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Annou mete navigatè ou an ajou pou ou kapab pwofite yon eksperyans sit lan ki gen plis rapidite ak sekirite.
UnitedHealthcare Medi-Cal is no longer active as of January 1, 2023
- Plan UnitedHealthcare Medi-Cal pa aktif ankò depi 1 Janvye 2023. Si kesyon ou an konsène sèvis ou resevwa anvan 1 Janvye 2023, tanpri vizite seksyon nou an sou Kesyon Yo Poze Souvan yo. To lean more about your health plan choices call Health Care Options at 1-800-430-4263 for TTY 1-800-430-7077 Monday – Friday 8 am to 6 pm, local time or go to www.healthcareoptions.dhcs.ca.gov. You may contact the Ombudsman at 1-888-452-8609 Monday – Friday 8am to 5pm, local time, or by email MMCDOmbudsmanOffice@dhcs.ca.gov.
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.
- UnitedHealthcare Community Plan of California Medi-Cal
Renewing Your Medi-Cal Coverage
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.
Important: Are you enrolled in Medi-Cal?
Has your contact information changed in the past two years? Give your county office your updated contact information so you can stay enrolled. Find your local county office.
Jwenn founisè yo ak pwoteksyon asirans pou plan sa a.
Chèche doktè, lopital, ak espesyalis.
Find medications for Medi-Cal Rx
Chèche yon famasi ki toupre w.
Avantaj & Karakteristik
Care Manager
Do you have a serious health problem? If so, our case managers are in your corner. Yo pral:
- Esplike tèm medikal yo nan yon langaj ki senp.
- Coordinate your doctor appointments.
- Provide your care team with your medical records.
The care manager will stay with you throughout your medical journey. Li pral:
- Think beyond your medical needs.
- Make sure you have support at home.
Chwazi Doktè
Each member can choose a primary care physician (PCP). Use the “Doctor Lookup” tool to see if your doctor is in our network.
PCP w la se doktè prensipal ou pou:
- Swen prevantif.
- Tretman si w malad oswa blese.
- Rekòmandasyon kay espesyalis pou sèten pwoblèm medikal.
For members who don’t have a doctor or whose doctor is not in our network, we can help find a new one close by.
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:
- Take a 1-minute quiz at solera4me.com/UHC.
- Or call 1-888-305-6015, TTY 711, Monday - Friday, 6 a.m. - 6 p.m. PT.
Jesyon maladi
If you have chronic or high-risk illnesses, our disease management services are designed to support you.
We have special programs for:
- Bwonkonemopati obstriktif ki kwonik (COPD)
- Coronary artery disease (CAD)
- Congestive heart failure (CHF)
- Dyabèt
- High Risk Pregnancy and Neonatal Intensive Care Unit
- Maladi anemi falsifòm
Ekipman ak Founiti
Some members may need extra support to live safely at home.
Our plan covers medical equipment ordered by a member's doctor or care manager. Sa ka gen ladan founiti tankou:
- Tank oksijèn.
- Wòkè oswa chèz woulant.
Swen pou Pye
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.
Our podiatry coverage includes:
- Routine foot exams.
- Tips about foot care and choosing the right shoes.
- Information about nerve damage warning signs.
Healthy First Steps®
Bati yon lavni ki ansante pou ou ak tibebe ou an epi resevwa gwo rekonpans ak Healthy First Steps. Pwogram nou an pral ede ou pran bon mezi yo pou kenbe ou ak tibebe ou an ansante. Met sou sa ou ka resevwa $20 jis paske ou enskri.
N ap ede ou:
- Chwazi founisè swen pou gwosès ak yon pedyat (doktè timoun).
- Planifye vizit ak egzamen yo ak òganize transpò pou vizit ou yo.
- Resevwa rekonpans dèske ou ale nan vizit yo pandan tout gwosès ou ak 15 premye mwa lavi tibebe a.
- Jwenn materyèl, tankou ponp tete pou manman nouris yo.
- Konekte avèk resous kominotè yo tankou sèvis pou Fanm, Tibebe ak Timoun (Women, Infants and Children, WIC).
