Mapan iti kangrunaan a linaon
Kangrunaan a Linaon

UnitedHealthcare Community Plan - Heritage Health

Medicaid

UnitedHealthcare Community Plan offers a range of benefits. It’s for pregnant women, children, families and adults who meet income requirements. There are no costs to you for Medicaid benefits and services. View the benefits below to see all that our plan offers.

This is a current summary of health services and drug coverage provided by UnitedHealthcare Community Plan of Nebraska. A detailed description of the benefits can be found in the Member Handbook.

Dagiti Benepisio ken Paset ti Plano

Taripato para ti Nakaradkad ken Agsakit

Get the care you and your children need to stay healthy — or to be at your best. Nga agraman ti:

  • Unlimited PCP Visits. See your primary care provider (PCP) as needed.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Nurse Hotline. Speak with a registered nurse 24/7.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Therapy Services. Physical or other therapy to help you be your best.
  • Foot Care. We provide special care to keep your feet healthy.
  • Hospitalization. You pay nothing for care in a hospital.
  • Chiropractor Services. Limited chiropractic visits are covered
  • Lead Screening. Can be done in the doctor’s office or local health department.
  • Prescriptions. Many preferred Brand and Genetic Prescriptions are covered.

Awan ti napatpateg ngem nu di ti salun-at ken karadkadyo nga agina. That’s why our plan benefits include: 

  • Choice of Birth Centers. Pick from our large network of hospitals or Birthing Center.
  • Choice of Doctors. Find a doctor you trust for your pregnancy care.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Prenatal Visits. Care for you before your baby is born.
  • Text4baby. Text messages with helpful tips and reminders for you and your baby.. 
  • Community Baby Showers. Education on prenatal and postpartum care.
  • Electric Breast Pumps covered.

If you or a family member has special health care needs, you can count on us. Our plan will provide the extra care and services you need. Dagiti benepisyo ket kairamanan ti: 

  • Asthma, Allergy, Heart Failure, CAD, Depression, Diabetes and COPD Care. Exams, testing and supplies are covered.
  • Care Management. Get personal help managing health conditions.
  • Mental Health and Substance Use Services. Get caring help to meet your recovery goals.

Siguradoen nga iti panagkitam ken panagdengngeg mo ket nasayaat da. Dagiti benepisyo ket kairamanan ti:

  • Hearing. Tests, checkups and hearing aids, if needed.
  • Vision. Routine eye exams, plus frames and prescription lenses are covered. 

Vision Provider Lookup

 

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. Dagiti benepisyo ket kairamanan ti:

  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Home Health Care. Medical care in your home, if needed.
  • Skilled Nursing Facility. Brief stay at a skilled nursing facility while you recover from sickness or injury.

Mabalin a kasapulam nu dadduma ti kanayonan a tulong a mangusar ti plano ti salun-at mo. Kadagidiay a tiempo, mabalin a mangnamnama ka kadakami: 

  • Nurse Hotline℠. Speak with a registered nurse 24/7.
  • Member Services. Your benefit questions are answered Monday - Friday, 7:00 a.m. - 7:00 p.m. CT or 6:00 a.m. – 6:00 p.m. MT
  • Language Help. Connect to an interpreter through Member Services at no cost to you.
  • Panangisardeng iti Tabako. Enroll with the Nebraska Tobacco - Free Quit Line and ask your doctor about support to help you quit.

Asthma, Allergy and COPD Care

Do you or a family member have trouble managing asthma or COPD symptoms?
You will get a customized treatment plan and medicine to:

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

Panangimaton iti taripato

When a member has complex health care needs, a care manager can really help. He or she will:

  • Work with you and family members and friends on a plan of care.
  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records. 
  • Make a referral to community social service programs.
  • Offer rewards like a gift card for chronic care checkups or well care visits.

Cell Phone Program

Eligible members can get health support with mobile phone service at NO COST to you from select Lifeline service providers. We want to help you stay connected!  Apply Now! Call Member Services at 1-800-641-1902, TTY 711 for assistance.. 

Children's Health Support

  • Rewards program for well-child visits.
  • Dr. Health E. Hound® provides nutritional education and promotes fitness and healthy habits.

