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- Call the New York State of Health Exchange at 1-855-355-5777
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New York Pharmacy Program Changes Effective 04/01
UnitedHealthcare Wellness4Me
Medicaid
The Wellness4me Plan is offered through UnitedHealthcare Community Plan, a Health and Recovery Plan, or HARP, approved by New York State. HARPs are a new kind of plan that provide Medicaid members with their health care, plus care for behavioral health, including Serious Mental Illness and Substance Use Disorders.
This plan is for New York residents age 21 and who qualify for Medicaid coverage.
UnitedHealthcare Community Plan is a special health care plan with providers who have a lot of experience treating people who may need mental health and/or substance use care to stay healthy. We also provide care management services to help you and your health care team to work together to keep you as healthy as possible.
Daytoy a plano ket sidadaan para kadagiti sumaganad a county:
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Schenectady, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, Westchester, Wyoming, and Yates.
- UnitedHealthcare Wellness4Me
Agbirok kadagiti mangipapaay ken masakupan ti seguro para iti daytoy a plano.
Agbirok kadagiti doktor, ospital ken espesialista.
Agsapul kadagiti medikasyon a masakupan daytoy a plano.
Agsapul iti parmasia nga asideg kenka.
Agsapul iti dentista nga asideg kenka.
Dagiti Benepisio ken Paset ti Plano
Adult Day Care
Companionship is important. If your Primary Care Provider (PCP) recommends it, you may be able to participate in adult day health care. Adult day health care provides care and companionship for seniors who need extra help during the day.
Caregivers also benefit, knowing their loved one is safe when they can’t provide care.
Adult day care can provide:
- Social connections and friendship.
- Bathing and personal care.
- Meals.
Asthma and COPD Care
Do you need help trouble managing asthma, allergies or COPD symptoms? You’ll get a customized treatment plan and medicine to help:
- Manage flare-ups.
- Reduce symptoms.
- Live an active life.
Salun-at ti Kababalin
Ti salun-at ti kababalin ket napateg kas iti pisikal a salun-at. Our behavioral health care includes mental health and substance use treatment services.
Ti kasapulan a taripato ket 100% a masakupan nga awan ti copay. Mairaman ditoy ti:
- Intensive psychiatric rehab treatment (IPRT).
- Inpatient mental health treatment.
- Continuing day treatment.
- Personalized Recovery Oriented Services (PROS).
- Assertive Community Treatment Services (ACT).
- Individual and group counseling.
- Crisis intervention services.
You can also get help with alcohol or other substance use issues.
Panangimaton iti taripato
A serious health problem requires extra care and support. We use Health Homes to coordinate services for our members.
Health Home Care 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.
- Your care manager will stay close by throughout the medical journey. He or she will:
- Think beyond immediate medical needs.
- Help manage ongoing medical issues like diabetes, asthma and high blood pressure
- Make sure you have support at home.
Panagpili ti Paganakan
Nu sadino ti paganakam ket napateg a pangngeddeng. That's why you can pick from 142 hospitals across New York.
We also encourage you to tour the hospital's birthing center. Ta iti kastoy ket masanay ka iti dayta. And you'll be more relaxed when you have your baby.
Ti Panagpili ti Doktor
When you join UnitedHealthcare Community Plan, one of our providers will take care of you. Most of the time that person will be your Primary Care Provider (PCP). You may want to choose a PCP from your mental health or substance use clinic. If you need to have a test, see another specialist, or go into the hospital, your Primary Care Provider will arrange it.
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.
Pannakaaywan ti Ngipen
Dental checkups and cleanings can help keep teeth and gums healthy. Covered services include:
- Regular checkups.
- Cleanings.
- X-rays.
- Treatments, including fillings and other services.
You do not need a referral from your PCP to see a dentist.
Diabetic Supplies
If you have diabetes, you may need insulin, needles, wipes and glucose strips. Masakupan mi dagita ken dadduma pay.
Ti plano mi ket sakupen na pay dagiti serbisyo a mangtulong kenka a mangimaton ti diabetes mo, kairamanan ti:
- Diabetes counseling and self-management training.
Natibker ken manayon a ramit-medikal
Sakupen ti planomi dagiti medikal nga instrumento nga ibilin ti doktormo wenno ti mangimatmaton iti kasom. Mabalin a mairaman ditoy dagiti suplay kas koma iti:
- Dagiti hearing aid.
- Prosthetics.
- Orthotics.
