UnitedHealthcare Community Plan KanCare

Medicaid

This plan offers a range of benefits along with extras that other KanCare plans don't offer. We also offer extra support and care to adults and children who need help with daily activities. You qualify based on income and health needs. View the benefits below to see all that it offers.

Available ang planong ito sa lahat ng county.

More information on eligibility and enrollment can be found on the KanCare website.

Mga Pakinabang at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the care needed to stay healthy — or to be at your best. That includes:

  • Choice of Doctors. Find a doctor you know and trust in our network.
  • Medicines. Fill your prescriptions at local pharmacies.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Therapy Services. Physical or other therapy to help be your best.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Hospitalization. You pay nothing for care in a hospital.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Foot Care. We provide more visits to keep your feet healthy.
  • Community Rewards. You can earn rewards for going to important wellness exams.

Wala nang mas mahalaga pa sa kalusugan at kapakanan mo at ng iyong sanggol. That's why our plan benefits include:

  • Choice of Birth Center. Pick from 100's of hospitals across Kansas.
  • Choice of Doctors. Find a doctor or OB/GYN you trust in our network.
  • Healthy First Steps®. Extra support to help you and your baby stay healthy.
  • Prenatal Visits. Care for you before your baby is born.
  • Baby Blocks™. Earn rewards for keeping you and your baby healthy.
  • Community Rewards. You can earn rewards for taking your baby to important exams in their first months of life.

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

  • Behavioral Health. Counseling and other treatments are covered.
  • Diabetic Support. Medicine needles and wipes for managing diabetes.
  • Asthma and COPD Support. Exams, testing and supplies are covered.
  • Care Management. If you qualify, get personal help managing health conditions.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Health Rewards Program. Earn debit card rewards for well care visits and immunizations.

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

  • Vision Care. Yearly eye exams and eyeglasses as needed.
  • Dental Care. Exams, x-rays and cleaning for kids and adults.
  • Hearing Care. Tests, checkups and hearing aids, if needed.

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Kabilang sa mga benepisyo ang:

  • Equipment and Supplies. In-home medical and safety equipment are covered.

Kung minsan, maaaring kailanganin mo ng kaunting karagdagang tulong sa paggamit ng iyong planong pangkalusugan. Para sa mga pagkakataong iyon, maaari kang umasa sa:

  • Transportation. We provide rides to and from medical visits.
  • Community Rewards. Your can earn rewards for going to important wellness exams.
  • Programs for Kids and Teens. Free activities at local youth organizations.
  • Member Services. Your benefit questions are answered Monday – Friday 8 am – 6 pm 1-877-542-9238.
  • Quitting Tobacco. Coaches and supplies to help you quit using tobacco.
  • Interpreters. Interpreters are available over the phone for you at your doctor visits.

If you're elderly or living with a disability or illness, your health needs are unique. Our job is to make it as easy as possible for you to meet those needs and more. Benefits may include:

  • Care Coordinator. Someone to get you the services to be at your best.
  • Disease Management. Focused care for those with critical health needs.
  • In-Home Care. Medical and personal care at home, if needed.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Emergency Response System. Sends an urgent request for someone to help you.
  • Adult Day Care. Friendship and social activities in a safe setting.
  • Home Meal Delivery. If you cannot safely make meals, we'll provide them.
  • Respite Care. In-home help to give your caregivers a rest.

Adult Day Care

Companionship is important. Adult day care provides care and companionship for frail elderly waiver members 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 Support

Do you or a family member have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. You will get a customized treatment plan and medicine to:

  • Manage flare-ups.
  • Reduce symptoms.
  • Help you stay active.

Attendant Care Services

If you live with a disability or chronic health condition, you may need extra help to stay in your own home. Our plan gives members who qualify the services needed to be safe and comfortable. An attendant can provide:

  • Companionship.
  • Homemaking services.
  • Personal care.

You and your caregiver can decide which chores you want your care attendant to do in your home.