Chiropractic a Panangtaripato

Medicaid limits coverage of chiropractic services to: (i) Certain spinal X-rays; (ii) Manual manipulation of the spine; (iii) Certain evaluation and management services; (iv) Traction; (v) Electrical stimulation; (vi) Ultrasound; and (vii) Certain therapeutic procedures, activities, and techniques designed and implemented to improve, develop, or maintain the function of the area treated.

Panagpili ti Paganakan

Nu sadino ti paganakam ket napateg a pangngeddeng. That’s why you can pick from our large network of hospitals or Birthing Center.

We also encourage you to tour the hospital’s birthing center. This way you will be familiar with it and be better informed when you have your baby.

Ti Panagpili ti Doktor

Tunggal miembro ket mabalin a mangpili iti mangipaay ti kangrunaan a pannakataripato (PCP). Usaren ti Panagbirok iti Doktor a tool tapno makitam no ti doktormo ket adda iti networkmi.

Ti PCP-mo ti kangrunaan a doktormo para iti:

  • Manglapped a panangaywan.
  • Panagagas no sika ket agsakit wenno nadunor.
  • Care coordination with specialists.

For members who don’t have a doctor or whose doctor is not in our network, Member Services can help find a new one close by.

Pannakaaywan ti Ngipen

Napateg para iti salun-atmo ti panangala iti tinawen a panagpatsek-ap iti ngipen. Karaman iti masakupam ti: 

  • Two exams and cleanings per year for children and adults.
  • Bitewing X-ray once every 12 months and one complete set of X-rays every three years. 
  • Minor restorations such as filling. 
  • Major restorations such as crowns and root canals (one of each per 12 months). 
  • Deep cleanings and surgical treatment for gum disease. 
  • Partial or full dentures, and repairs to partials or full dentures. 
  • Sedation and nitrous oxide (known as laughing gas) if medically necessary.

No dadduma marigatan dagiti tattao a mapan iti dentista. Mabalin a sensitibo dagitoy a sagiden. Mabalin a kasapulanda ti kanayonan a tiempo wenno naalumamay a panangaywan. Bay-annakami a tulongandaka a mangbirok iti umno a dentista para kenka wenno iti pamiliam. Tawagan ti Dagiti Serbisio iti Miembro iti 1-800-641-1902, TTY 711.

Suporta iti Diabetic

Nu addaanka iti diabetis, tumulongkami a mangpalaka iti biag para kenka. You'll get medicine, supplies and education to help you reach and stay your best. Our diabetes program also includes self-care training and classes focused on:

  • Managing stress.
  • Living a healthy lifestyle.
  • Wellness Rewards for getting needed exams.

Panangimaton ti Sakit

If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:

  • Congestive heart failure.
  • Angkit.
  • HIV.
  • Chronic obstructive pulmonary disease (COPD).
  • Coronary artery disease.

Makinarya ken dagiti Suplay

Our member’s health and safety at home are important.

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

  • Tangke ti oxygen.
  • Katre ti ospital.
  • Wheelchair wenno walker. 

Taripato ti Saka

Ipaaymi dagiti suot nga kasapulam tapno pagtalinaeden nga nasalun-at dagiti sakam. And if you have 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. 

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)

Taripato ti Panagdengngeg

Trouble hearing can affect your everyday life in many ways.  Our plan includes services and support to help protect your hearing. 

Sakupen mi:

  • Exams, aids and tests.
  • Hearing aid ken dagiti baterya.

Home Care

After surgery or a serious illness, you may need  in-home medical visit(s) to check on how well you are healing.

No maaprubaran, sakupen ti planomi ti:

  • In-home medical visit(s).
  • Medikal a ramit kas koma dagiti katre ti ospital, walker wenno wheelchair.
  • Dagiti disposable a medikal a suplay.

Pannakaospital

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

Mairaman iti masakupan ti seguro para iti pannaka-ospital ti:

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

And after leaving hospital, we can provide transitional care services. Siguradoen mi nga adda ti follow-up a taripato tapno agtultuloy ka nga agimbag iti pagtaengam.

Dagiti Serbisyo ti Hospisio

Hospice services are covered when they are ordered by a physician.

