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UnitedHealthcare Community Plan - Heritage Health Adult Expansion

Medicaid

The UnitedHealthcare Community Plan Heritage Health Adult Expansion plan is for Nebraska adults, ages 19-64, who are not eligible for or already in Medicare, and meet income requirements. You can enjoy many benefits and services that we have to offer. We will partner with your doctors to give you the quality of care you deserve.

Heritage Health Adult Expansion Benefits includes:

A comprehensive benefits package that includes ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive, wellness and chronic disease management and other services such as long-term care, non-emergent transportation, and durable medical equipment. Also Includes Basic Benefits, plus dental and vision services and select over-the-counter medications. 

Health Risk Screening

A tool that has a few questions about your health that will help UnitedHealthcare Community Plan’s clinical care team will work with you to identify areas where you may want to focus on to maintain or improve your health as well assist you with area of social service needs.

Daytoy a plano ket sidadaan a mausar iti amin a county.

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.
  • NurseLine. 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 Care. 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.. Note: Heritage Health Adult Expansion Prime Coverage includes Over-the-Counter (OTC) medication. * Coverage rules apply. Ammoen ti ad-adu pay. 

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.

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: 

  • NurseLine℠. 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.
  • Panangisardeng ti Panagsigarilyo. 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.

Care Management

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.. 

Chiropractic a taripato

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 PCPim ket iti kangrunaam nga doktor para:

  • Managlapped a taripato.
  • 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

This service is provided by Medicaid and Long-Term Care. MCNA Dental is the Medicaid dental plan for the State of Nebraska. MCNA administers the dental benefits for eligible children and adults. MCNA Member Hotline: 1-844-351-6262, TTY (Hearing Impaired) 1-800-833-7352, or visit www.mcnane.net.

Suporta iti Diabetic

If you have diabetes, we'll help make life a little easier for you. 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. Ti programami ket tumulong kena a mangaramid kadagiti umiso nga addang tapno mapagtalinaedka ken ti babym 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

If you have trouble hearing, you can get help by phone. Call the TTY Service at TTY 711. Ask them to call Member Services at 1-800-641-1902. They will connect you to us. 

If you don't speak English, you can get help by phone. Call Member Services at 1-800-641-1902. They can let you speak to someone in your language.

Members can get information in their preferred language. You will get member materials in English and Spanish. We can give you member materials in a language or format that is easier for you to understand. Agdamag ka laeng.

Dagiti Serbisyo para ti Kameng

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

We help you find:

  • Dodoktor
  • Parmasia.
  • Ospital wenno dadduma a pasilidad iti salun-at.
  • Lokal a paggapuan ti tulong wenno mausar.

Mental Health and Substance Use Services

Inpatient, residential and outpatient services for mental health and substance use disorders are covered by UnitedHealthcare. The type, amount and length of services provided will be based on the level of your needs. Visit www.liveandworkwell.com.

No Copays

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

This includes in network services:

  • Visits to doctors
  • Treatments at hospitals and clinics.
  • Home medical equipment and supplies to help you be at your best.

NurseLine

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: 

  • Listen to symptoms.
  • 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 (OTC) Medicines

UnitedHealthcare Community Plan also covers many Over-the-Counter (OTC) Medications that are on the state’s approved list. 

A provider must write you a prescription for the OTC medication you need. Then all you have to do is take your prescription and member ID card into any network pharmacy to fill the prescription. 

OTCs include: • Pain relievers. • Cough or cold medicine. • First-aid cream. • Contraceptives. • Acne medicine. For a complete list of covered OTCs, go to .myuhc.com/CommunityPlan

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.

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

Your coverage for transportation includes rides with ModivCare (formerly Logisticare) for medical visits and other health related appointments. ModivCare (formerly Logisticare) provides dependable rides and excellent personal service. Your health care appointments are important, and they work to meet your unique transportation needs with 24/7 support.

  • Schedule non-urgent rides at least three business days before your appointment.
  • Urgent care and same-day rides are accepted.

Call to schedule rides at 1-833-583-5683 (TTY 1-866-288-3133). 

You can also learn more, schedule rides at www.modivcare.com

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

Makatulong dagitoy a panagbisita tapno matakuatan a nasapa dagiti problema iti salun-at, tapno maagasan dagitoy.

Dagiti Serbisio a Panglapped

  • 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.

Dagiti Pamuspusan ti Kameng

Kitaen Dagiti Sidadaan a Pagbasaran (aglukat iti modal a window)

Ammuen ti Ad-adu pay

UnitedHealthcare Community Plan - Heritage Health Adult Expansion

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