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Verify your mailing address today!
It is important to keep your mailing address up to date to make sure you get important messages about your health care coverage. To update your mailing address:
- Call the New York State of Health Exchange at 1-855-355-5777
- Log on to your New York State of Health account at nystateofhealth.ny.gov/apply
New York Pharmacy Program Changes Effective 04/01
UnitedHealthcare Wellness4Me
Medicaid
The Wellness4me Plan is offered through UnitedHealthcare Community Plan, a Health and Recovery Plan, or HARP, approved by New York State. HARPs are a new kind of plan that provide Medicaid members with their health care, plus care for behavioral health, including Serious Mental Illness and Substance Use Disorders.
This plan is for New York residents age 21 and who qualify for Medicaid coverage.
UnitedHealthcare Community Plan is a special health care plan with providers who have a lot of experience treating people who may need mental health and/or substance use care to stay healthy. We also provide care management services to help you and your health care team to work together to keep you as healthy as possible.
Available ang planong ito sa mga sumusunod na county:
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Schenectady, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, Westchester, Wyoming, and Yates.
- UnitedHealthcare Wellness4Me
Maghanap ng mga provider at coverage para sa planong ito.
Maghanap ng mga doktor, ospital, at espesyalista.
Maghanap ng mga gamot na sakop ng planong ito.
Maghanap ng parmasyang malapit sa iyo.
Maghanap ng dentistang malapit sa iyo.
Mga Benepisyo at Feature
Adult Day Care
Companionship is important. If your Primary Care Provider (PCP) recommends it, you may be able to participate in adult day health care. Adult day health care provides care and companionship for seniors who need extra help during the day.
Caregivers also benefit, knowing their loved one is safe when they can’t provide care.
Adult day care can provide:
- Social connections and friendship.
- Bathing and personal care.
- Meals.
Asthma and COPD Care
Do you need help trouble managing asthma, allergies or COPD symptoms? You’ll get a customized treatment plan and medicine to help:
- Manage flare-ups.
- Reduce symptoms.
- Live an active life.
Behavioral Health
Kasinghalaga ng behavioral health ang physical health. Our behavioral health care includes mental health and substance use treatment services.
Ang kinakailangang pangangalaga ay 100% sinasaklaw nang walang copay. Kasama rito ang:
- Intensive psychiatric rehab treatment (IPRT).
- Inpatient mental health treatment.
- Continuing day treatment.
- Personalized Recovery Oriented Services (PROS).
- Assertive Community Treatment Services (ACT).
- Individual and group counseling.
- Crisis intervention services.
You can also get help with alcohol or other substance use issues.
Pamamahala sa pangangalaga
A serious health problem requires extra care and support. We use Health Homes to coordinate services for our members.
Health Home 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 close by throughout the medical journey. He or she will:
- Think beyond immediate medical needs.
- Help manage ongoing medical issues like diabetes, asthma and high blood pressure
- 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 142 hospitals across New York.
We also encourage you to tour the hospital's birthing center. Nang sa gayon ay maging pamilyar ka rito. And you'll be more relaxed when you have your baby.
Pagpili ng Doktor
When you join UnitedHealthcare Community Plan, one of our providers will take care of you. Most of the time that person will be your Primary Care Provider (PCP). You may want to choose a PCP from your mental health or substance use clinic. If you need to have a test, see another specialist, or go into the hospital, your Primary Care Provider will arrange it.
Ang iyong PCP ay ang iyong pangunahing doktor para sa:
- Preventive care.
- Paggagamot kung mayroon kang sakit o injury.
- Mga referral sa mga espesyalista para sa ilang partikular na kondisyon.
Pangangalaga sa Ngipin
Dental checkups and cleanings can help keep teeth and gums healthy. Covered services include:
- Regular checkups.
- Cleanings.
- X-rays.
- Treatments, including fillings and other services.
You do not need a referral from your PCP to see a dentist.
Diabetic Supplies
If you have diabetes, you may need insulin, needles, wipes and glucose strips. Sinasaklaw namin ang lahat ng iyon at higit pa.
Ang aming plano ay may kasama ring mahuhusay na serbisyo upang tulungan kang mapamahalaan ang iyong diabetes, kabilang ang:
- Diabetes counseling and self-management training.
Durable Medical Equipment
Sakop ng aming plano ang medikal na kagamitang ibinilin ng iyong doktor o case manager. Puwedeng kasama sa mga supply ang:
- Mga hearing aid.
