Planong Pangkomunidad ng UnitedHealthcare

Medicaid

Our Ohio Medicaid plan covers eligible families, pregnant women of any age, infants, children and young adults. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. Members can choose a primary care doctor from our network. Plus get access to a 24/7 nurse advice hotline, health education materials and extras that other plans don't offer. View the benefits below to see all that it offers.

More information on eligibility and enrollment can be found on the Ohio Medicaid website, or by calling the Medicaid Hotline at 1-800-324-8680, TTY users should call Ohio Relay at 7-1-1.

 

Available ang planong ito sa lahat ng county.

Mga Pakinabang at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the care you need to get better if you are injured or sick — or to reach your full potential. Kabilang sa mga benepisyo ang:

  • NurseLineSM. Speak with a registered nurse 24/7.
  • No Copays. You pay nothing for your care or services.
  • Mga gamot. Fill your prescriptions, including over the counter drugs at local pharmacies.
  • Therapy Services. Physical or other therapy to recover and heal.
  • Chiropractor Services. We provide up to 15 chiropractic visit per year.
  • Mga Pagpapatingin Habang Walang Sakit. Annual checkups can help keep you healthy.
  • Urgent Care. Convenient care for a sudden illness or injury.

Nothing is more important than the health and well-being of a mother and her child. That's why our plan benefits include:

  • Choice of Doctors and Birthing Center. Find a doctor and hospital you trust in our network.
  • Mga Pagpapatingin Habang Nagbubuntis. Pangangalaga para sa iyo bago ipanganak ang iyong sanggol.
  • Baby Blocks™ Earn rewards for keeping you and your baby healthy.
  • Text4baby. Get helpful tips and links to free health and wellness items for you and your baby.
  • Healthy First Steps®. Karagdagang suporta upang tulungan kayo ng iyong sanggol na manatiling malusog.

If you have asthma, diabetes or another chronic condition, you can depend on us. Tinitiyak ng aming plano na nakukuha mo ang pangangalaga, suporta at mga serbisyong kailangan mo. Kabilang sa mga benepisyo ang:

  • Mental Health and Substance Abuse Services. With prior approval counseling and other treatments are covered.
  • Pamamahala sa Pangangalaga. Personal support from an experienced professional.
  • Asthma Care. Exams, testing and supplies are covered for asthma and other lung diseases.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Obesity Care. We cover screenings and counseling for obesity.

We help members keep their vision, smile and hearing at their best. Kabilang sa mga benepisyo ang:

  • Vision. Covers exams, glasses or $150 toward contact lenses.
  • Dental. We pay for cleanings, checkups and some dental work.
  • Hearing. Tests, checkups and with prior approval hearing aids are provided.

You get the medical care and equipment needed to live safely at home. Kabilang sa mga benepisyo ang:

  • Kagamitan at Mga Supply. With prior approval, in-home medical and safety equipment are covered.
  • Nurse Visits. Medical care to help with a safe recovery at home.
  • Respite na Pangangalaga. In-home help to give caregivers taking care of children under age 21 a rest.
  • Care Coordinator. Someone to get you the services you need after surgery or illness.
  • Home Health Care. With prior approval, medical and personal care in your home, if needed.

Sometimes members need a little extra help using their health plan. For those times, they can rely on:

  • Transportasyon. We pay for up to 30 one way or 15 round trip rides to medical visits or the pharmacy.
  • Tulong sa Wika. Connect to a translator through Member Services.
  • Members Matter. Someone to help you get the most from your plan.
  • Paghinto sa Paninigarilyo. Coaches and supplies to help quit using tobacco.
  • My Advocate. We help members connect to community services.
  • Healthy Rewards. Earn up to $100 in credits for completing healthy activities.

Asthma and COPD Care

Individual care to help control asthma or COPD symptoms.

Some members may have trouble managing asthma or COPD symptoms. For them, a nurse who specializes in breathing issues can really help. They get a customized treatment plan and medicine to:

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

Care Management

Members who need extra help get a Personal Care Manager. The care manager is there for you throughout your medical journey. He or she will:

  • Work with you to develop a plan of care that meets your individual needs.
  • Coordinate with family members, caregivers and health care providers.
  • Help get additional services or support you may need.

Chiropractor Services

Our plan includes visits for chiropractic care.

  • Members of all ages can get up to 15 visits per year.
  • Members under 21 may get additional visits with prior authorization.

Pagpili ng Doktor

From regular checkups to preventive health screenings, we want to make sure you get access to the right care at the right time.

You get a primary care physician (PCP), who is your main doctor. 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

Where a mother has her baby is an important choice. That's why pregnant moms can pick from hundreds of hospitals across Ohio.

We encourage mothers-to-be to tour the hospital's birthing center. This way they will be familiar with it. And be more relaxed when they have their baby.

Pangangalaga sa Ngipin

Checkups and cleanings are covered.

Exams and cleanings every six months help keep teeth and gums strong and healthy. If you obtain prior approval for a dental problem that needs to be fixed, that's covered as well.

Employment Physicals

Some employers or training programs require a physical before a person can start work. Our plan covers pre-employment physical exams.

Mga Kagamitan at Supply

The health and safety of our members at home are important.

Our plan covers medical equipment ordered by a member's doctor or care manager. This can include supplies like:

  • Mga kama sa ospital.
  • Oxygen tanks.
  • Wheelchairs or walkers.
For some of these services prior approval is required. Please check your member handbook for these details.

Pangangalaga sa Paa

We provide the exams and treatments needed to help keep your feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.