Taripato ti Panagdengngeg
Ti parikut ti panagdengngeg ket apektaran na ti inaldaw a biag mo iti nadum-duma a wagas. Ti plano mi ket kairamanan dagiti serbisyo ken suporta a makatulong a mangprotekta ti panagdengngeg.
Ti plano mi ket sakupen na:
- Exams and tests.
- Hearing aid ken dagiti baterya.
Panangtaripato ti Salun-at iti Pagtaengan
Sometimes our members are living with a long-term health condition or disability. Others are coming out of the hospital after surgery or a serious illness. These members can receive extra support from our plan.
No maaprubaran, sakupen ti planomi ti:
- Medikal a panagbisita iti uneg ti pagtaengan.
- Medikal a ramit kas koma dagiti katre ti ospital, walker wenno wheelchair.
- In-home medical visit
- Help with day-to-day tasks like cleaning, cooking or dressing.
- Dagiti disposable a medikal a suplay.
Pannakaospital
Bayadan daytoy a plano ti amin a gastos mainaig iti pannakayospital, tapno makainana ken umimbag ka.
Mairaman iti masakupan ti seguro para iti pannaka-ospital ti:
- Inpatient care.
- Outpatient care.
- Lab, X-ray, other tests.
Your Health Home Care Manager can:
- Help you safely return home after a hospital stay.
Dagiti Agas
Our plan covers prescription drugs and refills with a small copayment. Your copay is:
| Prescription Item | Wellness4me Plan | |
|---|---|---|
| Co-Payment Amount | Co-Payment Details | |
| Brand name prescription drugs | $3.00/$1.00 | 1 co-pay charge for each new prescription and each refill |
| Generic prescription drugs | $1.00 | Refer to the Preferred Drug List |
| Over-the-counter drugs, such as for smoking cessation and diabetes | $0.50 | Refer to the Preferred Drug List |
Over-the-counter medicines with a written order from your doctor are available for a copayment of $0.50 for each medicine.And we make getting your medicine easy. You can fill your prescriptions at:
- Local pharmacies.
- Services that deliver right to your door.
Dagiti Serbisyo para ti Kameng
You can call Member Services to get help any time you have a question.
You may call us to choose or change your Primary Care Provider (PCP for short), to ask about benefits and services, to get help with referrals, to replace a lost ID card, to report that you are pregnant, the birth of a new baby or ask about any change that might affect your benefits.
Residential Care
After a serious illness, surgery or injury, you may need extra nursing and therapy.
No kasapulan, sakupen ti planomi dagiti apagbiit a panagtalinaed iti sentro ti rehabilitasion no sadino a makapaimbagka. 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.
If you are in need of long-term placement in a nursing home, your local department of social services must determine if you meet certain Medicaid income requirements.
Taripato iti Temporaryo nga Institusyon (Respite Care).
Adda kadi kameng ti pamilyam wenno gagayyem a mangaywan kenka nu addaka iti pagtaengan?
Nu adda, kayat mi a suportaran ti trabaho da met a tumulong kenka. Isu a mangipapaay kami ti respite care tapno makainana met dagiti manartaripato kenka. Ti respite care ket mangidiaya kadagiti mangay-aywan ti waya a makabakasyon wenno makainana manipud kadagiti ay-ayaten da ti biag nga agsaksakit wenno addaan naisangsangayan a kasapulan a taripato.
- Short-Term Respite — gives you a safe place to go when you need to leave a stressful situation.
- Intensive Respite — helps you stay out of the hospital when you are having a crisis by providing a safe place to stay that can offer you treatment.
Indieksion ken Bakuna
Tumulong dagiti kadawyan nga indieksion tapno maprotektaranka manipud iti sakit.
Isu a sakupen ti planomi:
- Pneumonia, influenza and shingles shots.
- Other recommended shots and vaccines.
Taripato ti Panagkita
You'll get the care, eyeglasses and treatment that help you see better.
Iraman ti masakupan iti:
- Eye exams every two years, or as medically needed.
- Prescription lenses, including contact lenses.
- Glasses and frames.
- Specialist care when needed.
Dagiti Panagbisita ti Nakaradkad
Ti panagbisita ti kinakaradkad iti doktor ket makatulong kenka nga agtalinaed 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.
- Pannakataripato ti nasalun-at a maladaga.
- Pannaripato para kadagiti babbai a masikog.
- Kadawyan a bakuna ken pannakaeksamen.
- Dagiti Mammogram.
Awan ti copayment para iti pannaripato tapno maliklikan ti sakit.
UnitedHealth Group is 100% owner of UnitedHealthcare of New York, Inc