In order to properly coordinate your benefits, UnitedHealthcare needs to determine if you or your family
members have other health care coverage. Accurate
and complete information is required so that claims
processing for your family will not be delayed.
If you and/or other covered dependents have Medicare
and other coverage, please submit a form for each
type of coverage.
UnitedHealthCare Services Company of the River
UnitedHealthcare Plan of the River Valley, Inc.
UnitedHealthcare Insurance Company of the River