- Prosthetics.
- Orthotics.
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 para matulungang protektahan ang iyong pandinig.
Sakop ng aming plano ang:
- Exams and tests.
- Mga hearing aid at baterya.
Pangangalagang Pangkalusugan sa Tahanan
Sometimes our members are living with a long-term health condition or disability. Others are coming out of the hospital after surgery or a serious illness. These members can receive extra support from our plan.
Kapag naaprubahan, sakop ng aming plano ang:
- Isang medikal na pagbisita sa bahay.
- Medikal na kagamitan tulad ng mga kama sa ospital, walker o wheelchair.
- In-home medical visit
- Help with day-to-day tasks like cleaning, cooking or dressing.
- Mga disposable na medical supply.
Pagkakaospital
Nagbabayad ang planong ito para sa lahat ng gastusing kaugnay ng pananatili sa ospital nang sa gayon, makapagpahinga at makapagpagaling ka.
Kasama sa coverage ng pagkakaospital ang:
- Inpatient care.
- Outpatient care.
- Lab, X-ray, other tests.
Your Health Home Care Manager can:
- Help you safely return home after a hospital stay.
Mga Gamot
Our plan covers prescription drugs and refills with a small copayment. Your copay is:
| Prescription Item | Wellness4me Plan | |
|---|---|---|
| Co-Payment Amount | Co-Payment Details | |
| Brand name prescription drugs | $3.00/$1.00 | 1 co-pay charge for each new prescription and each refill |
| Generic prescription drugs | $1.00 | Refer to the Preferred Drug List |
| Over-the-counter drugs, such as for smoking cessation and diabetes | $0.50 | Refer to the Preferred Drug List |
Over-the-counter medicines with a written order from your doctor are available for a copayment of $0.50 for each medicine.And we make getting your medicine easy. You can fill your prescriptions at:
- Local pharmacies.
- Services that deliver right to your door.
Mga Serbisyo para sa Miyembro
You can call Member Services to get help any time you have a question.
You may call us to choose or change your Primary Care Provider (PCP for short), to ask about benefits and services, to get help with referrals, to replace a lost ID card, to report that you are pregnant, the birth of a new baby or ask about any change that might affect your benefits.
Residential Care
After a serious illness, surgery or injury, you may need extra nursing and therapy.
Kung kinakailangan, saklaw ng aming plano ang maiikling pananatili sa rehabilitation center kung saan puwede kang magpagaling. Kabilang ang:
- Mga serbisyo ng pangangalaga sa bahay.
- 24 na oras ng pangangalaga.
- Tulong sa mga aktibidad sa pang-araw-araw na pamumuhay.
- Physical, occupational at speech therapy.
If you are in need of long-term placement in a nursing home, your local department of social services must determine if you meet certain Medicaid income requirements.
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. Kaya kami nagbibigay ng pansamantalang pangangalaga para makapagpahinga ang iyong mga tagapag-alaga. Ang respite na pangangalaga ay nag-aalok sa mga tagapag-alaga ng pansamantalang bakasyon malayo sa kanilang mga mahal sa buhay na may karamdaman o mga espesyal na pangangailangan sa pangangalaga.
- Short-Term Respite — gives you a safe place to go when you need to leave a stressful situation.
- Intensive Respite — helps you stay out of the hospital when you are having a crisis by providing a safe place to stay that can offer you treatment.
Mga Iniksyon at Bakuna
Nakakatulong ang mga regular na iniksyon para maprotektahan ka mula sa sakit.
Kung kaya, sakop ng aming plano ang:
- Pneumonia, influenza and shingles shots.
- Other recommended shots and vaccines.
Pangangalaga sa Paningin
You'll get the care, eyeglasses and treatment that help you see better.
Kasama sa saklaw ang:
- Eye exams every two years, or as medically needed.
- Prescription lenses, including contact lenses.
- Glasses and frames.
- Specialist care when needed.
Mga Pagpapatingin Habang Walang Sakit
Makakatulong sa iyo ang mga regular na medikal na pagbisita 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.
- Pangangalaga sa sanggol nang walang sakit.
- Pangangalaga para sa mga babaeng nagbubuntis.
- Mga regular na iniksyon at pagte-test.
- Mga mammogram.
Walang copayment para sa pangangalagang pang-iwas sa sakit.
UnitedHealth Group is 100% owner of UnitedHealthcare of New York, Inc