Ale nan kontni prensipal la
Kontni Prensipal

UnitedHealthcare Community Plan QUEST Integration Program

Medicaid

UnitedHealthcare Community Plan QUEST Integration is a managed care plan offered through Hawai‘i’s Department of Human Service Med-QUEST. UnitedHealthcare Community Plan is a health plan for members who are eligible for State-assisted Medicaid benefits. That includes pregnant women, children, adults, seniors, those who have special needs, and families. With UnitedHealthcare Community Plan QUEST Integration, you are on a better path to your health care.

Our primary goal is to help you stay healthy and independent. The UnitedHealthcare Community Plan QUEST Integration plan offers medical and behavioral health services including, vision, drug, and supplies. Call UnitedHealthcare Community Plan QUEST Integration today to find out more about how you can get skilled guidance and service coordination. 

Our local staff will work with you to coordinate your services and specific needs. We will help guide you through the complex health care system and work with your doctors and family members to help you meet your health-related goals.  UnitedHealthcare Community Plan is here for you, every step of the way.

UnitedHealthcare Community Plan has been doing care management for a long time.  

Trust your family’s health with UnitedHealthcare Community Plan.

UnitedHealthcare Community Plan provides free aids and services to people with disabilities to communicate effectively with us, such as: written information in other formats (large print, audio, accessible electronic formats, other formats). If you need these services, contact us toll-free at 1-888-980-8728 (TTY: 711).  We will provide you with the requested information, at no cost to you within five (5) business days.

  • UnitedHealthcare Community Plan QUEST Integration Program Etap pou Enskri
  • Verifye Kalifikasyon (louvri yon fenèt modal)

Dental Value-Added Services Benefit Change

Avantaj & Karakteristik

With UnitedHealthcare Community Plan QUEST Integration you can get:

Access to care

  • A Primary Care Provider (PCP) that you can choose from in our large list of providers. Here is the link to help you find one in your area
  • Referral specialty care from a Specialist Provider
  • Scheduled rides to health-related appointments
  • 24-hour/7 day Nurse HotlineSM and on-line Nurse Chat to talk to a nurse any time you have a question
  • Language interpreter services (including Sign language)

Benefits to help you stay healthy

No cost for any services provided under your benefit plan

  • Pwoteksyon Medikaman Preskripsyon
  • Vision and eyewear coverage
  • Help with behavioral health issues such as mental, alcohol, or substance abuse
  • Preventive health care
  • Vaccines (such as for flu and other illnesses)
  • Child immunizations
  • Health education classes
  • Quarterly newsletters

Rural Exceptions

In areas in which there is only one QUEST Integration health plan, members have the freedom to:

  • Choose from at least two (2) PCPs
  • Obtain services from any other provider under any of the following circumstances:
    • The service or type of provider (in terms of training, experience, and specialty) is not available within the health plan’s provider network;
    • The provider is not part of the health plan’s provider network but is the main source of a service to the member. We will work with the provider to participate in our provider network. If the provider chooses not to join our provider network, or does not meet the necessary qualifications to be part of the provider network, we will transition the member to an in-network provider within sixty (60) days. If the provider is not appropriately licensed or is sanctioned, we will transition the member to another provider immediately;
    • The only provider in-network and available to the member does not, because of moral or religious objections, provide the services the member seeks, or all related services are not available;
    • The member’s PCP determines that the member needs related services that would be subject the member to unnecessary risk if received separately and not all of the related services are available within the health plan’s provider network; and
    • The State determines that other circumstances warrant out-of-network treatment.

Chwazi Doktè

Each member can choose a primary care provider (PCP). Itilize zouti pou chèche Doktè a, pou wè si doktè ou nan rezo nou a.

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.

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:

  • Home care providers.
  • Specialists.
  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

There is no cost for covered prescriptions. We make getting your child's medicine easy. We'll provide a list of covered medicines if you have questions about what prescriptions are covered.

You can fill the prescriptions at local pharmacies in the UnitedHealthcare Community Plan network.

Plan sa a peye pou tout depans ki gen rapò avèk yon sejou lopital, konsa ou ka repoze epi geri.

Hospitalization coverage includes:

  • Swen enfimyè.
  • Chanm ak manje.
  • Materyèl ak ekipman.
  • Tretman ak terapi.
  • Tès dyagnostik ak egzamen.

