Planong Pangkomunidad ng UnitedHealthcare

Medicaid

Our Medicaid family plan is for children, pregnant women, families and adults who meet income and health need requirements. We also cover children and young adults with special health or developmental needs. 

Michigan has a confirmed case of measles.

The CDC has information on the disease and how to protect your family. Please visit the CDC resources at https://www.cdc.gov/measles/resources/parents-caregivers.html

Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Bay, Benzie, Berrien, Branch, Calhoun, Cass, Charlevoix, Cheboygan, Clare, Crawford, Emmet, Genesee, Gladwin, Grand Traverse, Gratiot, Hillsdale, Huron, Ionia, Iosco, Isabella, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Lapeer, Leelanau, Lenawee, Livingston, Macomb, Manistee, Mason, Mecosta, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Sanilac, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Washtenaw, Wayne, and Wexford.

Mga Pakinabang 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. That includes:

  • Pagpili ng Doktor. Find a doctor you trust in our network.
  • Unlimited PCP Visits. You can see your doctor as often as medically needed.
  • Mga gamot. Fill your prescriptions at network pharmacies.
  • Laboratoryo at mga X-ray. Ang mga pagsusuri sa laboratoryo, x-ray at diagnostic imaging ay sinasaklaw.
  • Mga Pagpapatingin Habang Walang Sakit. Annual checkups can help keep you healthy.
  • Shots and Vaccines. Routine shots to help protect against illness.
  • Transportasyon. Get a ride or gas reimbursement to medical visits.

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

  • Pagpili ng Doktor. Find a doctor you trust in our network.
  • Choice of Birth Centers. Deliver at one of 100 hospitals in Michigan.
  • Mga Pagpapatingin Habang Nagbubuntis. Pangangalaga para sa iyo bago ipanganak ang iyong sanggol.
  • Baby BlocksTM. Earn rewards for keeping you and your baby healthy.
  • Healthy First Steps®. Karagdagang suporta upang tulungan kayo ng iyong sanggol na manatiling malusog.
  • Transportasyon. Get a ride or gas reimbursement to medical visits.

If you have diabetes or another health condition, you can depend on us. Our plan makes sure you get the care and services you need. Kabilang sa mga benepisyo ang:

  • Kalusugan ng pag-iisip. Saklaw ang pagpapayo at iba pang mga panggagamot.
  • Pamamahala sa Pangangalaga. Personal support from an experienced professional.
  • Asthma and COPD Care. Individual care for asthma, allergies or COPD.
  • Diabetic Support. Insulin, needles and wipes ordered by your doctor.
  • Heart Care. Extra support for members who have coronary artery disease.
  • Pregnancy Care. Special programs and extra support for pregnant members.

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

  • Vision. Covers exams and eyeglasses Including designer-style frames.
  • Speech. Screenings and needed short-term therapies are covered.
  • Hearing. Exams to determine if a hearing problem exists.

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:

  • Kagamitan at Mga Supply. We cover wheelchairs, hospital beds and more.
  • Nurse Visits. Medical care to help you recover at home.

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

  • Transportasyon. Get a ride or gas reimbursement to medical visits.
  • Tulong sa Wika. Connect to a translator through Customer Services.
  • Customer Services. Your benefit questions are answered by our friendly representatives.
  • Paghinto sa Paninigarilyo. Coaches and supplies to help you quit using tobacco.
  • Pagkontrol sa Timbang. Support to help you reach a healthy weight.
  • Gym Membership. Get a discount gym membership at local clubs.

The Children Special Health Care Services program is for children and young adults with special health or developmental challenges. Our plan provides extra services and support to help manage your child's care needs. If you are enrolled in Medicaid, you may qualify for this additional coverage.

Download more information about the CSHCS program here: Children's Special Health Care Services (CSHCS) Program.

Asthma and COPD Care

Do you 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.
  • Help you stay active.

Asthma Care

Does your child have asthma or respiratory allergies? A nurse who specializes in breathing issues can really help childhood breathing problems. Your child's nurse will

  • Get to know your child
  • Learn his or her triggers and activities.
  • Develop a customized treatment plan.

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.

Care Management

Do you or a family member have a serious health problem or a high-risk pregnancy? If so, our care managers 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 manager will stay with you on your medical journey. He or she will:

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

So you can focus on getting better.

Choice of Doctors

You or your child gets a primary care provider (PCP) who is your main doctor. 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.

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That's why you can pick from nearly 100 hospitals across Michigan.

