Mapan iti kangrunaan a linaon
Kangrunaan a Linaon

UnitedHealthcare Community Plan of California Medi-Cal

Medicaid

UnitedHealthcare Community Plan of California includes a range of benefits. Children, pregnant women, families, adults and seniors and people with disabilities may qualify based on income. View the benefits below to see what our plan covers.

If you have Medi-Cal benefits, your coverage will need to be renewed every year. The county will send you a Medi-Cal renewal form. Complete this form and return it to your local county human services agency. You can also visit or call your local human services agency. To find an office near you, visit the San Diego Health & Human Service Agency website.

If you lose Medi-Cal coverage, you may enroll in health insurance coverage through Covered California in the special-enrollment period due to a loss of coverage.

Nagbaliw kadi ti impormasion ti pagkontakan kenka iti napalabas a dua a tawen? Give your county office your updated contact information so you can stay enrolled. Find your local county office.

Dagiti Benepisio ken Paset ti Plano

Taripato para ti Nakaradkad ken Agsakit

Get the assistance you need to be at your best — or to get better if you are injured or sick. Nga agraman ti:

  • Dagiti Panagbisita ti Kinakaradkad. Annual checkups to help keep you healthy. 
  • Kayat a Doktor. Agsapul iti doktor a matalekmo iti network mi. 
  • Indieksion ken Bakuna. Routine shots to help protect against illness. 
  • Maganat a Pannakataripato. Convenient care for a sudden illness or injury. 
  • Nurse Hotline. Speak with a registered nurse 24/7. Call 1-866-270-5785.
  • Lab ken X-rays. Dagiti eksamen ti lab, x-rays ken diagnostic imaging ket masakupan. 

Nothing is more important than the health and well-being of a mother and your baby. Dayta ti rason a karaman kadagiti benepisio ti planomi ti:

  • Choice of Doctor. Find a doctor or OB/GYN you trust in our network. 
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Text4Baby. Receive text messages with helpful tips and reminders.

Dagiti medikal a saludsod ken kasasaad ket mapaspasamak nu dadduma kadagiti saan a nanam-ay a tiempo. No adda saludsodmo maipanggep iti salun-atmo, mabalinmo ti tumawag iti nars 24 nga oras kada aldaw, 7 nga aldaw kada lawas: 1-855-366-5032.

Our Nurse Hotline will:

  • Agdengngeg kadagiti sintomas.
  • Tumulong iti panangtaripato iti bukod a bagi.
  • Balakadan naka maipapan ti panangalam ti taripato iti panagbisitam iti doktor mo wenno iti urgent care center.
  • Tulongan naka a mang-ammo nu kaano ka a mapan ti emergency room.

If you have a life threatening emergency, go immediately to the emergency room or call 911.

No adda angkit mo, diabetes wenno dadduma a kondisyon a naunday, mabalin ka nga mangnamnama kadakami. Our plan makes sure you get the care and services you need. Dagiti benepisyo ket kairamanan ti:

  • Care Manager. If you qualify, get personal help managing health conditions. 
  • Panangimaton iti sakit. Focused care for those with chronic health needs, like asthma and diabetes. 
  • Salun-at ti Panagpampanunot. Iti pamagbaga ken dagiti sabali a panagagas ket masakupan. 
  • Residential Care. Brief stay at a care facility while you recover from sickness or injury.

UnitedHealthcare Community Plan of California, Inc. covers Enhanced Care Management (ECM) services for members with highly complex needs. ECM is a benefit that provides extra services to help you get the care you need to stay healthy. It coordinates the care you get from different doctors. ECM helps coordinate primary care, acute care, behavioral health, developmental, oral health, community-based long-term services and supports (LTSS), and referrals to available community resources.

If you qualify, you may be contacted about ECM services. You can also call UnitedHealthcare Community Plan of California, Inc. to find out if and when you can receive ECM. Or talk to your health care provider who can find out if you qualify for ECM and when and how you can receive it.

Covered ECM services

If you qualify for ECM, you will have your own care team, including a care coordinator. This person will talk to you and your doctors, specialists, pharmacists, case managers, social services providers and others to make sure everyone works together to get you the care you need. A care coordinator can also help you find and apply for other services in your community. ECM includes:

  • Outreach and engagement
  • Comprehensive assessment and care management
  • Enhanced coordination of care
  • Health promotion
  • Comprehensive transitional care
  • Member and family support services
  • Coordination and referral to community and social supports

To find out if ECM may be right for you, talk to your UnitedHealthcare Community Plan of California, Inc. representative or health care provider. 