Apre ou fin kite lopital la, ou pa poukont ou. Nou asire ou jwenn swen swivi pou w kontinye geri lakay ou.

Healthy First Steps is a free online wellness program for pregnant women and moms who have given birth within the last 15 months. This program offers rewards for obtaining your prenatal, postpartum and child’s well-baby care (up to 15 months of age). This program can help keep track of your appointments. You can also earn as many as 8 rewards of your choosing.  Rewards include a diaper bag or Old Navy gift card, a nursing cover or teething rattle, a first aid kit or tabletop toy, a childproofing kit or puzzles and books among other rewards to support your well-being and your child/children’s development. Sign up for Healthy First Steps at UHCHealthyFirstSteps.com and start earning rewards.

Tanpri konnen: rewards options may be subject to change and we will notify you in the future through various methods (i.e., Member Handbook, website, HealthTalk (Member Newsletter) or written communication by mail or post card).

Incentive Completed Action Option 1 Option 2 Value
1 Baby Blocks enrollment Diaper Bag Old navy gift card $10
2 24-week prenatal visit Nursing cover Teething rattle with mirror $10
3 32-week prenatal visit First-aid kit Tabletop toy $10
4 Birth Digital thermometer Rubber duck bath thermometer $10
5 Postpartum visit Car seat cover Old navy gift card $10
6 6-month-well-child visit Dental care kit Baby feeding kit $10
7 Lead screening Childproofing kit Children's book $10
8 15-month well-child visit Puzzle Bath accessories for mother $10

Sipò pou Dyabetik

Si w gen dyabèt, n ap rann lavi a yon jan pi fasil pou ou. W ap jwenn medikaman, founiti ak edikasyon pou ede w rive ak rete nan pi bon eta w. 

Durable Medical Equipment

Some members may need extra support to live safely at home.

Plan nou an garanti ekipman medikal doktè w oswa manadjè dosye w mande. Sa ka gen ladan founiti tankou:

  • Tank oksijèn.
  • Kabann lopital.
  • Chèz woulant oswa wòkè.

Rekonpans Manm yo

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

You may be able to earn a gift for you or your child by doing things like:

  • Completing a well-child exam or a postpartum visit

Swen oditif

Pwoblèm pou tande ka afekte lavi toulejou ou nan anpil sans. Plan nou an gen ladan sèvis ak sipò pou ede pwoteje kapasite pou w tande (odisyon).

Nou kouvri:

  • Egzamen, terapi ak tès.
  • Hearing aids and batteries.

In-Home Care

After surgery or a serious illness, you may need extra 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.

Entèprèt

Doktè ou ansanm avèk oumenm, youn dwe konprann lòt. Lè w pa pale Anglè byen sa fè l pi difisil. Nou ka fè aranjman pou yon entèprèt medikal la nan randevou ou yo.

Nou gen moun tou nan depatman sèvis pou manm yo ki pale pliske yon lang. Chances are, we have someone who speaks your language. Interpreter Services also includes sign language interpretation or help.

Swen pou Maladi Ren

Maladi ren se yon pwoblèm medikal grav. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.

Plan nou an gen ladan:

  • Dyaliz.
  • Medikaman.
  • Edikasyon ak sipò pou lasante.
  • Organ Transplant if needed (We will coordinate benefits with Medicare and the State of Hawai’i Tissue and Transplant program (SHOTT))

Laboratwa ak Radyografi

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

We can give you member materials in a language and/or in a written format that is easier for you to understand. We make all written information for Members available in languages that comply with Section 1557 of the Patient Protection and Affordable Care Act. If you need information in a language other than English (i.e., Ilocano, Vyetnamyen, Chinwa (traditional), Korean, etc.), call Member Services. You can also get information in large print, braille or audio tapes. We can send you the information in another language within seven (7) days of the request. If the request is received after normal business hours, we will send you the information within seven (7) days of the next business day following the request. These services and help are available to current and potential members at no cost.

Examples of written materials include but are not limited to:

  • Anyè Founisè
  • Manyèl pou Manm
  • Appeals and Grievance Notices
  • Adverse Benefit Determination Notices
  • Network Provider Termination Notices to Members

Defansè Manm yo

We're looking out for you. Member advocates can help solve problems, provide training and education, and work on issues that concern members.

