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Pangunahing Nilalaman

UnitedHealthcare Community Plan

Medicaid

The New York State Medicaid Managed Care Plan is offered through UnitedHealthcare Community Plan. It’s for New York State residents who meet the income or disability requirements.

To find out if UnitedHealthcare Community Plan is offered in your county, please call 1-888-617-8979.  A representative will contact you to schedule an appointment to help you apply.

More information on eligibility and enrollment can be found on the New York State of Health website.

For more information about Child Health Plus or Medicaid, call New York Health Options at 1-800-541-2831.  

To learn more about applying for health insurance through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.

Mga Benepisyo at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the care you need to stay healthy — or to get better if you are injured or sick. Kasama rito:

  • Choice of Doctor. Use "Doctor Lookup" to see if your doctor is in our network or to find a new one.
  • Dental. We cover cleanings, checkups and dental work.
  • Well Visits. Annual checkups can help keep you healthy.

Make sure your sight, teeth, speech and hearing are at their best. Kabilang sa mga benepisyo ang:

  • Vision. Covers eye exams and glasses.
  • Dental. We cover cleanings, checkups and dental work.
  • Hearing. Screenings and therapies, if needed, are provided.

Get the medical care and equipment you need to live at home. Kabilang sa mga benepisyo ang:

  • Care Coordinator. Someone to get you the services you need to recover safely.
  • Personal Care. Services to help you heal after illness or injury.
  • Home Meal Delivery. If you can’t safely make meals, we'll provide them.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Nurse Visits. Care after surgery or illness to recover at home.

Wala nang mas mahalaga pa sa kalusugan at kapakanan mo at ng iyong sanggol. Ito ang dahilan kung bakit kabilang sa aming mga benepisyo sa plano ang:

  • Choice of Doctor. Find an OB-GYN you trust in our network.
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. Get extra support to help you and your baby stay healthy.
  • Choice of Birth Center. Pick from hospitals across New York.

If you have special health care needs, you can count on us. Our plan will provide the extra care and services needed. Kabilang sa mga benepisyo ang:

  • Mental Health. Counseling and other treatments are covered.
  • Case Management. If you qualify, get personal help managing health conditions.
  • Asthma and COPD Care. Exams, testing and supplies are covered.

Adult Day Care

Companionship is important. Adult day care provides care and companionship for seniors who need extra help during the day.

Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

Adult day care can provide:

  • Social connections and friendship.
  • Bathing and personal care.
  • Meals.

Asthma and COPD Care

Individual care to help control asthma, allergies or COPD symptoms.

Do you or your child have trouble managing asthma, allergies or COPD symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:

  • Manage flare-ups.
  • Reduce symptoms.
  • Let you or your child stay active.

Pamamahala ng Kaso

Do you or your child have a serious health problem or a high-risk pregnancy? If so, and you or your child qualifies, we offer case managers that can:

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records.

Your case manager will stay with you or your child throughout the medical journey. He or she will:

  • Think beyond your medical needs.
  • Make sure you have support at home.

So you or your child can focus on getting better.

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That's why you can pick from hundreds of hospitals across New York.

We encourage you to tour the hospital's birthing center. Nang sa gayon ay maging pamilyar ka rito. And you'll be more relaxed when you have your baby.

Pagpili ng Doktor

You get a primary care physician (PCP), who is your main doctor. Gamitin ang tool na Maghanap ng Doktor para makita kung nasa aming network ang iyong doktor.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you. 

Ang iyong PCP ay ang iyong pangunahing doktor para sa:

  • Preventive care.
  • Paggagamot kung mayroon kang sakit o injury.
  • Mga referral sa mga espesyalista para sa ilang partikular na kondisyon.

Pangangalaga sa Ngipin

Checkups and emergency care are covered.

Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that’s covered as well.

Diabetic Supplies

If you have diabetes, you may need insulin, needles, wipes and glucose strips. Sinasaklaw namin ang lahat ng iyon at higit pa.

Ang aming plano ay may kasama ring mahuhusay na serbisyo upang tulungan kang mapamahalaan ang iyong diabetes, kabilang ang:

  • Classes on keeping diabetes in control.
  • Pag-coordinate sa pangangalaga ng doktor.
  • Nutrition and diet.

Durable Medical Equipment

Ang iyong kalusugan at kaligtasan sa tahanan ay mahalaga.

Sakop ng aming plano ang medikal na kagamitang ibinilin ng iyong doktor o case manager. Puwedeng kasama sa mga supply ang:

  • Diabetic supplies.
  • Mga kama sa ospital.
  • Mga wheelchair or walker.

