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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.

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If you have a change in address please report this change with MO Healthnet. It is important so they can contact you with information about your coverage. 

To make a change go here: Welcome to myDSS | mydss.mo.gov and click the “Report a Change” icon.

Mga Benepisyo 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. Kasama rito:

  • 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.
  • Pagpapaospital. 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:

  • Electronic breast pumps: Enrolled pregnant members are eligible for an electronic breast pump (limit one).
  • Asthma support: Special supplies are available, including a hypoallergenic mattress cover and pillow case.
  • Peer support specialists: Coaches can provide support for substance use disorder (SUD) recovery.
  • Mga Pagkain ni Nanay: Post-delivery moms can receive 30 meals (2 meals per day for 15 days) delivered to their home. These requests can be made through your case manager or by calling member services.
  • YMCA Memberships: Members up to age 17 years of age can receive a Youth Membership to their local YMCA.  Just go into your local Y and bring your member ID card to get signed up. Learn more here.
  • One Pass: Members 18 and older will have access to this membership which gets them into over 300 gyms across Missouri including the YMCAs, Planet Fitness, Anytime Fitness, and many small local gyms. Information can be found at One Pass UHCMO | Rally Health or learn more here
  • Transportation: Unlimited trips to doctors appointments, dental appointments, WIC, and pharmacy. In addition, members can get rides to grocery stores and food pantries, weight management classes or programs such as their YMCA or local gym, job and vocational training, and substance abuse services for pregnant members. Learn more here. Members and Members family and friends (when assisting the member with a ride) are eligible to submit for gas mileage reimbursement by filling out MTM’s GMR form.  You can find the form here. Remember, the form must be signed off by the correct medical personnel to receive reimbursement.
  • Sanvello Application: an app that offers clinical solutions to dial down symptoms of stress, anxiety, and depression. Members can download the app, create an account and choose “upgrade through insurance”, and search for and select United Healthcare and enter the information on your insurance card.

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:

  • Nurse HotlineSM.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 Ingles 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.

YMCA Benefit:  Members up to age 17 years of age can receive a Youth Membership to their local YMCA.  Just go into your local Y and bring your member ID card to get signed up. Learn more here.

One Pass Benefit:  Members 18 and older will have access to this membership which gets them into over 300 gyms across Missouri including the YMCAs, Planet Fitness, Anytime Fitness, and many small local gyms. Information can be found at One Pass UHCMO | Rally Health or learn more here

Transportation: Unlimited trips to doctors appointments, dental appointments, WIC, and pharmacy. In addition, members can get rides to grocery stores and food pantries, weight management classes or programs such as their YMCA or local gym, job and vocational training, and substance abuse services for pregnant members. Learn more here.

UHC Doctor Chat: As a UnitedHealthcare member, you can skip the waiting room and connect to doctors in seconds with the UHC Doctor Chat app. Doctors are available 24 hours a day, 7 days a week to answer any questions.  Learn more here.

Breast Pump Benefit: Members now call Aeroflow at 1-844-867-9890 and their dedicated mom and baby specialists will be able to assist you or visit aeroflowbreastpumps.com/united-qualify.

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.

Babyscripts

Earn great rewards:

  • The Babyscripts program rewards you for going to your prenatal and postpartum visits
  • Earn up to 3 rewards in all
  • Get a gift card just for signing up

To sign up, visit the Apple App Store® or Google Play™ store on your smartphone. Download the Babyscripts myJourney app. Or call 1-800-599-5985, 8 AM–5 PM, Monday–Friday. It’s that simple.

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.

Learn more about the Sanvello app in InglesEspañol

Pamamahala sa pangangalaga

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

Ang bawat miyembro ay maaaring pumili ng provider ng pangunahing pangangalaga (PCP). Gamitin ang tool na Maghanap ng Doktor para makita kung nasa aming network ang iyong doktor.

The PCP is the main doctor for:

  • Preventive care.
  • Paggagamot kung mayroon kang sakit o injury.
  • 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.

Doctor Chat

As a UnitedHealthcare member, you can skip the waiting room and connect to doctors in seconds with the UHC Doctor Chat app. Doctors are available 24 hours a day, 7 days a week to answer any questions.  Learn more here.

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. Puwedeng kasama sa mga supply ang:

  • Mga oxygen tank.
  • Mga kama sa ospital.
  • Mga wheelchair or walker.

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).
  • Medikal na kagamitan tulad ng mga kama sa ospital, walker o wheelchair.
  • Mga disposable na medical supply.

Pagkakaospital

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

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.

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.

Mga interpreter

Kailangang magkaunawaan kayo ng iyong doktor. 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 Nurse Hotline.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 Ingles 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 AM to 5:00 PM

Laboratoryo at mga X-ray

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

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

Tutulungan ka naming makuha ang impormasyong kailangan mo upang mapabuti ang iyong kalusugan o maibalik ka sa pinakamalusog mong kundisyon.

Tulong sa Wika

Members can get printed information in their preferred language. You will get member materials in Ingles 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 Ingles 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 AM to 5:00 PM

Mga Serbisyo para sa Miyembro

Minsan kailangan mo ng tulong para maunawaan ang iyong mga opsyon sa pangangalagang pangkalusugan. Tawagan kami. Sasagutin namin ang iyong mga tanong sa simple at kumpletong paraan.

We help you find:

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

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.

Hotline ng Nars

Minsan may mga medikal na tanong at sitwasyon sa mga hindi magandang oras. Kapag may mga tanong ka tungkol sa iyong kalusugan, puwede kang tumawag sa nurse 24 (na) oras sa isang araw, 7 (na) araw sa isang linggo.

Gagawin ng aming mga nurse ang sumusunod:

  • Pakinggan ang mga sintomas.
  • Tutulong sa pangangalaga sa sarili.
  • 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.

Sakop ng aming plano ang lahat ng inirerekomendang prenatal clinical visit at test.

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.

Paghinto sa Paninigarilyo

Alam ng karamihan ng mga tao ang masasamang epekto ng paninigarilyo. At alam nilang kailangan nilang huminto. 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. Tumawag sa 1-800-784-8669.

Mga Iniksyon at Bakuna

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.

Mga Serbisyo sa Therapy

Makakatulong ang physical, occupational at speech therapy sa iyo na gumaling mula sa malubhang injury o sakit, o maabot ang buo mong potensyal.

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.

Transportasyon

Members get unlimited trips to the following:

  • Doctors and providers
  • Mga dentista
  • Mga parmasya
  • WIC
  • Grocery stores
  • Mga food pantry
  • Weight management classes or programs
  • YMCA or local gym
  • Job and career training
  • If you’re pregnant, substance abuse services
  • Learn more here
    Members and Member’s family and friends (if helping the member with a ride) can submit a form for gas mileage reimbursement. You can find the form here. Tandaan: The form must be signed off by the correct medical personnel to receive reimbursement.
     

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. 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.
  • Mga regular na iniksyon at pagte-test.
  • Mga mammogram.

Walang copayment para sa pangangalagang pang-iwas sa sakit.

NCQA Accredited Commendable Health Plan

Mga Resource ng Miyembro

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