Lab ken X-rays

Knowing what’s wrong and finding it early can make all the difference.  Our plan covers:

  • 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

Mangipaaykami kadagiti materiales ti miembro kenka iti lengguahe wenno pormat a mangpalaka iti panangawatmo. Ti network ti tagaipaaymi iti serbisio ket kairamanan ti adu a doktor nga agsasao iti nadumaduma a pagsasao. Ipakita ti mangipapaay a directory-mi no ania dagiti pagsasao nga us-usaren dagiti doktor. Additionally, many of our Member Service Advocates speak multiple languages. No tumawagka, mabalinmi ti agkonekta iti serbisiomi nga agipatarus a mangidiaya iti suporta iti nasursurok ngem 240 a pagsasao. Makatulongkami kadagiti serbisio ti tagaipatarus, kairamanan ti American Sign Language.

Nu adda problemam iti panagdengngeg iti telepono mabalinmo nga usaren ti text a telepono. Palubosan daytoy libre a serbisio dagiti tattao nga addaan kadagiti disabilidad iti panagdengngeg wenno panagsao a tumawag ken umawat kadagiti tawag iti telepono Tumawag iti 711. Itedmo kadakuada ti numero a 1-800-641-1902, ket ikonektadaka kadakami.

Maalam met ti impormasion iti dadakkael a letra, braille wenno kadagiti audio file.

All of the language interpretation and material translations/alternate formats are available at no cost to you. 

Member Services Advocates

Mabalin a narigat ti bukbukod a panangimaton iti taripato ti salun-atmo, nangruna nu aggigiddan a sangsangoem ti adu a parikut iti salun-at. Nu masapulmo ti kanayonan a suporta tapno maalam ken agtalinaedka a nasalun-at, makatulongkami. All our UnitedHealthcare members have access to Member Service Advocates.

Your Advocate can help you:

  • Understand the Heritage Health program.
  • Get information in a different format, like audio (CD or flash drive), large print, or Braille.
  • Find a doctor, dentist or eye doctor.
  • Explain your benefits and coverage.
  • Talk to you about special programs that are available to you.
  • Connect you with a Clinical Coordinator if needed.
  • Find resources located near you to help you with other problems like food, housing, transportation, employment, feeling safe or getting an education.
  • Make sure you are aware of other State programs and services available to you, such as SNAP (Supplemental Nutrition Assistance Program) or WIC (Women, Infants and Children) program benefits.
  • Help you update your personal contact information like address, phone number, or email.
  • Make sure we know how you would like to be contacted (email, phone, or mail).
  • Resolve issues with providers, including specialty care and behavioral health.
  • Assist with challenges due to prior approval, payment for services, care delivery, and family welfare.

Remember, answers to any questions you have are just a click away at myuhc.com/CommunityPlan. Or you can call Member Services at 1-800-641-1902, TTY 711, 7:00 AM–7:00 PM CT (6:00 AM–6:00 PM MT), Monday–Friday

 

Mental Health and Substance Use Services

Ti salun-at ti kababalin ket maipapan iti panagriknam ken panagtignaymo. Maaw-awagan met daytoy a salun-at ti panunot. Your behavioral/mental health is important. All Heritage Health members can get behavioral/mental health and substance use services. You may see any in-network behavior/mental health doctor without a referral for outpatient treatment.

You can get behavioral/mental health services without a referral from your Primary Care Provider. Sometimes it makes sense to talk to your Primary Care Provider about any behavioral/mental health problems you believe you may have. That way, your Primary Care Provider can help to refer you to an appropriate provider in our network. If you want to find a provider on your own, you can search for one at any time and make an appointment. You can also call Member Services at 1-800-641-1902, TTY 711, for help or visit liveandworkwell link.

Sakupen mi:

Behavioral/Mental Health Services 

  • Terapiya iti indibidual, grupo, ken pamilia 
  • Dagiti serbisio iti pasiente iti ruar ti ospital iti salun-at ti kababalin 
  • Dagiti serbisio iti pasiente iti uneg ti ospital iti salun-at ti kababalin 
  • Specialized behavioral health services for children with autism.
  • Behavioral health rehabilitation services

Dagiti Serbisio iti Diperensia iti Panagusar iti Substansia 

  • Panagagas iti pasiente iti ruar ti ospital iti opioid (agas ti ut-ot) 
  • Panagagas iti pagtaengan

Additional health resources can be found at myuhc.com/CommunityPlan. Sapulen ti balanse, suporta, ken panangaywan a kasapulam tapno agbiagka iti kasasalun-atan a biag a posible.

