Planong Pangkomunidad ng UnitedHealthcare

Medicaid

Our TennCare Medicaid plan offers a range of benefits. Children, pregnant women, adults and people who are elderly or have a disability may qualify based on income. View the benefits below to see all that our Tennessee Medicaid plan offers.

This plan is available wherever you live in Tennessee.

More information on eligibility and enrollment can be found on the TennCare website.

Available ang planong ito sa lahat ng county.

We obey federal and state civil rights laws.  We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion, or sex.  Do you think we did not help you or you were treated differently because of your race, color, birth place, language, age, disability, religion, or sex?  You can file a complaint by mail, by email, or by phone. Download and print the information (PDF 30.64 KB) or see below:

Planong Pangkomunidad ng UnitedHealthcare
Paunawa: Mga Apela at Daing
2035 Lakeside Centre Way, Suite 200
Knoxville, TN 37922
Phone: 800-690-1606 TTY: 711

Health Care Finance and Administration
Office of Civil Rights Compliance
310 Great Circle Road, Floor 4W
Nashville, Tennessee 37243
Email: HCFA.Fairtreatment@tn.gov
Telepono: 855-857-1673 (TRS 711)

You can get a complaint form online at:
http://www.tn.gov/hcfa/article/civil-rights-compliance

You can get a complaint form online at:
http://www.hhs.gov/ocr/office/file/index.html

Or you can file a complaint online at:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

U.S. Department of Health & Human Services
Office for Civil Rights

200 Independence Ave SW, Rm 509F, HHH Bldg.
Washington, D.C. 20201
Phone: 800-868-1019 (TDD): 800-537-7697

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. And pregnant moms get support to keep you and your baby healthy. Kabilang sa mga benepisyo ng miyembro ang:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Lab and X-rays. Lab tests and x-rays are covered.

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

  • Choice of Doctor. Find an OB/GYN you trust in our network.
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • Choice of Birth Centers. Pick from hospitals all across Tennessee.

Kung mayroon kang hika, diabetes o isa pang pangmatagalang kundisyon, maaasahan mo kami. Our TennCare Medicaid plan makes sure you get the care and services you need. Kabilang sa mga benepisyo ang:

  • Mental Health. Counseling and other treatments are available.
  • Care Management. Personal support from an experienced professional.
  • Population Health Services. Help to manage your ongoing health or chronic condition.

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

  • Vision. Eye exams and glasses covered to age 21.
  • Dental. Exams and dental work covered to age 21.
  • Hearing. Tests and hearing aids covered to age 21.

Members who qualify can get the medically necessary equipment and help needed to live safety at home. Kabilang sa mga benepisyo ang:

  • Equipment and Supplies. In-home medical safety materials are covered.
  • Nurse Visits. Short-term medical care while recovering at home.
  • Care Coordinator. Someone to get you the services to live safely at home.

Kung minsan, maaaring kailanganin mo ng kaunting karagdagang tulong sa paggamit ng iyong planong pangkalusugan. Para sa mga pagkakataong iyon, maaari kang umasa sa:

  • Transportation. We provide rides to and from needed medical visits.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Language Help. Connect to a translator through Member Services.
  • Member Services. Someone to help you understand and use your benefits.
  • Weight Control. Support and treatment to reach a healthy weight.
  • Health Education. Free classes to help improve your health.
  • Quitting Tobacco. Coaches, supplies and medicines to help you quit using tobacco.

TennCare CHOICES is for people who need extra support and care to live safely in their own home. If you qualify for CHOICES, you have access to these extra benefits:

  • Vision. Glasses or contact lenses after cataract surgery.
  • Equipment and Supplies. In-home medical safety materials are covered.
  • Nurse Visits. Short-term medical care while recovering at home.
  • Personal Care. Someone to help with dressing, bathing and eating.
  • Home Meal Delivery. If you can’t safely prepare meals, we’ll bring them to you.
  • Chore Services. Someone to do your errands, cleaning or laundry.
  • Care Coordinator. Someone to get you the services to live safely at home.
  • Respite Care. In-home help to give your caregiver a break.

Care Management

Do you or your child have a serious health problem? Then our care managers are in your corner. They will:

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

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

  • Think beyond immediate medical needs.
  • Make sure there is support at home.

Care Coordinator

Our members' safety at home is our priority. That is why we conduct home visits for those needing extra help to stay at home.

During this visit, we:

  • Understand your personal needs.
  • See if your home needs minor modifications, such as ramps and bathroom safety devices.
  • Set up emergency monitoring.
  • Arrange for personal care attendants.