Baby Blocks™

Build a healthy future for you and your baby — and earn great rewards — through Baby Blocks. This program helps keep you and your baby healthy during your pregnancy and your baby's first 15 months of life.

Baby Blocks includes:

  • Email appointment reminders.
  • Fun program to keep track of appointments.
  • Reward cards for clothing and more.

Once you sign up, you can choose either a $20 Old Navy gift card or a stylish diaper bag. The choice is yours. To learn more visit UHCBabyBlocks.com.

Kalusugan sa Pag-uugali

Ang kalusugan ng pag-iisip na apektado ng pag-uugali ay kasinghalaga ng kalusugan ng pangangatawan. That's why we have coverage for both.

Required care is 100% covered with no copay. This includes:

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

Care Coordinator

The daily care and safety of our members is important. That’s why we conduct home visits for eligible waiver members who need extra help staying at home. 

During this visit we:

  • Understand your personal needs.
  • See if your home needs minor modifications, such as ramps and bathroom safety devices.
  • Set up emergency monitoring.
  • Arrange for personal care attendants.

Care Management

Do you have a disability or a serious health problem? If your health needs qualify then our care coordinators are in your corner. They will:

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

Your care coordinator will stay with you throughout the medical journey. He or she will:

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

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That's why you can pick from hospitals across Kansas and surrounding states.

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

Cell Phone Program

Contact Member Services for help applying for a cell phone plan.

Choice of Doctors

Magkakaroon ka ng doktor ng pangunahing pangangalaga (primary care physician, PCP) na iyong pangunahing doktor. Use the Doctor Lookup tool to see if your doctor is in our network.

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:

  • Pampigil na pangangalaga.
  • Panggagamot kung mayroon kang sakit o pinsala.
  • Mga referral sa mga espesyalista para sa ilang partikular na kundisyon.

Pangangalaga sa Ngipin

Child members up to age 20 receive Preventative exams and cleaning 2 times a year. This helps keep teeth and gums strong and healthy.

Adults over 20 can visit participating dental provider for exams, x-rays, cleanings and fillings. Covers up to $500 per year*.

 

*The $500 coverage that includes fillings begins in 2019

Diabetic Support

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

Our diabetes program also includes self-care training and classes focused on:

  • Planning healthy meals.
  • Managing stress.
  • Living a healthy lifestyle.
  • Wellness Rewards for getting needed exams.

Pamamahala sa Sakit

If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:

  • Congestive heart failure.
  • Hika.
  • HIV.
  • Chronic obstructive pulmonary disease (COPD).
  • Coronary artery disease.

Emergency Response System

If you are on one of the waiver programs and 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.

Equipment and Medical Supplies

Ang iyong kalusugan at kaligtasan sa tahanan ay mahalaga.

Our plan covers medical equipment ordered by your doctor. This might include supplies like:

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

Pangangalaga sa Paa

Children can get the exams needed to help keep your feet in great shape. And if you have diabetes, good foot care can help prevent much more serious problems.

Kasama ng aming saklaw sa podiatry ang:

  • Routine foot exams.
  • Mga tip tungkol sa pangangalaga sa paa at pagpili ng mga tamang sapatos.
  • Impormasyon tungkol sa mga senyales ng babala sa pinsala sa nerve.

Healthy First Steps®

When you're pregnant, you receive help and advice from your mom, aunts, sisters and girlfriends. Gayunpaman, magkakaiba ang bawat pagbubuntis. Susuportahan ka ng programang ito sa kabuuan ng iyong pagbubuntis.

We can help you:

  • Find a doctor for both mother and baby.
  • Learn about nutrition, fitness and safety.
  • Get supplies, including breast pumps for nursing moms.

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 when ordered by your doctor.

Home Meal Delivery

If you are on the PD or TBI waiver and live with a disability or chronic health condition, we may be able to arrange home meal deliver. You will not be eligible if you are getting home meals through different program.

Pagkakaospital

This plan pays for all expenses related to a hospital stay, so you can rest and heal.