Call Member Services at 1-866-270-5785 (TTY 711).

UnitedHealthcare Community Plan of California, Inc. is here 7:00 AM to 7:00 PM PST, Monday through Friday, except State holidays. The call is toll free. Or call the California Relay Line at 711. Visit online at myuhc.com/CommunityPlan.

 

 

The plan covers: 

  • Routine eye exam once every 24 months; UnitedHealthcare Community Plan of California, Inc. 
    may pre-approve (prior authorization) additional services as medically necessary. 
  • Eyeglasses (frames and lens) once every 24 months; contact lens when required for medical 
    conditions such as aphakia, aniridia and keratoconus. 

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Some benefits include:

  • Makinarya ken dagiti Suplay. In-home medical and safety equipment. 
  • Pannakataripato ti salun-at iti pagtaengan. Medical and personal care in your home, if medically needed.

Sometimes members need a little extra help using their health plan. Kadagidiay a tiempo, mabalin a mangnamnama ka kadakami:

  • Transportation. Get rides to and from doctor appointments and more. 
  • Tulong iti Lengguahe. Translated materials and interpreters who are ready to help you 24/7. 
  • Dagiti Serbisyo para ti Kameng. Available 7 a.m. to 7 p.m. PT, Monday – Friday. 
  • Member Advocate. Local advocates to get you information, services and care. 
  • Nurse Hotline℠. Makitungtong iti rehistrado a nars 24/7. Tawagan ti 1-866-270-5785.


UnitedHealthcare Community Plan of California, Inc. has health education programs, services and materials to help you improve your health and manage illness at no cost to you. 

  • Health Education Resource Library: Many of the materials are offered in different languages and/or in formats for the hard of hearing and visually impaired.
  • Health Education Classes: UnitedHealthcare is partnering with Champions for Health to sponsor virtual health education classes about multiple topics such as Chair Yoga, Childhood Health, Cooking Demo, Women’s Health, and Diabetes. The classes will be offered to our members and the community at no cost in English and Spanish.

To enroll in a class, download the Health Education Class Schedule in English or Spanish or visit championsforhealth.org/virtual-health-education-classes to register.
For questions about our health education programs, please call 866-782-2037 or email uhchealthed@uhc.com.

Tagimaton ti Taripato

Do you have a serious health problem? If so, our case managers are in your corner. They will:

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

The care manager will stay with you throughout your medical journey. He or she will:

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

 

Ti Panagpili ti Doktor

Each member can choose a primary care physician (PCP). Use the “Doctor Lookup” tool to see if your doctor is in our network. 

Ti PCP-mo ti kangrunaan a doktormo para iti:

  • Manglapped a panangaywan.
  • Panagagas no sika ket agsakit wenno nadunor.
  • Dagiti reperal kadagiti espesialista iti partikular a kondision.

Para kadagiti miembro nga awanan iti doktor wenno ti doktorda ket saan a paset ti networkmi, matulongandaka nga agbirok iti baro nga asideg kenka.  

Community supports

California Advancing and Innovating Medi-Cal (CalAIM) establishes the framework to address social determinants of health and improve health equity statewide.

A key feature of CalAIM is the introduction of a menu of in lieu of Community Supports.

What Are Community Supports?
Community Supports are services or settings that the Plan may offer in place of services or settings covered under the California Medicaid State Plan and that are medically appropriate, cost-effective alternatives to a State Plan covered service.
Community Supports are optional for the Plan to offer and for Members to utilize. The Plan will not require Members to use Community Supports instead of a service or setting.

Community Supports that may be offered are:

  • Housing Transition and Navigation Services
  • Housing Deposits
  • Housing Tenancy and Sustaining Services
  • Short-Term Post-Hospitalization Housing
  • Recuperative Care (Medical Respite)
  • Respite Services
  • Medically Supportive Food/ Meals/Medically Tailored Meals
  • Sobering Centers

For more information, call Member Services at 1-877-650-1477 (TTY 711)

Diabetes Prevention Program

Diabetes Prevention Program is a covered benefit offered to our eligible members designed to assist in preventing or delaying the onset of Type 2 Diabetes by making lifestyle changes.

