Hla mus rau cov ntsiab lus xub thawj
Cov Ntsiab Lus Xub Thawj

UnitedHealthcare Community Plan

Medicaid

UnitedHealthcare Community Plan of Ohio

Our Ohio Medicaid plan covers eligible families, pregnant women of any age, infants, children and young adults. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. Members can choose a primary care doctor from our network. Plus get access to a 24/7 nurse advice hotline, health education materials and extras that other plans don't offer. View the benefits below to see all that it offers.

More information on eligibility and enrollment can be found on the Ohio Medicaid website, or by calling the Medicaid Hotline at 1-800-324-8680, TTY users should call Ohio Relay at 7-1-1.

OhioRISE

Ohio Resilience through Integrated Systems and Excellence (OhioRISE) program is a managed care program for youth with behavioral health needs. OhioRISE increases access to in-home and community-based services to ensure OhioRISE members and families have help with systems such as juvenile justice, child protection, developmental disabilities, mental health and addiction, education, and others.

An individual who is enrolled in the OhioRISE program will also keep their managed care enrollment for the physical health benefit. To be eligible for OhioRise, you must be: enrolled in Ohio Medicaid, under the age of 21 and meet a functional needs threshold for behavioral health care, as identified by the Child and Adolescent Needs and Strengths (CANS) assessment. 

Beginning November 1, Ohio Medicaid managed care members will be able to select their plan by calling the Ohio Medicaid Consumer Hotline at 1-866-693-0898 or utilizing the Ohio Medicaid Consumer Hotline Member Portal at https://members.ohiomh.com/Login.aspx. You do not have to do anything if you want to keep your current Medicaid Managed Care Plan.

Visit the Ohio Medicaid Consumer Hotline website at www.ohiomh.com for information.

After you receive your renewal form from the Ohio Department of Medicaid (ODM) you will need to take a few steps to keep UnitedHealthcare as your health insurance company.

Click here to learn how to renew your Medicaid coverage.

Cov Kev Pab thiab Cov Yam Ntxwv

For OhioRISE, please refer to the OhioRISE handbook

Kev Saib Xyuas Kho Mob Tus Zoo thiab Tus Muaj Mob

Get the care you need to get better if you are injured or sick — or to reach your full potential. Cov kev pab muaj xws li:

  • Tus Xov Tooj Hu Rau Tus Kws Tu Mob. Tham nrog tus kws tu mob uas tau rau npe lawm 24/7.
  • No Copays. You pay nothing for your care or services.
  • Medicines. Fill your prescriptions, including over the counter drugs at local pharmacies.
  • Therapy Services. Physical or other therapy to recover and heal.
  • Chiropractor Services. We provide up to 15 chiropractic visit per year.
  • Well Visits. Annual checkups can help keep you healthy.
  • Urgent Care. Convenient care for a sudden illness or injury.

Nothing is more important than the health and well-being of a mother and her child. Vim li ntawd peb daim phiaj cov kev pab thiaj muaj xws li:

  • Choice of Doctors and Birthing Center. Find a doctor and hospital 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. Get helpful tips and links to free health and wellness items for you and your baby.
  • Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

If you have asthma, diabetes or another chronic condition, you can depend on us. Our plan makes sure you get the care, support and services you need. Cov kev pab muaj xws li:

  • Mental Health and Substance Abuse Services. With prior approval counseling and other treatments are covered.
  • Care Management. Personal support from an experienced professional.
  • Asthma Care. Exams, testing and supplies are covered for asthma and other lung diseases.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Obesity Care. We cover screenings and counseling for obesity.

We help members keep their vision, smile and hearing at their best. Cov kev pab muaj xws li:

  • Vision. Covers exams, glasses or $150 toward contact lenses.
  • Dental. We pay for cleanings, checkups and some dental work.
  • Hearing. Tests, checkups and with prior approval hearing aids are provided.