Dagiti Serbisio iti Krisis iti Salun-at ti Kababalin

Kasano nu addaanak iti krisis iti salun-at ti kababalin?

You are always covered for a behavioral health, mental health, and substance use emergency. An emergency means a condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated.

Dagiti emerhensia a serbisio ket masakup uray sadinoman iti Estados Unidos. Nu ipagarupmo nga addaanka iti makapatay nga emerhensia, tawagam ti 911 wenno mapanka iti kaasitgan a lokasion ti ospital a matulongannaka dagiti tagaipaay iti serbisio iti emerhensia.

As soon as it is possible, please call us to arrange for follow-up care after an emergency.

Dagiti Serbisio iti Krisis:

Nu ipaagrupmo nga addaanka iti emerhensia, uray sadino ti ayanmo, tawagam ti 911 wenno mapanka iti kaasitgan a lokasion ti ospital a matulongannaka dagiti tagaipaay iti serbisio iti emerhensia. Apagisu, maidawat a tawagam ti doktormo wenno ti tagaipaay iti serbisio iti salun-at ti kababalin nga iyurnosda ti pasurnad a taripato kalpasan ti emerhensia.

Nu masapulmo a makitungtong iti maysa a tao, addakami ditoy para kenka. Nu saanmo marikna a tiempon tapno tumawag 911 ngem kasapulam a dagus ti tulong, mabalinmo a tawagan ti Hotline ti Krisis iti Salun-at ti Kababalin 24/7 iti 1-800-641-1902.

Online: http://www.suicidepreventionlifeline.org

No Copays

You will not have a copayment for care and services covered by our plan.

Hotline dagiti Nars

Dagiti medikal a saludsod ken sitwasion ket mabalin a sumangbay kadagiti tiempo a saanmo a namnamaen. No adda saludsodmo maipapanggep iti salun-atmo, mabalinmo ti tumawag iti nars 24 nga oras kada aldaw, 7 nga aldaw kada lawas.

Dagiti narsmi ket: 

  • Dumngeg 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.

Over-The-Counter Drugs/Supplies

Select over-the-counter drugs and supplies are covered 100% with your doctor’s prescription.  

Your health care costs may include non-prescription medicines and supplies like aspirin, cough medicine or diabetic testing supplies. Covered 100% with your doctor’s prescription.

 

Parmasia wenno botika

Our plan includes prescription drugs and refills, and we make getting your medicine easy. Medicare and other insurance copays may apply. You can fill your prescriptions at:

  • Local pharmacies.
  • Services that deliver right to your door.

When you have a prescription filled, be sure to check that:

  • It’s included on the Preferred Drug List (PDL). 
  • It’s written by a network provider. 
  • It’s filled at a network pharmacy. 
  • You show your member ID card when you have it filled. 

Prescription Drug Copays

You can receive many available PREFERRED brand name and generic drugs with no copay. Brand NON-PREFERRED prescriptions drugs have a $3 copay.

If the Center of Medicare and Medicaid Services (CMS) shows you’re copay exempt, you will not have to pay the $3 copay. You may be copay exempt if you are:

  • 18 years old or younger.
  • Pregnant or gave birth within the last 60 days.
  • Staying in an inpatient hospital, long-term care facility, residential facility, adult family home or center for the developmentally disabled.
  • Staying in a medical facility and spending most of your income on medical costs.
  • A Native American getting services from an Indian Health Center.
  • Receiving waiver services under a 1915(c) waiver.
  • Receiving assistance from the State Disability Program.

90 Day Supply

You will be able to get a 90-day supply of select prescription medications from a retail pharmacy. Iti 90 nga aldaw a suplay, saanmo a masapul ti agsakada iti tunggal bulan. You’ll have three months between refills.

  • Talk with your pharmacist - Your pharmacist can call your doctor to get a new prescription for a 90-day supply. 
  • Talk with your doctor - Your doctor can write you a new 90-day supply prescription for the medicine above. We’ve let your doctor know about this change to your pharmacy benefit.  

If you have any questions, please call Member Services at 1-800-641-1902, TTY 711, 7:00 AM–7:00 PM CT (6:00 AM–6:00 PM MT), Monday–Friday

Panagbisita Sakbay ti Panaganak.