UnitedHealthcare Community Plan is pleased to offer a healthy lifestyle program at no cost to qualified members. The program can help you make small changes to live a healthy life, lose weight and lower your chance of developing type 2 diabetes.

To see if you qualify:

Panangimaton ti Sakit

Nu addaan ka ti nakaro wenno nangato a peggad ti saksakit, dagiti serbisyo ti panangimaton ti saksakit ket naaramid a mangsuporta kenka.

Adda dagiti naisangsangayan a programa para ti:

  • Agsubli-subli a sakit a panagpullat ti bara (COPD)
  • Coronary artery disease (CAD)
  • Congestive heart failure (CHF)
  • Diabetes
  • High Risk Pregnancy and Neonatal Intensive Care Unit
  • Sickle Cell nga Sakit

 

 

Makinarya ken dagiti Suplay

Mabalin a masapul ti sumagmamano a miembro ti ekstra a suporta tapno makapagnaedda a natalged iti pagtaengan.

Our plan covers medical equipment ordered by a member's doctor or care manager. Mabalin a mairaman ditoy dagiti suplay kas koma iti:

  • Tangke ti oxygen.
  • Dagiti sarrukod wenno wheelchairs.

Taripato ti Saka

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

Iti masakupan ti podiary a serbisyo iramanna iti:

  • Routine foot exams.
  • Singasing panggep iti panagtaripato ti saka ken panagpili iti umno a sapatos.
  • Impormasyon panggep kadagiti patigmaan nga senyales ti panagdadael iti urat.

 

Umuna nga Addang wenno Healthy First Steps®

Mangibangon iti nasalun-at a masakbayan para kenka ken para iti maladagam ken makaala kadagiti nagmamayat a gunggona iti ’s Healthy First Steps. Tulongannakayo ti programami a mangaramid kadagiti umno nga addang tapno agtalinaedkayo ken ti maladagayo a nasalun-at. Ken mabalinka a makaurnong iti $20 uray no agpalistaka laeng. 

Tulungandaka:

  • Mangpili ti maysa a tagapaay para iti masikog ken maysa pediatrician (doktor ti ubing)
  • Iyiskedyul dagiti panagbisita ken panagpaeksamen ken ikoordinar dagiti pagluganam nga agbisita.
  • Agurnong kadagiti gunguna bayat ti panagsikogmo ken kadagiti umuna 15 a bulbulan ti maladagam babaen ti papan panagbisita
  • Mangala kadagiti kasapulan, kairamanan dagiti breast pump para kadagiti agpaspasuso nga inna.
  • Makikonektar kadagiti pagtaudan ti komunidad kas kadagiti Serbisio ti Babbai, Maladaga ken Ub-ubbing (Women, Infants and Children/WIC)

Panangtaripato ti Salun-at iti Pagtaengan

After surgery or a serious illness, you may need extra help with day-to-day tasks. Mabalin pay a masapulmo ti medikal a panagbisita iti uneg ti pagtaengan tapno ammuen no umim-imbagka met laeng. With approval from your doctor, our plan covers:

  • In-home medical visits.
  • Medikal a ramit kas koma dagiti katre ti ospital, walker wenno wheelchair.
  • Dagiti disposable a medikal a suplay.
  • Help with personal care.

Pannakaospital

This plan pays for all expenses related to a hospital stay - the member will never be changed. Ti plano mi ket sakupen na:

  • Kuarto ken makan.
  • Dagiti suplay ken makinarya.
  • Panagagas ken dagiti therapy.  
  • Dagiti eksamen a diagnostic.

And after leaving the hospital, you are not alone. We make sure the follow-up care is available to continue healing at home.

Dagiti mangipatarus ti pagsasao

UnitedHealthcare offers services to help you talk with your doctor or other health care workers. You can get this service if you do not speak English or have hearing and speech barriers. You do not need a referral from your doctor to get these services.

Interpreter services are offered free of charge.

Labs and X-Rays

Iti pannakaammo nu ania iti kamali ken panagduktal daytoy iti nasapa ket maaramidna amin iti pagbaliwan. Ti plano mi ket sakupen na:

  • Dagiti Lab ken eksamen.
  • Dagiti X-rays, scans ken dadduma nga imaging.

Tulungandaka nga mangala iti impormasyon a kasapulam tapno maparang-ay ti salun-at wenno tapno addaka ti nasayaat a kasasaad.