Kasama ng aming saklaw sa podiatry ang:

  • Routine foot exams.
  • Mga tip tungkol sa pangangalaga sa paa at pagpili ng mga tamang sapatos.
  • Impormasyon tungkol sa mga senyales ng babala sa pinsala sa nerve.

Pangangalaga sa Pandinig

Trouble hearing can affect a person's everyday life in many ways. Kabilang sa aming plano ang mga serbisyo at suporta upang matulungang protektahan ang iyong pandinig.

Sinasaklaw namin ang:

  • Exams, therapy and tests.
  • With prior approval, hearing aids and batteries.

Healthify

Sometimes a person's health and safety needs require the assistance from community support programs.

Here's where UnitedHealthcare's Healthify program can easily help. By calling 1-800-895-2017 our members can learn about and sign up for money-saving programs like: food, legal assistance, housing, utility discounts, free cell phone service; adult and child day care; and other social service programs.

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.

We can help:

  • Find a doctor for both mother and baby.
  • Learn resources for nutrition, fitness and safety.

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

Earn great gifts for you or your child by doing things like:

  • Completing well-child exams.
  • Getting lab tests.
  • Recording the family's health activities.

Home Health Care

If you are living with a long-term health condition, disability or leaving the hospital after surgery or a serious illness, you may need extra support. This can include 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:

  • An in-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.
  • Help with personal care or housekeeping.

Pagkakaospital

This plan pays for all medically necessary expenses related to a hospital stay. Sa paraang ito, makakapagpahinga ka at gagaling.

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.

And after leaving the hospital, you are not alone. Titiyakin naming makakakuha ka ng follow-up na pangangalaga upang maipagpatuloy ang pagpapagaling sa tahanan.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working regular treatments, called renal dialysis, or an organ transplant are needed to live. Dialysis uses a machine to clean the blood just like healthy kidneys do.

Kasama ng aming plano ang:

  • Dialysis.
  • Medications.
  • Health education and support.
  • Organ transplant if needed.

Laboratoryo at mga X-ray

Napakainam na malaman nang maaga pa lang kung ano ang problema. With prior approval, our plan 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

You can receive information in your preferred language. Magtanong lang. We also have people at our service centers who speak more than one language. Chances are, we have someone who speaks your language.

Medicines

Our plan includes prescription drugs and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.

You pay a co-pay amount, if needed, and you can get your prescription drugs at any in-network pharmacy.

Member Matters Representative

Meet your personal health plan assistant. Our job is to help you get the most of your benefits. We can help you:

  • Schedule doctor, dental and vision appointments.
  • Arrange for extra support services.
  • Complete a health risk assessment.
  • Stay in touch with you.

Mental Health and Substance Abuse Services

Get help with personal problems that may affect your mental or physical health. These may include stress, depression, anxiety or drugs and alcohol abuse. Our services also include:

  • Therapy
  • Counseling
  • Medications
For some of these services prior approval is required. Please contact Member Services to learn more.

No Copays

With our plan there are no copayments for covered services.

Members get:

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Home medical equipment and supplies to help them be their best.

NurseLine℠

Dumarating ang mga medikal na tanong at sitwasyon sa mga hindi magandang pagkakataon. For questions about health, call a nurse 24/7.

Our NurseLine nurses will:

  • Tutukuyin ang mga sintomas.
  • Provide guidance on self-care.
  • Advise the member about getting care at a doctor visit or an urgent care center.
  • Help know when to go to the emergency room.

Obesity Care

Obesity is common and serious. It can also lead to other health problems. To help our members be their best, our plan includes:

  • Screening for obesity.
  • Counseling for obesity.

Mga Pagpapatingin Habang Nagbubuntis

Ang pagbubuntis ay isang hindi kapani-paniwalang karanasan. It's a journey the new mother wants to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

Sa mga pagpapatinging ito, ang klinika ay:

  • Make sure both mother and baby are healthy.
  • Explain what to expect at each stage of the pregnancy.
  • Answer any questions.

Residential Care

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

With prior approval, 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.
Call Member Services for information on available providers.

Respite na Pangangalaga

Caring for a child recovering from an illness, surgery or with special health needs is an act of love. It can also be physically and emotionally exhausting. This service is for SSI members under 21 years of age.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members with coaching while they quit. We support our members while they quit, with coaches and supplies. The only thing they won't get from us is a lecture.

Therapy Services

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

With prior approvals, our plan covers visits for:

  • Occupational therapy.
  • Physical therapy.
  • Speech therapy.
  • In-home therapy.

Transportasyon

Our plan provides up to 30 one way or 15 round trip rides to medical appointments and other needed services. Rides are available to:

That includes trips to:

  • Dental and vision appointments.
  • Mga parmasya.
  • Women, infants and children (WIC) visits.
  • Job and Family Services offices for benefits redetermination.

UnitedHealthcare OMW™

UnitedHealthcare On My WayTM is an engaging, interactive program that informs Ohio youth and helps prepare them for many real-world situations that lie ahead. UnitedHealthcare OMW™ teaches the practical skills of managing bank accounts, securing housing, creating a resume, finding job training and applying for college. It is a reliable, go-to resource they can use throughout their journey toward independent living.

Urgent Care

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

  • Mga center ng agarang pangangalaga.
  • Federally qualified health centers.
  • Other walk-in clinics.

Pangangalaga sa Paningin

You'll get the care, eyeglasses and treatment that let you see life more clearly.

Kabilang sa mga benepisyo ang:

  • Annual eye exams.
  • Glasses and $150 toward contact lenses.

You also can chose from an expanded selection of frames.

This benefit is offered by Block Vision.

Mga Pagpapatingin Habang Walang Sakit

Well visits with your doctor can help keep you and your family 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.

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Planong Pangkomunidad ng UnitedHealthcare

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