Earning a reward for taking care of yourself or your child is easy. The following programs offer incentives:

  • Healthy First Steps®  -  Earn $20 for signing up. Our program will help keep you and your baby healthy. 
  • Healthy Rewards -  Earn gifts for you or your child with preventive care.  

You get the medical care and equipment needed to live safely at home. Cov kev pab muaj xws li:

  • Equipment and Supplies. With prior approval, in-home medical and safety equipment are covered.
  • Nurse Visits. Medical care to help with a safe recovery at home.
  • Respite Care. In-home help to give caregivers taking care of children under age 21 a rest.
  • Care Coordinator. Someone to get you the services you need after surgery or illness.
  • Home Health Care. With prior approval, medical and personal care in your home, if needed.

Sometimes members need a little extra help using their health plan. For those times, they can rely on:

  • Transportation. We pay for up to 30 one way or 15 round trip rides to medical visits or the pharmacy.
  • Language Help. Connect to a translator through Member Services.
  • Member Services. Someone to help you get the most from your plan.
  • Quitting Tobacco. Coaches and supplies to help quit using tobacco.
  • My Advocate. We help members connect to community services.
  • Healthy Rewards. Earn up to $100 in credits for completing healthy activities.
  • Mileage Reimbursement. Mileage reimbursement is now available for those members or their representative that would prefer to use their own vehicle for trips to medical appointments. Members must call for trips in 5 days in advance.

Asthma and COPD Care

Individual care to help control asthma or COPD symptoms.

Some members may have trouble managing asthma or COPD symptoms. For them, a nurse who specializes in breathing issues can really help. They get a customized treatment plan and medicine to:

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

Kev Tswj Xyuas Mob Nkeeg

Members who need extra help get a Personal Care Manager. The care manager is there for you throughout your medical journey. He or she will:

  • Work with you to develop a plan of care that meets your individual needs.
  • Coordinate with family members, caregivers and health care providers.
  • Help get additional services or support you may need.

Cov kev pab cuam zuaj tu ib ce

Our plan includes visits for chiropractic care.

  • Members of all ages can get up to 15 visits per year.
  • Members under 21 may get additional visits with prior authorization.

Kev Xaiv Tus Kws Kho Mob

From regular checkups to preventive health screenings, we want to make sure you get access to the right care at the right time.

You get a primary care physician (PCP), who is your main doctor. If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Koj tus PCP yog koj tus kws kho mob tseem ceeb rau:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

Choice of Birth Center

Where a mother has her baby is an important choice. That's why pregnant moms can pick from hundreds of hospitals across Ohio.

We encourage mothers-to-be to tour the hospital's birthing center. This way they will be familiar with it. And be more relaxed when they have their baby.

Kho Hniav

Checkups and cleanings are covered.

Exams and cleanings every six months help keep teeth and gums strong and healthy. If you obtain prior approval for a dental problem that needs to be fixed, that's covered as well.

Employment Physicals

Some employers or training programs require a physical before a person can start work. Our plan covers pre-employment physical exams.

Cov Cuab Yeej thiab Tej Khoom Siv

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

Our plan covers medical equipment ordered by a member's doctor or care manager. Qhov no muaj xam nrog rau cov khoom siv xws li:

  • Hospital beds.
  • Oxygen tanks.
  • Wheelchairs or walkers.

For some of these services prior approval is required. Please check your member handbook for these details.

Kev Kho Mob Ko Taw

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

Our podiatry coverage includes:

  • Routine foot exams.
  • Tips about foot care and choosing the right shoes.
  • Information about nerve damage warning signs.

Hearing Care

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

Peb them rau:

  • Exams, therapy and tests.
  • With prior approval, hearing aids and batteries.

Healthchek

Healthchek covers medical exams, immunizations (shots), health education, and laboratory tests for Medicaid eligible individuals under the age of 21. Healthchek also covers medical, vision, dental, hearing, nutritional, developmental, and behavioral health exams, in addition to other care to treat physical, behavioral or other problems or conditions found by an exam. Learn more information about Healthchek. 

