Planong Pangkomunidad ng UnitedHealthcare

Medicaid

The New York State Medicaid Managed Care Plan is offered through UnitedHealthcare Community Plan. It’s for New York State residents who meet the income or disability requirements.

To find out if UnitedHealthcare Community Plan is offered in your county, please call 1-800-493-4647. A representative will contact you to schedule an appointment to help you apply.

More information on eligibility and enrollment can be found on the New York State of Health website.

For more information about Child Health Plus or Medicaid, call New York Health Options at 1-800-541-2831.  

To learn more about applying for health insurance through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.

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.

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. Use "Doctor Lookup" to see if your doctor is in our network or to find a new one.
  • Mga gamot. Prescription drugs are covered with a small copay.
  • Dental. We cover cleanings, checkups and dental work.
  • Mga Pagpapatingin Habang Walang Sakit. Annual checkups can help keep you healthy.

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

  • Vision. Covers eye exams and glasses.
  • Dental. We cover cleanings, checkups and dental work.
  • Hearing. Screenings and therapies, if needed, are provided.

Get the medical care and equipment you need to live at home. Kabilang sa mga benepisyo ang:

  • Care Coordinator. Someone to get you the services you need to recover safely.
  • Personal Care. Services to help you heal after illness or injury.
  • Home Meal Delivery. If you can’t safely make meals, we'll provide them.
  • Kagamitan at Mga Supply. Ang medikal at pangkaligtasang kagamitan sa tahanan ay sinasaklaw.
  • Nurse Visits. Care after surgery or illness to recover at home.

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

  • Pagpili ng Doktor. Find an OB-GYN you trust in our network.
  • Mga Pagpapatingin Habang Nagbubuntis. Pangangalaga para sa iyo bago ipanganak ang iyong sanggol.
  • Healthy First Steps®. Karagdagang suporta upang tulungan kayo ng iyong sanggol na manatiling malusog.
  • Pagpili ng Birth Center. Pick from hospitals across New York.

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

  • Kalusugan ng pag-iisip. Saklaw ang pagpapayo at iba pang mga panggagamot.
  • Pamamahala sa kaso. Kung kwalipikado ka, kumuha ng personal na tulong sa pamamahala sa mga kundisyon ng kalusugan.
  • Asthma and COPD Care. Exams, testing and supplies are covered.

Adult Day Care

Companionship is important. Adult day care provides care and companionship for seniors 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 Care

Individual care to help control asthma, allergies or COPD symptoms.

Do you or your child 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.
  • Let you or your child stay active.

Pamamahala sa sitwasyon

Do you or your child have a serious health problem or a high-risk pregnancy? If so, and you or your child qualifies, we offer case managers that can:

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

Your case manager will stay with you or your child throughout the medical journey. He or she will:

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

So you or your child can focus on getting better.

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That's why you can pick from hundreds of hospitals across New York.

We 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

You get a primary care physician (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.

Pangangalaga sa Ngipin

Checkups and emergency care are covered.

Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that’s covered as well.

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:

  • Classes on keeping diabetes in control.
  • Pag-coordinate sa pangangalaga ng doktor.
  • Nutrition and diet.

Matibay na Medikal na Kagamitan

Ang iyong kalusugan at kaligtasan sa tahanan ay mahalaga.

Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:

  • Diabetic supplies.
  • Mga kama sa ospital.
  • Wheelchairs or walkers.

Emergency Response System

If you are 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.

Grief Support

A loss can take many different forms. And you may get lots of suggestions on what to do. Grieving is part of the healing process.

If a recent loss has made you sad or unhappy, help is available. Our plan offers counseling and support during the grieving process. Our team will work with you to find a counselor or program to help you adjust to your loss.

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, 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 ng aming plano ang:

  • Exams, therapy and tests.
  • Mga hearing aid.

Home Meal Delivery

Taking care of the basics, like cooking, can be hard to do yourself after an illness or sickness.

If you are receiving personal care services, you may need extra help to get through the tough times. We'll step in to bring nutritious meals to you. You can get up to 10 meals delivered each year.

In-Home Care

After surgery or a serious illness you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

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

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.

Medicines

Our plan covers prescription drugs and refills with a small copayment. Your copay is:

  • $1.00 for generic drugs.
  • $3.00 for brand name drugs.

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

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We'll answer your questions simply and completely.

Maaari ka rin naming tulungang humanap ng:

  • Home care providers.
  • Dentists and vision providers.
  • Adult day health centers.

Mental Health/Substance Use Disorder

Addiction can happen to anyone, any family, at any time according to the New York State Office of Alcoholism and Substance Abuse Services (OASAS).

UnitedHealthcare is here to assist you in all your healthcare needs. We have trained professionals who are experienced in understanding Substance Use Disorder and able to help you get treatment or give you information that will help you make decisions about your healthcare. You or your provider can call Optum Behavioral Health anytime for help at 1-888-291-2506.

Covered services include:

  • All inpatient mental health and substance use disorder services (including alcohol and substance use disorder).
  • Most outpatient mental health services (contact plan for specifics).
  • Medicaid recipients who receive SSI or who are certified blind or disabled get mental health and substance use disorder services from any Medicaid provider by using their Medicaid Benefit Card.
  • Detoxification services are covered by UnitedHealthcare Community Plan as a benefit.

No Copays

You will not have a copayment for care and services covered by our plan, other than for prescription drugs.

Ibig sabihin, wala kang babayaran para sa mga sinasaklaw na serbisyo, kabilang ang:

  • Pampigil na pangangalaga.
  • Mga taunang checkup.
  • Routine dental or vision care.

You pay nothing for your child's care and services covered by our plan.

Nurse Visit

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.

Nutrition Coaching

Healthy eating goes a long way to helping you stay at your best.

A nutritionist can meet with you to review your eating habits and food choices.

You'll come away with new ideas for:

  • Making good choices for quick meals and snacks.
  • Preparing healthy meals on a budget.

Outpatient Services

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 help improve your health or be your best.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury.

If needed, we provide someone to help with:

  • Dressing.
  • Bathing.
  • Feeding.

Mga Pagpapatingin Habang Nagbubuntis

A 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 the help of coaches and supplies. The only thing you won't get from us is a lecture.

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.

If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:

  • Nursing home services.
  • 24-hour nursing care.
  • Help with activities of daily living.
  • Physical, occupational and speech therapy.

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 naman nagbibigay kami ng respite na pangangalaga upang makapagpahinga ang iyong mga caregiver. 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.

Shots and Immunizations

Routine shots help keep you healthy.

So, our plan covers:

  • Recommended shots and vaccines.
  • Mga diagnostic na pagsusuri at eksaminasyon.

Pangangalaga sa Paningin

See life more clearly with routine eye exams and glasses, if needed.

We also include:

  • Mga inireresetang lens.
  • Medicaid approved frames.
  • New eyeglasses every two years.

This benefit is offered by March Vision Care.

Mga Pagpapatingin Habang Walang Sakit

Well visits with your doctor can help you stay healthy. 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.
  • Well-baby care.
  • Care for women expecting a baby.
  • 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

Planong Pangkomunidad ng UnitedHealthcare

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