UnitedHealthcare Community Plan - MO HealthNet Managed Care

Medicaid

The UnitedHealthcare Community Plan – MO HealthNet Managed Care offers a range of benefits. It’s for children, families, pregnant women and adults who meet income requirements. We also offer support to adults with special health care needs. View the benefits below to see all that our health plan offers.

Available ang planong ito sa lahat ng county.

Mga Pakinabang at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the care you and your children need to stay healthy — or to be at your best. That includes:

  • Unlimited PCP Visits. See your primary care provider (PCP) as needed.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Laboratoryo at mga X-ray. Ang mga pagsusuri sa laboratoryo, x-ray at diagnostic imaging ay sinasaklaw.
  • Pagkakaospital. Wala kang babayaran para sa pangangalaga sa isang ospital.
  • Lead Screening. Can be done in the doctor's office or local health department.

Wala nang mas mahalaga pa sa kalusugan at kapakanan mo at ng iyong sanggol. That's why your MO HealthNet Managed Care benefit includes:

  • Choice of Birth Centers. Pick from our large network of hospitals or birthing centers.
  • Choice of Doctors. Find a doctor you trust for your pregnancy care.
  • Mga Pagpapatingin Habang Nagbubuntis. Pangangalaga para sa iyo bago ipanganak ang iyong sanggol.

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

  • Asthma Care. Exams and supplies are covered.
  • Pamamahala sa Pangangalaga. Get personal help managing health conditions.
  • Disease Management. Focused care for those with critical health needs.
  • Behavioral Health and Substance Use Services. Get caring help to meet your recovery goals.

Make sure your sight and smile are at their best. Your MO HealthNet Managed Care benefits include:

  • Vision. Routine eye exams, plus frames and prescription lenses are covered.
  • Dental. Cleanings, check-ups and dental work.

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. Ang medikal at pangkaligtasang kagamitan sa tahanan ay sinasaklaw.
  • Home Health Care. Medical care in your home, if needed.

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

  • Paghinto sa Paninigarilyo. Enroll Quit for Life - Call the No Cost to You Quit Line and ask your doctor about support to help you quit.

Kung minsan, maaaring kailanganin mo ng kaunting karagdagang tulong sa paggamit ng iyong planong pangkalusugan. For those times, you can rely on us for assistance:

  • NurseLineSM.S peak with a registered nurse 24/7.
  • Mga Serbisyo sa Miyembro. Your benefit questions are answered Monday - Friday, 7:00 a.m. - 7:00 p.m. CT
  • Tulong sa Wika. Connect to a language or ASL interpreter through Member Services. We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Asthma Care

Do you or a family member have trouble managing asthma symptoms?
You will get a customized treatment plan and medicine to:

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

Baby Blocks™

Build a health future for you and your baby — and earn great rewards — through Baby BlocksTM. 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

Behavioral Health and Substance Use Services

Inpatient, residential and outpatient services for behavioral health and substance use are covered. The type, amount and length of services provided will be based on the level of your needs. These services are part of your MO HealthNet Managed Care benefits.

Care Management

When a member has complex health care needs, a care manager can really help. He or she will:

  • Work with you and family members and friends on a plan of care.
  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records. 
  • Make a referral to community social service programs.

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That's why you can pick from our large network of hospitals or Birthing Center.

We also encourage you to tour the hospital's birthing center. This way you will be familiar with it and be better informed when you have your baby.

Pagpili ng Doktor

Each member can choose a primary care provider (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.

The PCP is the main doctor for:

  • Pampigil na pangangalaga.
  • Panggagamot kung mayroon kang sakit o pinsala.
  • Care coordination with specialists.

For members who don’t have a doctor or whose doctor is not in our network, member services can help find a new one close by.

Pamamahala sa Sakit

Kung mayroon kang mga pabalik-balik o lubhang mapanganib na sakit, idinisenyo ang aming mga serbisyo sa pamamahala ng sakit upang suportahan ka.

Mga Kagamitan at Supply

Our member's health and safety at home are important.

MO HealthNet Managed Care covers medical equipment ordered by the doctor or care manager. This can include supplies like:

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

Home Care

After surgery or a serious illness, you may need  in-home medical visit(s) to check on how well you are healing.

MO HealthNet Managed Care covers:

  • In-home medical visit(s).
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.

Pagkakaospital

MO HealthNet Managed Care covers expenses related to a hospital stay, so our members 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.

And after leaving hospital, we can provide transitional care services. MO HealthNet Managed Care makes sure you get follow-up care to continue healing at home.

Interpreters

You and your doctor need to understand each other. We have interpreters for you if your provider does not speak your language. We also have qualified American Sign Language interpreters available. This is provided at no cost to you when you speak to us, your provider, or NurseLine.SM

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Laboratoryo at mga X-ray

Napakainam na malaman nang maaga pa lang kung ano ang problema. MO HealthNet Managed Care covers:

  • 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.

Tulong sa Wika

Members can get printed information in their preferred language. You will get member materials in English and Spanish. We can give you member materials in a language or format that is easier for you to understand. We also have qualified American sign language interpreters available. Magtanong lang.

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Mga Serbisyo para sa Miyembro

Sometimes you might need a little help understanding your health care options. Tawagan kami. We'll answer your questions simply and completely.

We help you find:

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

No Copays

You will not have a copayment for care and services covered by MO HealthNet Managed Care.

This includes in network services:

  • Visits to doctors
  • Treatments at hospitals and clinics.
  • Behavioral Health and Substance Use.
  • Home medical equipment and supplies to help you be at your best.

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:

  • 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.

Pharmacy

All pharmacy benefits are covered by MO HealthNet Fee-for-Service. For more information:

Please contact 1-800-392-2161 or visit the MO HealthNet website at www.dss.mo.gov.

Mga Pagpapatingin Habang Nagbubuntis

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor.

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.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. That's why we encourage members to talk to their doctor about getting smoking cessation support. UnitedHealthcare Community Plan covers counseling when you enroll with Quit for Life. Medication for smoking cessation is available. Call 1-800-784-8669.

Shots and Vaccines

Routine shots help protect members and their family from illness. MO HealthNet Managed Care covers:

  • Pneumonia, influenza and shingles shots.
  • Vaccines and Immunizations. Routine shots to help keep your child healthy.
  • Other recommended shots and vaccines.

Therapy Services

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

For children under age 21 and for pregnant women, MO HealthNet Managed Care provides:

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

Transplant Services

Covered when ordered by a network physician.

Unlimited Primary Care Provider Visits

There may be times when a member's health requires repeated doctor visits. Our plan does not limit the number the number of visits to a primary care provider (PCP). This way the members get the care they need. And the doctor can see how their health is progressing.

Pangangalaga sa Paningin

You'll get the care, eyeglasses and treatment that help you see better. Kasama sa saklaw ang:

  • One eye exam every 24 months for members 21 and over.
  • One eye exam every 12 months for children under 21 and pregnant women.
  • One pair of frames and lenses ever 24 months.

This benefit is offered by MARCH Vision Care.

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.

Mga Mapagkukunan ng Miyembro

Tingnan ang Mga Available na Mapagkukunan

Matuto Nang Higit Pa

MO HealthNet Managed Care

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