follow. HealthCare.gov: internal appeals HealthCare.gov: external review

What tends to work

• Appeal Medicare Advantage post-acute care denials. In June 2024, UnitedHealth Group denied 12.9 percent of skilled nursing facility admission requests and overturned 99.7 percent of the denials that were appealed; it received 42 percent of all such appeals among the 19 insurers studied. HHS OIG OEI-09-24-00331, June 2026
• Its contractor naviHealth, a UnitedHealth Group subsidiary, processed half of all skilled nursing requests in the study and denied 14 percent; 97 percent of naviHealth denials that were appealed were overturned. HHS OIG OEI-09-24-00331, June 2026
• In Medicaid managed care, UnitedHealth overturned 81 percent of appealed prior authorization denials in 2025 data. KFF, August 2026
• In urgent cases, file the internal appeal and the external review request at the same time. HealthCare.gov: internal appeals

Traps and fine print

• Member phone numbers and appeal addresses are plan-specific; use the ID card and the denial letter rather than a number from a search result. UnitedHealth Group contact
• The online appeal form does not cover behavioral health, dental or vision services, except for individual family plans. UnitedHealthcare appeals and grievances form
• Federal employees in California have grievance rights through the Office of Personnel Management instead of the DMHC. UnitedHealthcare appeals and grievances form

By the numbers

• 2025 prior authorization data: UnitedHealth denied 17 percent of standard requests in Medicare Advantage, 11 percent in Medicaid managed care and 21 percent in the ACA Marketplace. KFF, August 2026
• In a July 14, 2026 letter, Senators Blumenthal and Hawley of the Senate Permanent Subcommittee on Investigations cited an HHS OIG report finding that UnitedHealthcare denied 66 percent of inpatient rehabilitation facility admission requests, against an average of 41 percent at 16 smaller Medicare Advantage insurers. Senate PSI letter to UnitedHealthcare

Scams that target customers

• Medicare will never call you to sell anything or visit your home; give your Medicare number only to your doctor, your insurer or others who should have it. Report Medicare Advantage plan fraud to the I-MEDIC at 1-877-772-3379. Medicare.gov: reporting fraud and abuse
• "Free" genetic tests and cheek swabs offered by phone, at events or door to door are used to steal Medicare information; refuse kits your doctor did not order. HHS OIG genetic testing alert
• To check a caller who says they are from UnitedHealthcare, hang up and call the number on your health plan ID card. UnitedHealth Group contact