Tulong ti Lenggwahe

You may be able to receive information in your preferred language or format, including Braille. Agdamag ka laeng. We also have people at our member service centers who speak more than one language. Nalabit adda maalami a makasao iti lengguahem. All languages required by the State of California are covered, plus more.

Dagiti Agas

Prescriptions and certain over-the-counter items are covered by our plan.

You may receive a prescription from a UnitedHealthcare doctor or specialist. You can fill your prescription at any UnitedHealthcare contracted pharmacy. Just show your State Benefit Identification Card (BIC) and your UnitedHealthcare Identification card to the pharmacy when you get your prescriptions filled. 

Dagiti Mangitandudo iti Miembro

We’re looking out for you. Our local member advocates can help solve problems, provide training and education, and work on issues that concern you.

Mabalinda ti:

  • Answer your questions about your benefits.
  • Tumulong kadagiti isyu wenno reklamo iti doktor.
  • Help you clarify your health care benefits.

Dagiti Serbisyo para ti Kameng

No dadduma mabalin a masapulmo ti bassit a tulong tapno maawatam dagiti pagpilian para iti pannakataripato ti salun-atmo. Babaen kadakami, adda namnamaem a matawagam. We’ll answer your questions simply and completely.

Mabalindaka pay a tulongan a mangsapulka iti/kadagiti:

  • Find a doctor.
  • Change your primary care physician.
  • Questions on benefits.

Just call 1-866-270-5785, TTY: 711 Monday - Friday, 7:00 AM – 7:00 PM PT.

 

No Copays

Awan pulos ti bayadam kadagiti serbisyo a masakupan.

While your health care is low-cost or free, the care quality is high. Makaalaka: 

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Prescription drugs and over-the-counter medicines.

On My Way

UnitedHealthcare OMW™ (On My Way) is a mobile-friendly website aimed at helping young adults through the process of transitioning into adulthood. This interactive website also makes it fun to learn as you go. Register at www.uhcomw.com and begin the journey.

Outpatient Mental Health

Ti salun-at ti panunot ket kas kapateg ti salun-at a pisikal. Isu a sakupenmi dagitoy a dua.

Mental Health Screening:

  • A mental health screening will be completed to determine if you are in mild or moderate distress or have acute impairment of mental, emotional or behavioral functioning.
  • This screening can be completed by a PCP, UnitedHealthcare Community Plan of California, Inc. or county mental health plan.

Outpatient Mental Health Services- Covered by UnitedHealthcare Community Plan of California:

  • If your mental health screening results determine you are in mild to moderate distress, UnitedHealthcare Community Plan of California covers the following outpatient mental health services:
    • Outpatient mental health services
    • Individual and group mental health evaluation and treatment (psychotherapy)
    • Psychological testing when clinically indicated to evaluate a mental health condition
      Psychiatric consultation for medical management
    • Screening and Brief Intervention (SBI)
    • Outpatient laboratory, supplies and supplements
    • Drugs (excluding anti-psychotic drugs which are covered by Medi-Cal fee-for-service)
    • Family Counseling
    • Neuro behavioral testing
    • Neuro psychological testing
  • Outpatient mental health services do not require a referral from your PCP.
  • For help finding more information on mental health services provided by UnitedHealthcare Community Plan of California, Inc., call 1-866-270-5785, TTY 711.

Specialty Mental Health Services- Covered by County Mental Health Plan

  • If your mental health screening results determine you have acute impairment of mental, emotional or behavioral functioning, you may be eligible for specialty mental health services.
  • Your PCP or UnitedHealthcare Community Plan of California, Inc. can refer you to the county mental health plan to receive an assessment.
  • County mental health plans cover specialty mental health services for Medi-Cal beneficiaries who meet criteria.
  • Specialty mental health services may include the following inpatient and outpatient services:
    • Outpatient specialty mental health services:
      • Mental health services (assessments, plan development, therapy, rehabilitation, and collateral)
      • Medication support services
      • Day treatment intensive services
      • Day rehabilitation services
      • Serbisyo para iti interbensyon ti krisis
      • Crisis stabilization services
      • Targeted case management services
      • Therapeutic behavioral services
      • Intensive care coordination (ICC)
      • Intensive home-based services (IHBS)
      • Therapeutic foster care (TFC)
    • Residential services:
      • Adult residental treatment services
      • Crisis residental treatment services
    • Inpatient services:
      • Acute psychiatric inpatient hospital services.
      • Psychiatric inpatient hospital professional services.
      • Psychiatric health facility services.
  • For help finding more information on specialty mental health services provided by the county mental health plan, call the county at 1-888-724-7240.

