UnitedHealthcare Connected® for MyCare Ohio H2531-001-000

Medicaid

H2531-001

This plan is for adults who need extra support and care. You may qualify based on income and health needs. The plan offers members a customized care plan and a single point of contact for all Medicare and Medicaid services. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. You get many services to help with daily activities that other MyCare Ohio plans don’t offer. View the benefits below to see all that it offers.

More information on eligibility and enrollment can be found on www.ohiomh.com, or by calling the Medicaid Hotline at 1-800-324-8680, TTY users should call Ohio Relay at 7-1-1. The Hotline operates from 7 a.m. to 8 p.m. ET Monday through Friday and 8 a.m. to 5 p.m. ET on Saturday.

 

 

Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Stark, Summit, Trumbull, and Wayne.

Mga Pakinabang at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

If you just need a checkup or if you are injured or sick, you will have access to the care you may need. That includes:

  • Unlimited PCP Visits. See your doctor as often as needed.
  • NurseLineSM. Speak with a registered nurse 24/7. Call 1-800-542-8630.
  • Laboratoryo at mga X-ray. Ang mga pagsusuri sa laboratoryo, x-ray at diagnostic imaging ay sinasaklaw.
  • Therapy Services. Physical and other needed therapies are covered.
  • Urgent Care. Convenient care for a sudden illness or injury.

A healthy mom is more likely to have a healthy baby. Pregnancy is an important time for women to take good care of themselves and their unborn baby. We have a special program for pregnant members. Our Healthy First Steps program gives pregnant women information, education and support during pregnancy. Pregnant members can enroll in Healthy First Steps by calling 1-800-599-5985.

If you have asthma, diabetes or another chronic condition, you can depend on us. Our plan helps you get the care, support and services you may need. Kabilang sa mga benepisyo ang:

  • Mental Health and Substance Abuse Services. Saklaw ang pagpapayo at iba pang mga panggagamot.
  • Pamamahala sa Pangangalaga. Personal support from an experienced professional.
  • Asthma and COPD Care. Exams, testing and supplies are covered for asthma and other lung diseases.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.

We help members keep their vision, smile and hearing in the best shape possible. Kabilang sa mga benepisyo ang:

  • Vision. Eye exams are covered every year for members age 21-59.
  • Dental. We pay for an exam every six months for members over the age of 21.
  • Hearing. Ang mga pagsusuri, checkup at hearing aid, kung kailangan, ay ibinibigay.

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

  • Kagamitan at Mga Supply. Ang medikal at pangkaligtasang kagamitan sa tahanan ay sinasaklaw.
  • Care Coordinator.. Someone to get you the services after surgery or illness.
  • Home Health Care. Medikal at personal na pangangalaga sa iyong tahanan, kung kailangan.

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

  • Transportasyon. Transportation to a doctor's office is only covered in certain circumstances.
  • Members Matter. Someone to help you get the most from your plan.
  • Tulong sa Wika. Connect to a translator through Member Services.
  • My Advocate. We help members connect to community services.

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.
  • Bathing and personal care.
  • 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.

Care Management

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:

  • Pampigil na pangangalaga.
  • Panggagamot kung mayroon kang sakit o pinsala.
  • Mga referral sa mga espesyalista para sa ilang partikular na kundisyon.

Pangangalaga sa Ngipin

Regular exams help keep teeth and gums strong and healthy. Beginning April 30, 2015, 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
  • Hospital beds

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 upang matulungang protektahan ang iyong pandinig.

Sinasaklaw ng aming plano ang:

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

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 1-877-542-9236 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

When you're pregnant, you receive help and advice from your family and friends. Gayunpaman, magkakaiba ang bawat pagbubuntis. Susuportahan ka ng programang ito sa kabuuan ng iyong pagbubuntis.

Tutulungan ka naming:

  • Find a doctor for both mother and baby.
  • Learn about nutrition, fitness and safety.
  • Get supplies, including breast pumps for nursing moms.

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. 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.
  • 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.

Language and Interpretation

You and your doctor need to understand each other. We can explain information in English 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 kundisyon ang sakit sa kidney. 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.

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 Matters Representative

Every member of the health plan gets a personal Members Matter 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
  • Medications

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 na:

  • Listen to symptoms.
  • Tumulong 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 include weight counseling. The counseling takes place in your primary care setting, so that it can be managed along with your other needs.

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 pinsala o biglaang sakit na hindi nakamamatay pero kailangan ng agarang atensyon. Saklaw 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 once every two years.

Beginning April 30, 2015, eye exams are covered once every two years for members age 21-59. No extra allowance for contact lenses. Contact lenses are covered only if medically necessary.

UnitedHealthcare Connected® for MyCare Ohio

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