Planong Pangkomunidad ng UnitedHealthcare na QUEST Integration Program

Diabetic Support

If you have diabetes, we'll make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best. 

Matibay na Medikal na Kagamitan

Some members may need extra support to live safely at home.

Our plan covers medical equipment ordered by your child's doctor or case manager. This can include supplies like:

• Oxygen tanks.
• Mga kama sa ospital.
• Wheelchairs or walkers.

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

You can earn great gifts for you or your child by doing things like:

• Completing well-child exams.

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 upang matulungang protektahan ang iyong pandinig.

Sinasaklaw namin ang:

• Exams, therapy and tests.
• Hearing aids and batteries.

In-Home Care

After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

• An in-home medical visit.
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.
• Help with personal care or housekeeping.

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.

Kasama ng aming plano ang:

• Dialysis.
• Medications.
• Health education and support.
• Organ transplant if needed.

Laboratoryo at mga X-ray

Napakainam na malaman nang maaga pa lang kung ano ang problema. Sinasaklaw ng aming plano ang:

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

Tutulungan ka naming makuha ang impormasyong kailangan upang makatulong na mapabuti ang iyong kalusugan at maibalik ka sa pinakamalusog na kundisyon.

Tulong sa Wika

You can get information in another language. Magtanong lang. This is provided at no cost to you.

Member Advocates

Pinapahalagahan namin ang iyong kapakanan. Member advocates can help solve problems, provide training and education, and work on issues that concern members.

They can:

• Provide information about your plan.
• Teach you to get the care you need.
• Help with doctor issues or complaints.

Kalusugan ng Pag-iisip

Mental health is as important as physical health. That's why we have coverage for both.

This includes:

• Therapy para sa kalusugan ng pag-iisip na apektado ng pag-uugali.
• Panggagamot sa pang-aabuso sa gamot.
• Medications.

NurseLine℠

Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.

Our nurses will:

• Tutukuyin ang mga sintomas.
• Help with self-care.
• Papayuhan ka tungkol sa pagkuha ng pangangalaga sa pagpapatingin sa isang doktor o sa isang center ng agarang pangangalaga.
• Tutulungan kang malaman kung kailan dapat pumunta sa emergency room.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

• Provide medical care.
• Answer any questions and concerns.

Nutrition Coaching

Healthy eating goes a long way to helping you stay at your best. A nutritionist can meet with you to review your eating habits and food choices.

You'll come away with new ideas for:

• Making good choices for quick meals and snacks.
• Preparing healthy meals on a budget.

Outpatient Services

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

Sinasaklaw ng aming plano ang:

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

We'll help you get the information needed to help improve your health or be your best.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

• Dressing.
• Bathing.
• Feeding.

Mga Pagpapatingin Habang Nagbubuntis

A pregnancy is a journey that’s better with the help of friends, family and a pregnancy doctor, or OB/GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

Sa mga pagpapatinging ito, ang klinika ay:

• Make sure both mom and baby are healthy.
• Ipapaliwanag kung ano ang dapat asahan sa bawat yugto ng iyong pagbubuntis.
• Answer questions.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture.

Rehabilitation Care

After a serious illness, surgery or injury you may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:

• Nursing home services.
• 24-hour nursing care.
• Help with activities of daily living.
• Physical, occupational and 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. That's why we provide respite care to give your caregivers a rest. Ang respite na pangangalaga ay nag-aalok sa mga caregiver ng pansamantalang bakasyon malayo sa kanilang mga mahal sa buhay na may karamdaman o mga espesyal na pangangailangan sa pangangalaga.

Shots and Vaccines

Routine shots help protect you from illness.

So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

Social Services

Many communities offer additional benefits for children in this plan. Social Services helps members connect to these local programs and services, such as:

• WIC and financial support.
• School services.
• Respite na pangangalaga.

Speech Therapy

Speech therapy visits and exercises can help those who have difficulty speaking.

Prior authorization needed except for  physical, occupational,  or speech therapy.

Text4baby

Text4baby can help new and expecting mothers keep themselves and their babies healthy.

You'll get text messages throughout your pregnancy and your baby's first year. Each text contains health and safety tips for topics like:

• Prenatal care.
• Labor and delivery.
• Breastfeeding.
• Safe sleep.
• Nutrition.
• Car seat safety.

So you and your baby can make a great start on life.

Therapy Services

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.

Our plan provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.

Unlimited Doctor Visits

There may be times when your or a family member’s health requires repeated visits to a primary care provider (PCP). Our plan does not limit the number the number of times you can see your PCP. This way you get care need when you need it. And your doctor can see how your health is progressing.

Urgent Care

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

• Mga center ng agarang pangangalaga.
• Medical aid units.
• Other walk-in clinics.

Mga Pagpapatingin Habang Walang Sakit

Well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated. Kabilang sa mga serbisyong pang-iwas sa sakit ang:

• Checkups for adults and children.
• Well-baby care.
• Care for women expecting a baby.
• Routine shots and tests.
• Mga mammogram.

There are no copayments for preventive care.