Personal a Pannakataripato

No maminsan narigat nga aramiden dagiti kangrunaan para iti bukodmo a bagi kalpasan ti panagsakit wenno pannakadangran. If needed, we provide help with:

  • Panagsukat ti bago.
  • Panagdigos.
  • Pannangan.

Panagbisita Sakbay ti Panaganak.

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. 

Amin dagiti nairekomendar a klinikal a panagbisita ti masikog ken eksamen ket sakupen ti planomi.

Kadagitoy a panagbisita, ti klinika ket:

  • Make sure both you and your baby are healthy.
  • Ipalawag nu ania ti namnamaem kada lebel ti panagsikog mo.
  • Sungbatan dagiti saludsod mo.

Panangisardeng ti Panagsigarilyo

Ammo ti kaaduan a tattao dagiti saan a nasayaat nga epekto ti panagsigarilyo iti salun-at. Ken ammoda a kayatda ti agsardeng. We support our members to help them quit. Ti laeng saanda a maala manipud kadakami ket maysa a lektyur.

Text4baby

Makatulong ti Text4baby kadagiti kalkalpas ken dandanin agpasngay tapno mapagtalinaedda ti salun-atda ken ti salun-at ti maladagada.

You’ll get text messages each week throughout your pregnancy and your baby’s first year. Tunggal text ket aglaon kadagiti makatulong nga impormasion ti salun-at ken kinatalged para kadagiti topiko a kas koma ti:

  • Pannakataripato sakbay ti panaganak.
  • Panagpasikal ken panaganak.
  • Panagpasuso.
  • Natalged a pannaturog.
  • Nutrision.
  • Kinatalged iti tugaw ti lugan.

  • Tapno mairugiyo ken ti maladagam ti napintas a panagbiag.

    Dagiti Serbisio a Terapiya

    Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.
    Our plan covers limited visits for:

    • Okupasyonal a therapy.
    • Pisikal a therapy.
    • Therapy ti panagbalikas.
    • Therapy ti pagnaedan.

    Pagluganan

    Rides can be scheduled at least 30 days in advance, and no later than 3 business days before your appointment. Scheduling your ride at least 3 business days in advance will help you to have the best experience. Urgent care and other urgent types of trips, like dialysis or chemotherapy, can be scheduled on the same day.

    Members can get round trip transportation to and from health care locations as needed, including rides to:  

    • Dagiti panagbisita iti doktor wenno terapia
    • Pickup prescription drugs that cannot be mailed directly to the member
    • Pickup medical supplies, prosthetics, orthotics and other equipment
    • Specialty mental health services
    • Dagiti serbisio iti diperensia iti panagusar iti substansia
    • Dental and any other benefits covered through Medi-Cal  

    serbisyoiti mata

    The plan covers: 

    • Routine eye exam once every 24 months; UnitedHealthcare Community Plan of California, Inc. 
      may pre-approve (prior authorization) additional services as medically necessary. 
    • Eyeglasses (frames and lens) once every 24 months; contact lens when required for medical 
      conditions such as aphakia, aniridia and keratoconus. 

    Dagiti Panagbisita ti Nakaradkad

    Well visits with your doctor can help keep you and your family healthy. Makatulong dagitoy a panagbisita tapno matakuatan a nasapa dagiti problema iti salun-at, tapno maagasan dagitoy. Dagiti serbisyo ti panagsakbay ket kairamanan ti:

  • Panagpa-checkup para kadagiti nataengan ken ubbing.
  • Pannakataripato ti nasalun-at a maladaga.
  • Pannaripato para kadagiti babbai a masikog.
  • Kadawyan a bakuna ken pannakaeksamen.
  • Dagiti Mammogram.
  • To File a Complaint or Grievance, Download the GRIEVANCE FORM - English | Español| Arabic | Chinese | FarsiTagalog | Vietnamese

    NONDISCRIMINATION NOTICE - English | Español| Arabic | Chinese | FarsiTagalog | Vietnamese

    Dagiti Pammataudan ti Miembro

    Kitaen Dagiti Available a Pagbasaran (aglukat iti modal a window)
    Powered by Translations.com GlobalLink OneLink SoftwarePowered By OneLink