Emergency Response System

If you are at risk for a fall or sudden illness, an emergency call system can really help. It sends an urgent request for someone to check on you and help you.

Grief Support

A loss can take many different forms. And you may get lots of suggestions on what to do. Grieving is part of the healing process.

If a recent loss has made you sad or unhappy, help is available. Our plan offers counseling and support during the grieving process. Our team will work with you to find a counselor or program to help you adjust to your loss.

Healthy First Steps®

The Healthy First Steps team is here for you. Tutulungan ka ng aming programang magawa ang mga tamang hakbang para mapanatiling malusog ang iyong sarili at ang iyong sanggol. 

Tutulungan ka namin:

  • Pumili ng provider sa pagbubuntis at isang pediatrician (doktor ng bata).
  • Mag-iskedyul ng mga pagpapatingin at pagsusulit at ayusin ang mga pagbiyahe papunta sa mga pagpapatingin mo.
  • Kumuha ng mga supply, kabilang ang mga breast pump para sa mga nagpapasusong ina.
  • Kumonekta sa mga mapagkukunan sa komunidad tulad ng mga serbisyo sa Women, Infants and Children (WIC).

Pangangalaga sa Pandinig

Ang problema sa pandinig ay maaaring makaapekto sa iyong pang-araw-araw na pamumuhay sa maraming paraan. Kabilang sa aming plano ang mga serbisyo at suporta para matulungang protektahan ang iyong pandinig.

Sakop ng aming plano ang:

  • Mga eksaminasyon, therapy, at test.
  • Mga hearing aid.

Home Meal Delivery

Taking care of the basics, like cooking, can be hard to do yourself after an illness or sickness.

If you are receiving personal care services, you may need extra help to get through the tough times. We'll step in to bring nutritious meals to you. You can get up to 10 meals delivered each year.

Pangangalagang Pantahanan

After surgery or a serious illness you may need extra help with day-to-day tasks like cleaning, cooking or dressing. Posibleng kailanganin mo rin ng medikal na pagbisita sa bahay para matingnan kung maaayos ba ang paggaling mo. Kapag naaprubahan, sakop ng aming plano ang:

  • Medikal na kagamitan tulad ng mga kama sa ospital, walker o wheelchair.
  • Mga disposable na medical supply.
  • In-home medical visit.

Pagkakaospital

Nagbabayad ang planong ito para sa lahat ng gastusing kaugnay ng pananatili sa ospital nang sa gayon, makapagpahinga at makapagpagaling ka.

Kasama sa coverage ng pagkakaospital ang:

  • Pangangalaga ng isang nurse.
  • Kuwarto at matutuluyan.
  • Mga supply at kagamitan.
  • Paggagamot at mga therapy.
  • Mga diagnostic na test at eksaminasyon.

At pagkalabas mo sa ospital, hindi ka mag-iisa. Titiyakin naming makakakuha ka ng follow-up na pangangalaga para maipagpatuloy ang pagpapagaling sa tahanan.

Mga Serbisyo para sa Miyembro

Minsan kailangan mo ng tulong para maunawaan ang iyong mga opsyon sa pangangalagang pangkalusugan. With us, you have someone you can call Monday – Friday 8 AM – 6 PM EST. Sasagutin namin ang iyong mga tanong sa simple at kumpletong paraan.

Maaari ka rin naming tulungang humanap ng:

  • Mga provider ng pangangalagang pantahanan.
  • Dentists and vision providers.
  • Adult day health centers.

Mental Health/Substance Use Disorder

Addiction can happen to anyone, any family, at any time according to the New York State Office of Alcoholism and Substance Abuse Services (OASAS).

UnitedHealthcare is here to assist you in all your healthcare needs. We have trained professionals who are experienced in understanding Substance Use Disorder and able to help you get treatment or give you information that will help you make decisions about your healthcare. You or your provider can call Optum Behavioral Health anytime for help at 1-844-206-1399.

Covered services include:

  • All inpatient mental health and substance use disorder services (including alcohol and substance use disorder).
  • Most outpatient mental health services (contact plan for specifics).
  • Medicaid recipients who receive SSI or who are certified blind or disabled get mental health and substance use disorder services from any Medicaid provider by using their Medicaid Benefit Card.
  • Detoxification services are covered by UnitedHealthcare Community Plan as a benefit.

No Copays

You will not have a copayment for care and services covered by our plan, other than for prescription drugs.

Ibig sabihin, wala kang babayaran para sa mga sinasaklaw na serbisyo, kabilang ang:

  • Preventive care.
  • Mga taunang checkup.
  • Routine dental or vision care.