Noj qab nyob zoo yog ua ntej tshaj plaws®

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

Peb yuav pab koj:

  • Choose a pregnancy provider and a pediatrician (child’s doctor).
  • Schedule visits and exams and arrange rides to your visits.
  • Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
  • Get supplies, including breast pumps for nursing moms.
  • Txuas nrog cov peev txheej hauv zej zog xws li Cov Kev Pab cuam Poj Niam, me nyuam mos thiab me Nyuam (WIC).

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

Earn great gifts for you or your child by doing things like:

  • Completing well-child exams.
  • Getting lab tests.
  • Recording the family's health activities.

Kev saib xyuas kho mob rau fab kev noj qab haus huv nyob rau tom vaj tom tsev

If you are living with a long-term health condition, disability or leaving the hospital after surgery or a serious illness, you may need extra support. This can include 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:

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

Kev kho mob hauv tsev kho mob

This plan pays for all medically necessary expenses related to a hospital stay. This way you can rest and heal.

Peb daim phiaj them rau:

  • Nursing care.
  • Room and board.
  • Supplies and equipment.
  • Treatment and therapies.
  • Diagnostic tests and exams.

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

Kev Kho Tus Mob Raum

Mob raum yog ib qho teeb meem mob loj heev. After the kidneys stop working regular treatments, called renal dialysis, or an organ transplant are needed to live. Kev lim ntshav yog siv ib lub tshuab los tu cov ntshav kom huv li thaum lub raum tsis tau muaj mob ua.

Peb daim phiaj muaj xws li:

  • Kev lim ntshav.
  • Cov tshuaj.
  • Kev kawm txog kev noj qab haus huv thiab kev pab txhawb.
  • Hloov qhov khoom nrog cev tshiab yog hais tias yuav tau ua.

Lab and X-rays

Kev paub tias dab tsi tsis yog lawm thiab nrhiav pom qhov ntawd thaum ntxov yuas ua rau muaj kev pab tau. With prior approval, our plan covers:

  • Kuaj kab mob thiab kev kuaj.
  • Xoos fais fab X-rays, yees duab thiab lwm yam kev yees duab.

Peb yuav pab koj kom tau txais tej ntaub ntawv qhia paub uas yuav tsum tau kho koj txoj kev noj qab haus huv zoo dua qub los yog nyob rau ntawm qhov koj ua tau zoo tshaj plaws.

Kev Pab Txhais Lus

You can receive information in your preferred language. Tsuav yog koj thov txog xwb. We also have people at our service centers who speak more than one language. Chances are, we have someone who speaks your language.

Cov Tshuaj

Our plan includes prescription drugs and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.

You pay a co-pay amount, if needed, and you can get your prescription drugs at any in-network pharmacy.

Member Services Representative

Meet your personal health plan assistant. Our job is to help you get the most of your benefits. Peb yuav pab tau koj:

  • Schedule doctor, dental and vision appointments.
  • Arrange for extra support services.
  • Complete a health risk assessment.
  • Stay in touch with you.

Mental Health and Substance Abuse Services

Get help with personal problems that may affect your mental or physical health. These may include stress, depression, anxiety or drugs and alcohol abuse. Our services also include:

  • Therapy
  • Counseling
  • Tshuaj

For some of these services prior approval is required. Thov tiv tauj mus rau Lub Chaw Pab Tswv Cuab txhawm rau kawm paub ntau ntxiv.

No Copays

With our plan there are no copayments for covered services.

Members get:

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Home medical equipment and supplies to help them be their best.

NurseLine (Tus Xov Tooj Pab Kho Mob)

Medical questions and situations come at inconvenient times. For questions about health, call a nurse 24/7. Call:  1-866-801-4407, TTY 711.