Hospitalization coverage includes:

  • Pangangalaga ng isang nurse.
  • Kwarto at matutuluyan.
  • Mga supply at kagamitan.
  • Panggagamot at mga therapy.
  • Mga diagnostic na pagsusuri at eksaminasyon.

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

In-Home Care / Skilled Home Health Care Services

If you have health or mobility challenges, you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. If ordered by a doctor for medical reasons, our Plan covers: 

  • In-home medical visits.
  • 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 available for you over the telephone 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.

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

Medicines

There are no copays for covered drugs. You can fill your prescriptions at local pharmacies. 

The medical card will cover many services and items. In order for a service to be covered, you must use a Kansas Medicaid provider. The type of coverage you have will determine how you receive coverage.

Specific limits and guidelines apply to all services, and these change often. Before getting any service or item, contact KMAP/MCO Customer Service. A general list of KMAP/MCO covered services is included on our website at https://www.kmap-state-ks.us/Public/Beneficiary/default.asp.

Medicaid requires some services to be approved before you get them. Your provider knows which services need prior authorization and is responsible for obtaining it for you. Medicaid will send you and your provider a letter approving or denying the prior authorization request.

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 how to get the care you need.
  • Help with doctor issues or complaints.
  • Call Member Services and ask for a Member Advocate to help you.

Mga Serbisyo para sa Miyembro

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call Monday-Friday 8 am - 6 pm at 1-877-542-9238. We'll answer your questions simply and completely.

Maaari ka rin naming tulungang humanap ng:

  • Mga doktor.
  • Mga parmasya.
  • Mga ospital o iba pang mga pasilidad na pangkalusugan.
  • Mga lokal na mapagkukunan.

NurseLine℠

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week. Call 1-855-575-0136.

Our nurses will:

  • Listen to symptoms.
  • 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.

Mga Pagpapatingin Habang Nagbubuntis

Your pregnancy is a journey and you will need help along the way. You can visit a family doctor or pregnancy doctor (OB-GYN) to get the care you need.  

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

Sa mga pagpapatinging ito, ang klinika ay:

  • Make sure both you and your baby are healthy.
  • Ipapaliwanag kung ano ang dapat asahan sa bawat yugto ng iyong pagbubuntis.
  • Sasagutin ang iyong mga tanong.

Programs for Kids and Teens

Positive role models can make a big difference in a child's life. That's why we provide one free activity each year at local youth organizations, like:

  • YMCA.
  • Boys & Girls Clubs.
  • 4-H.
  • Select Kansas Park and Recreation Departments.

Quitting Tobacco

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

You can also call the KanQuit smoking line at 1-800-784-8669 for support. 

Respite na Pangangalaga

Are you a waiver member who has family members or friends who care for you in your home? 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. Some members can get extra respite care. Ask your Care Coordinator if you qualify.

Shots and Vaccines

Routine shots help protect you from illness. So, our plan covers:

  • Pneumonia, influenza and shingles shots.
  • Tetanus, diphtheria, pertussis.
  • HPV.

Therapy Services

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

When approved by a doctor, covered therapies include:

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

Transportasyon

Our plan provides needed rides to and from health care locations for medical appointments. That includes trips to:

  • Doctor or therapy visits.
  • Health departments.
  • Vision clinics.
  • Rides to job activities for members who qualify.


Call 1-877-524-9238.

Pangangalaga sa Paningin

You'll get the care, eyeglasses and treatment that let you see life more clearly. Kasama sa saklaw ang:

  • Annual eye exams.
  • Mga inireresetang lens.

This benefit is offered by OptiCare.

Mga Pagpapatingin Habang Walang Sakit

Makakatulong sa iyo ang mga pagpapatingin habang walang sakit sa iyong doktor na manatiling malusog. 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.
  • Routine shots and tests.
  • Mga mammogram.

There are no copayments for preventive care. Earn Community Rewards points for getting exams.

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UnitedHealthcare Community Plan KanCare

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