You pay nothing for your child's care and services covered by our plan.

Nurse Visit

Sometimes you may need continued care after you leave the hospital or urgent care.

If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:

  • Provide medical care for you.
  • Answer your questions and concerns.

Pagtuturo tungkol sa Nutrisyon

Malaki ang maitutulong ng masustansyang pagkain para matulungan kang maging malusog.

Puwedeng makipagkita sa iyo ang isang nutritionist para suriin ang iyong mga kagawian sa pagkain at mga pinipiling pagkain.

Magkakaroon ka ng mga bagong ideya para sa:

  • Paggawa ng mabubuting desisyon para sa mabilis ihandang pagkain at merienda.
  • Paghahanda ng masusustansyang pagkaing pasok sa badyet.

Mga Serbisyo sa Outpatient

Mainam na malaman nang maaga pa lang kung ano ang problema.

Sakop ng aming plano ang:

  • Mga laboratoryo at pagte-test.
  • Mga x-ray, scan at iba pang imaging.

Tutulungan ka naming makuha ang impormasyong kailangan para matulungang mapahusay ang iyong kalusugan o maging pinakamalusog.

Palliative Care Services

Our plan offers the following palliative care services:

  • Pamamahala sa Sakit
  • Bereavement
  • Massage Therapy
  • Expressive Therapy

Personal na Pangangalaga

Minsan mahirap gawin nang mag-isa ang mga pangunahing kaalaman pagkatapos magkaroon ng sakit o injury.

Kung kinakailangan, magpapadala kami ng tao para tumulong sa:

  • Pagbibihis.
  • Pagligo.
  • Pagpapakain.

Mga Pagpapatingin Habang Nagbubuntis

A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

Ang lahat ng iyong inirerekomendang pagpapatingin at pagpapasuri sa klinika habang nagbubuntis ay sinasaklaw.

Sa mga pagpapatinging ito, ang klinika ay:

  • Titiyaking malusog kayo ng iyong sanggol.
  • Ipapaliwanag kung ano ang dapat asahan sa bawat yugto ng iyong pagbubuntis.
  • Sasagutin ang iyong mga tanong.

Paghinto sa Paninigarilyo

You know the bad health effects of smoking.

You know you need to quit. We support you while you quit with the help of coaches and supplies. The only thing you won't get from us is a lecture.

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.

Kung kinakailangan, saklaw ng aming plano ang maiikling pananatili sa rehabilitation center kung saan puwede kang magpagaling. Kabilang ang:

  • Mga serbisyo ng pangangalaga sa bahay.
  • 24 na oras ng pangangalaga.
  • Tulong sa mga aktibidad sa pang-araw-araw na pamumuhay.
  • Physical, occupational at speech therapy.

Respite na Pangangalaga

Mayroon ka bang mga kapamilya o kaibigan na nag-aalaga sa iyo sa tahanan? Kung mayroon, hinihiling naming suportahan sila sa kanilang pagsusumikap. Kaya naman nagbibigay kami ng respite na pangangalaga upang makapagpahinga ang iyong mga caregiver. Ang respite na pangangalaga ay nag-aalok sa mga tagapag-alaga ng pansamantalang bakasyon malayo sa kanilang mga mahal sa buhay na may karamdaman o mga espesyal na pangangailangan sa pangangalaga.

Shots and Immunizations

Routine shots help keep you healthy.

Kung kaya, sakop ng aming plano ang:

  • Mga inirerekomendang iniksyon at bakuna.
  • Mga diagnostic na test at eksaminasyon.

Pangangalaga sa Paningin

See life more clearly with routine eye exams and glasses, if needed.

We also include:

  • Mga inireresetang lens.
  • Medicaid approved frames.
  • New eyeglasses every two years.

This benefit is offered by March Vision Care.

Mga Pagpapatingin Habang Walang Sakit

Makakatulong sa iyo ang mga regular na medikal na pagbisita sa iyong doktor na manatiling malusog. Maaaring matukoy kaagad ang mga problema sa kalusugan sa mga pagpapatinging ito para magamot ang mga ito.

Kabilang sa mga serbisyong pang-iwas sa sakit ang:

  • Mga checkup para sa mga adult at mga bata.
  • Pangangalaga sa sanggol nang walang sakit.
  • Pangangalaga para sa mga babaeng nagbubuntis.
  • Mga regular na iniksyon at pagte-test.
  • Mga mammogram.

Walang copayment para sa pangangalagang pang-iwas sa sakit.

Mga Resource ng Miyembro

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