They can:

  • Provide information about your plan.
  • Teach you to get the care you need.
  • Help with doctor issues or complaints.

Sante mantal

Sante mantal toutosi enpòtan ke sante fizik. Se poutèt sa nou gen asirans ki kouvri toulède.

Sa gen ladann:

  • Terapi konpòtmantal.
  • Substance abuse treatment.
  • Medikaman.

NurseLine

Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.

Enfimye/enfimyè nou yo pral:

  • Tande ki sentòm ou di l ki prezante.
  • Ede pou swen pèsonèl.
  • Ba w konsèy sou kijan pou jwenn swen kay yon doktè oswa nan yon sant swen dijans.
  • Ede w konnen kilè pou w ale nan sal dijans.

Vizit enfimye(è)

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care.
  • Answer any questions and concerns.

Ankadreman pou Nitrisyon

Healthy eating goes a long way to helping you stay at your best. A nutritionist can meet with you to review your eating habits and food choices.

You'll come away with new ideas for:

  • Making good choices for quick meals and snacks.
  • Preparing healthy meals on a budget.

Outpatient Services

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.

We'll help you get the information needed to help improve your health or be your best.

Swen pèsonèl

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

  • Dressing.
  • Bathing.
  • Feeding.
  • Cooking.
  • Shopping.
  • Running errands.

Prenatal Visits

A pregnancy is a journey that’s better 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 mom and baby are healthy.
  • Eksplike kisa pou w atann nan chak etap gwosès ou.
  • Answer questions.

Sispann itilize tabak

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

Rehabilitation Care

After a serious illness, surgery or injury you may need extra nursing and therapy. Si sa nesesè, plan nou an garanti sejou kout nan yon sant reyabilitasyon kote ou kapab geri. Sa ki genyen se:

  • Sèvis mezon retrèt.
  • Swen enfimye 24-èdtan.
  • Èd avèk aktivite lavi toulejou.
  • Terapi fizik, okipasyonèl, ak pou lapawòl.

Respite Care

Do you have family members or friends who care for you at home?

If so, we want to support their hard work too. That's why we provide respite care to give your caregivers a rest. Respite care offers caregivers time away from their loved one who is ill or has special care needs.

Piki ak Vaksen

Piki woutin pou ede pwoteje ou kont maladi.

Kidonk, plan nou an kouvri:

  • Piki ak vaksen yo rekòmande.
  • Influenza, Pneumococcal, Diphtheria and Tetanus shots

Social Services

Many communities offer additional benefits for children in this plan. Social Services helps members connect to these local programs and services, such as:

  • WIC and financial support.
  • School services.
  • Swen repi.

Text4baby

Text4baby ka ede nouvo manman ak fiti manman yo kenbe tèt pa yo ak tibebe yo ansante.

You'll get text messages throughout your pregnancy and your baby's first year. Chak tèks gen ladan konsèy sou sante ak sekirite pou sijè tankou:

  • Swen prenatal.
  • Tranche ak akouchman.
  • Alètman matènèl.
  • Dòmi san danje.
  • Nitrisyon.
  • Sekirite chèz machin.

So you and your baby can make a great start on life.

To sign up, visit UHCHealthyFirstSteps.com

Therapy Services (Habilitation Services)

Terapi fizik, okipasyonèl ak terapi lapawòl ka ede ou refè apre yon blesi oswa maladi grav, oswa tou senpleman reyalize tout sa ou kapab fè.

Our plan provides:

  • Terapi okipasyonèl.
  • Terapi fizik.
  • Terapi lapawòl.

Vizit kay doktè san limit

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

Swen Ijan

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

  • Sant swen ijan yo.
  • Medical aid units.
  • Other walk-in clinics.

Vizit pou moun ansante

Vizit konsiltasyon sa yo ka ede detekte pwoblèm sante bonè, pou yo sa trete yo.

Preventive services :

  • Tchekòp pou granmoun ak timoun.
  • Swen pou tibebe ki ansante.
  • Swen pou fanm ki pral fè yon tibebe.
  • Piki ak tès woutin.
  • Mamogram.
NCQA Long-Term Services and Support Award Seal

Resous pou Manm

Gade Resous ki Disponib yo (louvri yon fenèt modal)

Aprann plis

UnitedHealthcare Community Plan QUEST Integration Program

Powered by Translations.com GlobalLink OneLink SoftwarePowered By OneLink