Your pregnancy is a journey you’ll want to make with the help of friends, family and a pregnancy doctor.

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. That’s why we encourage members to talk to their doctor about getting smoking cessation support. Counseling is covered when you enroll with the Nebraska Tobacco-Free Quit Line.  Medication for smoking cessation are available through Nebraska Medicaid. Call 1-800-784-8669

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.  If needed, our plan covers short stays in a skilled facility where you can heal. 

Mairaman dagiti sumaganad:

  • Serbisio a pannaripato iti pagtaengan.
  • 24-nga-oras a pannaripato ti nars.
  • Tulong kadagiti aktibidad ti inaldaw a panagbiag.
  • Speech, physical ken occupational therapy.

Indieksion ken Bakuna

Routine shots help protect members and their family from illness. Ti plano mi ket sakupen na:

  • Pneumonia, influenza and shingles shots.
  • Vaccines and Immunizations.  Routine shots to help keep your child healthy.
  • Other recommended shots and vaccines.

Dagiti Serbisio a Terapiya

Makatulong ti physical, occupational ken speech therapy tapno umimbagka manipud iti nakaro a pannakadangran wenno panagsakit, wenno tapno magun-odmo ti pagpatinggaan ti kabaelam. 

Ipaay ti planomi ti:

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

Pagluganan

Nu kasapulam ti pagluganan, karaman kadagiti benepisiom ti transportasion. We cover trips for Nebraska Medicaid coverable services within a 20-mile radius of your home. Kairamanan daytoy ti: medical, mental health, dental and vision appointments along with trips to the pharmacy.

Ti panangsurot kadagitoy a simple a pagalagadan ket makatulong kenka a mangala iti pagluganan: 

  • Tawagan ti 3+ nga aldaw ti negosio a nasapsapa 
  • Call Transportation Services at 1-833-583-5683 (TTY 1-866-288-3133) 7:00 a.m.–7:00 p.m. CT (6:00 a.m.–6:00 p.m. MT), Monday–Friday or visit www.modivcare.com.
  • Have your Medicaid ID card available. 
  • Know the name and address of your health care provider and the date and time of your appointment. 
  • Isalumina iti lugar a kasapulam iti pagluganan 
  • If you’re not sure how long your appointment will take, the return ride will be scheduled for “Call for Pickup.” That means you need to give Transportation Services a call when you’re ready to go home at 1-833-583-5683 (TTY 1-866-288-3133).   
  • Nu ikkannaka ti doktormo iti reseta mabalinmo ti agsardeng iti parmasia tapno maalam daytoy 
  • Let us know if you have special needs like a wheelchair, cane, or walker. 
  • Members under the age of 13 must have a parent or guardian with them. 
  • Transportation may be limited to a provider near you.
  • If you cancel your visit, call 1-833-583-5683 to cancel your ride.

You may also qualify for a bus pass. Give Modivcare a call to schedule a ride or ask questions about getting transportation services.

Daytoy a serbisio ket para kadagiti pagluganan a naplano a saksakbay. Nu addaanka iti makaipeggad iti biag nga emerhensia, tawagam ti 911. Maipaayto ti ambulansia nu masapulmo ti maitulod iti ospital.

Transplant Services

Covered when ordered by a network physician.

Unlimited Primary Care Provider Visits

There may be times when a member’s health requires repeated doctor visits. Our plan does not limit the number the number of visits to a primary care provider (PCP).  This way the members get the care they need. And the doctor can see how their health is progressing.

Taripato ti Panagkita

You'll get the care, eyeglasses and treatment that let you see life more clearly. Iraman ti masakupan iti:

·  Annual eye exams.
·  Prescription lenses.

This benefit is offered by March Vision.

Wandering and Elopement

We will provide members and families with door and window alarms (up to six per household) to help reduce wandering without caregiver awareness.

Dagiti Panagbisita ti Nakaradkad

Ti panagbisita iti doktor para ti karadkad ket makatulong kenyam tapno agtalinaed ka a nasalun-at. 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.
  • Kadawyan a bakuna ken pannakaeksamen.
  • Dagiti Mammogram.

Awan ti copayment para iti pannaripato tapno maliklikan ti sakit.

Dagiti Pammataudan ti Miembro

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