Swen sante adomisil
After surgery or a serious illness, you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. With approval from your doctor, our plan covers:
- In-home medical visits.
- Medical equipment like hospital beds, walkers or wheelchairs.
- Disposable medical supplies.
- Help with personal care.
Ospitalizasyon
This plan pays for all expenses related to a hospital stay - the member will never be changed. Plan nou an kouvri:
- Chanm ak manje.
- Materyèl ak ekipman.
- Tretman ak terapi.
- Tès dyagnostik ak egzamen.
And after leaving the hospital, you are not alone. We make sure the follow-up care is available to continue healing at home.
Entèprèt
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
Lè w konnen kisa pwoblèm lan ye e lè w detekte l bonè, sa ka fè tout yon diferans. Plan nou an kouvri:
- Laboratwa ak tès.
- Radyografi, eskanografi, ak lòt tès imajri.
N ap ede w jwenn enfòmasyon ki nesesè pou amelyore sante w oswa pou w nan pi bon fòm ou.
Èd nan domèn lang
You may be able to receive information in your preferred language or format, including Braille. Mande tousenpleman. We also have people at our member service centers who speak more than one language. Gen anpil chans ke nou gen youn moun ki pale menm lang avèk ou. All languages required by the State of California are covered, plus more.
Medikaman
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.
Defansè Manm yo
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.
They can:
- Answer your questions about your benefits.
- Help with doctor issues or complaints.
- Help you clarify your health care benefits.
Sèvis pou Manm
Gen dèfwa ou ka bezwen èd pou konprann opsyon swen sante w yo. Lè w avèk nou, ou gen yon moun ou ka rele. N ap reponn kesyon w yo konplètman e avèk yon langaj ki senp.
Nou ka ede w tou pou jwenn:
- 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.
Kopeman
You pay nothing for covered services.
While your health care is low-cost or free, the care quality is high. You get:
- 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
Sante mantal toutosi enpòtan ke sante fizik. Se poutèt sa nou gen pwoteksyon asirans pou toude.
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
- Sèvis entèvansyon pou kriz
- 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.
- Outpatient specialty mental health 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.
Swen pèsonèl
Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide help with:
- Dressing.
- Bathing.
- Feeding.
Prenatal Visits
Your pregnancy is a journey you'll want 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.
Nan vizit sa yo, klinik la ap:
- Make sure both you and your baby are healthy.
- Eksplike kisa pou w atann nan chak etap gwosès ou.
- Reponn kesyon w yo.
Sispann itilize tabak
Most people know the bad health effects of smoking. And they know they need to quit. We support our members to help them quit. The only thing they won’t get from us is a lecture.
Text4baby
Text4baby ka ede nouvo manman ak fiti manman yo kenbe tèt pa yo ak tibebe yo ansante.
You’ll get text messages each week throughout your pregnancy and your baby’s first year. Chak tèks gen ladan konsèy sou sante ak sekirite pou sijè tankou:
So you and your baby can make a great start on life.
Sèvis Terapi
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:
- Terapi okipasyonèl.
- Terapi fizik.
- Terapi lapawòl.
- In-home therapy.
Sèvis Transpò
- Members can schedule a ride at 844-772-6623
- Orè: Monday - Friday, 7 a.m. – 7 p.m.
- TTY 711 or 844-488-9724
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:
- Vizit ka doktè oswa nan terapi
- Pickup prescription drugs that cannot be mailed directly to the member
- Pickup medical supplies, prosthetics, orthotics and other equipment
- Specialty mental health services
- Sèvis pou twoub itilizasyon sibstans
- Dental and any other benefits covered through Medi-Cal
Sèvis Vizyon
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.
Vizit pou moun ansante
Well visits with your doctor can help keep you and your family healthy. Vizit konsiltasyon sa yo ka ede detekte pwoblèm sante bonè, pou yo sa trete yo. Sèvis prevantif gen ladan yo:
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Konnen Plis
UnitedHealthcare Community Plan of California Medi-Cal