We encourage you to tour the hospital's birthing center. Nang sa gayon ay maging pamilyar ka rito. At mas mapapanatag ka kapag nanganak ka na.

Customer Services

Understanding your health care options can be confusing. Now you have someone you can call. Maaari naming sagutin ang iyong mga tanong nang simple at kumpleto.

We help you find:

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

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

Diabetic Support

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

Our plan also steps up with services to help you manage your diabetes including:

  • Pag-coordinate sa pangangalaga ng doktor.
  • Dedicated team to help you understand your condition and manage it.

Mga Kagamitan at Supply

Ang iyong kalusugan at kaligtasan sa tahanan ay mahalaga.

Our plan covers medical equipment ordered by your doctor. This can include items like:

  • Mga kama sa ospital.
  • Oxygen tanks.
  • Mga walker o wheelchair.

Healthy First Steps®

Maaari kang makatanggap ng tulong at pagpapayo mula sa iyong ina, mga tita, kapatid at kaibigang babae. Gayunpaman, magkakaiba ang bawat pagbubuntis. Susuportahan ka ng programang ito sa kabuuan ng iyong pagbubuntis.

Tutulungan ka naming:

  • Find a doctor for you and your baby.
  • Learn resources for nutrition, fitness and safety.
  • Get supplies to help at home.

Hearing Services

Ang problema sa pandinig ay maaaring makaapekto sa iyong pang-araw-araw na pamumuhay sa maraming paraan. Our plan includes services and support to determine whether a hearing problem exists.

Sinasaklaw namin ang:

  • Exams, therapy and tests.
  • Hearing aids are covered for Members under age 21.

Pagkakaospital

This plan pays for medical expenses related to a hospital stay.

Sinasaklaw ng aming plano ang:

  • 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. We make sure you get follow-up care to continue healing.

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 get the information needed to improve your health or be your best.

Tulong sa Wika

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

Medicines

Our plan includes prescription drugs and refills.

We also cover many medically needed, over-the-counter medicines with a written order from your doctor. There is no copay for these medicines.

And we make getting your medicine easy. You can fill your prescriptions at:

  • Network pharmacies.

Kalusugan ng Pag-iisip

Mental health is as important as physical health. That's why we cover both.

Short-term required care is covered with no co-pay. This includes:

  • Therapy para sa kalusugan ng pag-iisip na apektado ng pag-uugali.
  • Medications.

No Copays

You will not have a copayment for most care and services covered by our plan. Ibig sabihin, wala kang babayaran para sa mga sinasaklaw na serbisyo, kabilang ang:

  • Pampigil na pangangalaga.
  • Mga taunang checkup.
  • Regular na pangangalaga sa paningin.

Nurse Visits

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.

Pangangalaga Habang Buntis

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

  • Prenatal Visit.
  • Baby BlocksTM.
  • Healthy First Steps®.
  • Transportasyon.

Mga Pagpapatingin Habang Nagbubuntis

Your 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.

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.

Shots and Vaccines

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

  • Recommended shots and vaccines.
  • Influenza shots.

Social Services

Many communities offer additional benefits for children with special care needs. Social Services helps members connect to local programs and services, such as:

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

Download more information about social services benefits here.

Speech Therapy

Speech therapy visits and exercises can help those who have difficulty speaking. At your doctor's request we will cover short-term, medically needed physical, occupational, speech and other therapy visits each year.

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.

With a doctor's request your coverage includes short term physical, occupational, speech and/or other therapy visits each year.

Transportasyon

Our plan provides a ride for you to and from health care locations. That includes rides to:

  • Doctor or therapy visits.
  • Health departments.
  • Vision clinics.

You can also be reimbursed for gas for driving to and from health care visits:
Logisticare Member Gas Reimbursement Instructions
Logisticare Member Gas Reimbursement Form

Unlimited Primary Care Provider/PCP Visits

There may be times when your health requires repeated doctor visits. Our plan does not limit the number of times you can see your primary care provider. This way you get the care you need when you need it. And your doctor can see how your health is progressing.

Pangangalaga sa Paningin

Regular eye exams and glasses, if needed, can help you see more clearly. We also include:

  • Mga inireresetang lens.
  • Designer-style frames.

Call Member Services at 1-800-903-5253 for vision services and providers.

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.
  • Mammograms and Pap Smears.
  • Well-baby care.
  • Colorectal Screenings.

There are no copayments for preventive care.

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Planong Pangkomunidad ng UnitedHealthcare

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