Pagpili ng Birth Center

Mahalagang pumili ng ospital kung saan ka manganganak. That’s why you can pick from hospitals all across Tennessee.

Hinihikayat ka naming maglibot sa birthing center ng ospital. Nang sa gayon ay maging pamilyar ka rito. At mas mapapanatag ka kapag nanganak ka na.

Chore Services

If you are having difficulty performing day-to-day household activities, chore services can step in. They can take on the routine tasks that may be hard for you to do on your own.

Services will vary by the member's coverage type and may include:

  • Running errands.
  • Paglilinis ng bahay.
  • Doing laundry.
  • Paghahanda ng mga pagkain.

Pangangalaga sa Ngipin

Cleanings, checkups and dental work are covered up to age 21.

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, we’ll fix it as well. 

Mga Kagamitan at Supply

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

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:

  • Mga kama sa ospital.
  • Oxygen tanks.
  • Mga walker o wheelchair.

Edukasyong pangkalusugan

Free classes to help improve your health or address a condition.

Our plan includes classes on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

Pangangalaga sa Pandinig

Ang problema sa pandinig ay maaaring makaapekto sa iyong pang-araw-araw na pamumuhay sa maraming paraan. Our plan includes services and support to help protect the hearing of members to age 21.

Sinasaklaw namin ang:

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

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.

Home Meal Delivery

Good nutrition is essential to good health. Yet you may not be able to safely fix meals for yourself at home. So we’ll arrange for home meal delivery if you qualify.

Pagkakaospital

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

This 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.

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:

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

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Laboratoryo at mga X-ray

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.

Tutulungan ka naming makuha ang impormasyong kailangan upang makatulong na mapabuti ang iyong kalusugan at maibalik ka sa pinakamalusog na kundisyon.

Tulong sa Wika

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

Mga Serbisyo para sa Miyembro

Understanding your health care options can be confusing. Maaari naming sagutin ang iyong mga tanong nang simple at kumpleto.

We help you find:

  • Mga doktor.
  • Mga parmasya.
  • Mga ospital o iba pang mga pasilidad na pangkalusugan.
  • Mga lokal na mapagkukunan.

Kalusugan ng Pag-iisip

Mental health is as important as physical health. That’s why we have the same coverage for both.

Required care is 100% covered with no copay. This includes:

  • Mental health therapy.
  • Panggagamot sa pang-aabuso sa gamot.
  • Medications.

No Copays

Members have no copayments for:

  • Pampigil na pangangalaga.
  • Mga taunang checkup.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care for you.
  • Answer your questions and concerns.

NurseLine℠

Medical questions and situations can sometimes come at inconvenient times. When you have questions about your health or your child’s health, you can call a trained nurse 24/7.

Our NurseLine nurses will: 

  • Tutukuyin ang mga sintomas.
  • Gagabayan ka 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.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help for:

  • Dressing.
  • Bathing.
  • Eating. 

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.

Pangunahing Provider ng Pangangalaga

Magkakaroon ka ng doktor ng pangunahing pangangalaga (primary care physician, PCP) na iyong pangunahing doktor. Use the Doctor Lookup tool to see if your doctor is in our network.

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. 

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.

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. That's why we provide respite care to give your caregivers a rest. 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 Vaccines

Routine shots help keep you healthy. So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots.

Transportasyon

Our plan provides round trip rides to and from health care locations when necessary.

Pangangalaga sa Paningin

Regular eye exams and glasses, if needed, can help you see more clearly.

Members up to age 21 receive:

  • Regular exams.
  • Frames.
  • Mga inireresetang lens. 

TennCare CHOICES members get glasses or contacts after cataracts surgery.

This benefit is offered by Vision Service Plan.

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

  • Screening for obesity.
  • Support for healthy diet and exercise choices.
  • Health coaching

Mga Pagpapatingin Habang Walang Sakit

Makakatulong sa iyo ang mga pagpapatingin habang walang sakit sa iyong doktor na manatiling malusog. These visits can help 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.

You will not have a copayment for preventive care.

Mga Mapagkukunan ng Miyembro

Healthier Tennessee is one of Tennessee Governor Bill Haslam's top priorities, involving action promoting healthier behaviors in schools, workplaces and in places of worship. More information is available at www.healthiertn.com.

Tingnan ang Mga Available na Mapagkukunan

Matuto Nang Higit Pa

Medicaid Managed Care

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