Our NurseLine nurses will:

  • Listen to the symptoms.
  • Provide guidance on self-care.
  • Advise the member about getting care at a doctor visit or an urgent care center.
  • Help know when to go to the emergency room.

Obesity Care

Obesity is common and serious. It can also lead to other health problems. To help our members be their best, our plan includes:

  • Screening for obesity.
  • Counseling for obesity.

Prenatal Visits

A pregnancy is an incredible journey. It's a journey the new mother wants to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

  • Make sure both mother and baby are healthy.
  • Explain what to expect at each stage of the pregnancy.
  • Answer any questions.

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.

With prior approval, our plan covers short stays in a rehabilitation center where you can heal. Included are:

  • Nursing home services.
  • 24-hour nursing care.
  • Help with activities of daily living.
  • Physical, occupational and speech therapy.

Call Member Services for information on available providers.

Respite Care

Caring for a child recovering from an illness, surgery or with special health needs is an act of love. It can also be physically and emotionally exhausting. This service is for SSI members under 21 years of age.

Txiav Kev Haus Luam Yeeb

Most people know the bad health effects of smoking. And they know they need to quit. We support our members with coaching while they quit. We support our members while they quit, with coaches and supplies. The only thing they won't get from us is a lecture.

Cov Kev Pab Cuam Kho Mob

Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.

With prior approvals, our plan covers visits for:

  • Occupational therapy.
  • Physical therapy.
  • Speech therapy.
  • In-home therapy.

Tsheb Thauj Mus Los

Our plan provides up to 30 one way or 15 round trip rides to medical appointments and other needed services. Call 1-800-895-2017 (TTY 711) to schedule a ride. You must call at least 48 hours ahead of time..  

Rides are available to:

  • Dental and vision appointments.
  • Pharmacies.
  • Women, infants and children (WIC) visits.
  • Job and Family Services offices for benefits redetermination.

UnitedHealthcare OMW™

UnitedHealthcare On My Way™ is an engaging, interactive program that informs Ohio youth and helps prepare them for many real-world situations that lie ahead. UnitedHealthcare OMW™ teaches the practical skills of managing bank accounts, securing housing, creating a resume, finding job training and applying for college. It is a reliable, go-to resource they can use throughout their journey toward independent living.

Kev Kho Mob Sai

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

  • Urgent care centers.
  • Federally qualified health centers.
  • Other walk-in clinics.

Kev Saib Xyuas Kho Mob Ntsig Txog Qhov Muag

You'll get the care, eyeglasses and treatment that let you see life more clearly.

Cov kev pab muaj xws li:

  • Annual eye exams.
  • Glasses and $150 toward contact lenses.

You also can chose from an expanded selection of frames.

This benefit is offered by March Vision.

Cov Kev Mus Ntsib Kws Kho Mob Kom Noj Qab Nyob Zoo

Well visits with your doctor can help keep you and your family healthy. Cov kev mus ntsib kws kho mob no yuav txhom tau tej teeb meem mob thaum tseem ntxov, kom thiaj kho tau.

Cov kev tiv thaiv kom txhob muaj mob muaj xws li:

  • Cov kev kuaj ib ce rau cov muaj hnub nyoog thiab cov me nyuam.
  • Kev tu xyuas rau cov me nyuam mos liab kom noj qab nyob zoo.
  • Kev tu xyuas rau cov poj niam cev xeeb tub.
  • Cov kev txhaj tshuaj thiab kev kuaj mob li ib txwm ua.
  • Cov kev kuaj mis.

Nws tsis muaj feem yus nrog them (co-payments) rau kev tiv thaiv kom txhob muaj mob.

Wellhop for Mom & Baby

Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.

Here’s how it works:

  • Join video conversations every other week with women who have similar due dates and a group leader.
  • Chat and share experiences with moms from your group on the Wellhop app or website.
  • Visit the Wellhop library. You’ll find articles, videos and more.

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