UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)

Adult Day Care

Companionship is important. Adult day care provides care and companionship for seniors who who qualify for extra help during the day.

Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

If your need for long‑term care has been determined by Ohio Medicaid, Adult day care can provide:

• Social connections and friendship.
• Meals.

Asthma and COPD Care

Individual care to help control asthma and other lung diseases.

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 help you:

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

Pamamahala sa pangangalaga

Members get a 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. Whether chiropractor services are your primary or alternative treatment method, you're covered.

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:

• Preventive care.
• Paggagamot kung mayroon kang sakit o injury.
• Mga referral sa mga espesyalista para sa ilang partikular na kondisyon.

Pangangalaga sa Ngipin

Regular exams help keep teeth and gums strong and healthy. Oral exams are covered once per year for members over age 21.

Mga Kagamitan at Supply

Our plan covers some medical equipment ordered by a member's doctor or case manager. Puwedeng kasama sa mga supply ang:

• Walkers
• Wheelchairs
• Mga kama sa ospital

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.
• Therapeutic shoes and inserts for members with diabetes.

Pangangalaga sa Pandinig

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

Sakop ng aming plano ang:

• Mga eksaminasyon, therapy, at test.
• Hearing aids, batteries, and accessories.

Pangangalagang Pangkalusugan sa Tahanan

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. Posibleng kailanganin mo rin ng medikal na pagbisita sa bahay para matingnan kung maaayos ba ang paggaling mo.

With approval, our plan may cover:

• Isang medikal na pagbisita sa bahay.
• Medikal na kagamitan tulad ng mga kama sa ospital, walker o wheelchair.
• A home health aide, nursing services or a private nurse.
• Physical, occupational, and speech therapy.
• Tulong sa personal na pangangalaga o housekeeping.
• Home infusion therapy.

Pagkakaospital

This plan pays for most expenses related to a hospital stay, so you can rest and heal.

Our plan covers these services and more:

• Pangangalaga ng isang nurse.
• Kuwarto at matutuluyan.
• Mga supply at kagamitan.
• Paggagamot at mga therapy.
• Mga diagnostic na test at eksaminasyon.

At pagkalabas mo sa ospital, hindi ka mag-iisa. Titiyakin naming makakakuha ka ng follow-up na pangangalaga para maipagpatuloy ang pagpapagaling sa tahanan.

Language and Interpretation

Kailangang magkaunawaan kayo ng iyong doktor. We can explain information in Ingles or in your primary language. If you are visually or hearing impaired, special help can be provided.

Pangangalaga para sa Sakit sa Kidney

Malubhang medikal na kondisyon ang sakit sa kidney. After the kidneys stop working regular treatments, called renal dialysis, or an organ transplant are needed to live. Ang dialysis ay gumagamit ng makina para linisin ang dugo tulad ng ginagawa ng malulusog na bato.

Our services may include:

• Dialysis.
• Needed equipment and supplies.
• Home support services.
• Health education and training.

Mga Gamot

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 Services Representative

Every member of the health plan gets a personal Members Services representative. This person can help you get the most of your benefits. Magagawa nilang:

• Welcome you to the plan and help you understand your benefits.
• Arrange for extra support services.
• Complete a health risk assessment.
• Help you access community services.

Mental Health and Substance Use Disorder Treatment 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
• Mga Gamot

Nurse Advice

Dumarating ang mga medikal na tanong at sitwasyon sa mga hindi magandang pagkakataon. 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.

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.

Paghinto sa Paninigarilyo

Alam ng karamihan ng mga tao ang masasamang epekto ng paninigarilyo. At alam nilang kailangan nilang huminto. We support our members with coaching while they quit.

Mga Serbisyo sa Therapy

Therapy can help you recover from a serious injury or illness, or simply reach your full potential. Members receive needed:

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

Agarang Pangangalaga

Posibleng mayroon kang injury o biglaang sakit na hindi nakamamatay pero kailangan ng agarang atensyon. Sakop ng aming plano ang pangangalaga sa:

• Mga center ng agarang pangangalaga.
• Federally qualified health centers.
• Iba pang walk-in na klinika.

Pangangalaga sa Paningin

Eye exams are covered every year for members age 21-59.