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:

• Jere rechit yo.
• Diminye sentòm.
• Help you stay active.

Jesyon Swen

When a member has complex health care needs, a care manager can really help. Li pral:

• Work with you and family members and friends on a plan of care.
• Esplike tèm medikal yo nan yon langaj ki senp.
• 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.. 

Children's Health Support

• Rewards program for well-child visits.
• Dr. Health E. Hound® provides nutritional education and promotes fitness and healthy habits.

Swen Kiwopratik

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.

Chwa Sant Nesans

Kote ou fè tibebe w lan se yon chwa ki enpòtan. That’s why you can pick from our large network of hospitals or Birthing Center.

Nou ankouraje tou pou w vizite sant nesans lopital la. This way you will be familiar with it and be better informed when you have your baby.

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.
• 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.

Swen Dantè

Li enpòtan pou sante ou ke ou fè yon bilan dantè chak ane. Kouvèti asirans ou gen ladann: 

• Two exams and cleanings per year for children and adults.
• Bitewing X-ray once every 12 months and one complete set of X-rays every three years. 
• Minor restorations such as filling. 
• Major restorations such as crowns and root canals (one of each per 12 months). 
• Deep cleanings and surgical treatment for gum disease. 
• Partial or full dentures, and repairs to partials or full dentures. 
• Sedation and nitrous oxide (known as laughing gas) if medically necessary.

Pafwa moun gen difikilte pou yo ale kay dantis. Yo ka sansib lè yo touche yo. Yo ta ka bezwen tan anplis oswa swen dou. Kite nou ede w jwenn dantis ki bon pou ou menm oswa fanmi w. Rele Sèvis Manm nan 1-800-641-1902, TTY 711.

Sipò pou Dyabetik

Si w gen dyabèt, n ap ede rann lavi a yon jan pi fasil pou ou. 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:

• Jesyon estrès.
• Viv yon mòd devi ki sen.
• Wellness Rewards for getting needed exams.

Jesyon maladi

If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:

• Congestive heart failure.
• Asthma.
• HIV.
• Chronic obstructive pulmonary disease (COPD).
• Coronary artery disease.

Ekipman ak Founiti

Our member’s health and safety at home are important.

Our plan covers medical equipment ordered by the doctor or care manager. Sa ka gen ladan founiti tankou:

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

Swen pou Pye

Nou fè egzamen ou bezwen yo pou ede kenbe pye w an bòn sante. And if you have 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. 

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 oditif

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

Nou kouvri:

• Exams, aids and tests.
• Hearing aids and batteries.

Home Care

After surgery or a serious illness, you may need  in-home medical visit(s) to check on how well you are healing.

With approval, our plan covers:

• In-home medical visit(s).
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.

Ospitalizasyon

This plan pays for expenses related to a hospital stay, so our members can rest and heal.

Hospitalization coverage includes:

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

And after leaving hospital, we can provide transitional care services. Nou asire ou jwenn swen swivi pou w kontinye geri lakay ou.

Hospice Services

Hospice services are covered when they are ordered by a physician.

Laboratwa ak Radyografi

Knowing what’s wrong and finding it early can make all the difference.  Our plan covers:

• 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

Nou ba ou dokiman manm yo nan yon lang oswa yon fòma ki rann li pi fasil pou ou konprann. Rezo founisè nou an gen ladan l anpil doktè ki pale diferan lang. Anyè founisè nou an montre ki lang doktè yo pale. Additionally, many of our Member Service Advocates speak multiple languages. Lè w rele, n ap kapab konekte w ak sèvis entèprèt nou an ki ofri sipò nan plis pase 240 lang. Nou ede pou sèvis entèprèt, sa gen ladan l Lang Siy Ameriken.

Si ou gen pwoblèm pou tande nan telefòn lan, ou ka itilize yon telefòn tèks. Sèvis gratis sa a pèmèt moun ki gen andikap pou tande oswa pou lapawòl fè ak resevwa koutfil. Rele 711. Ba yo nimewo 1-800-641-1902, epi yo ap konekte ou avèk nou.

Ou ka jwenn enfòmasyon tou nan gwo lèt, Braille oswa fichye odyo.

All of the language interpretation and material translations/alternate formats are available at no cost to you. 

Member Services Advocates

Li kapab difisil pou ou jere swen sante ou poukont ou, sitou si w ap fè fas ak anpil pwoblèm sante an menm tan. Si ou bezwen sipò anplis pou vin an bòn sante epi rete an sante, nou ka ede. All our UnitedHealthcare members have access to Member Service Advocates.

Your Advocate can help you:

• Understand the Heritage Health program.
• Get information in a different format, like audio (CD or flash drive), large print, or Braille.
• Find a doctor, dentist or eye doctor.
• Explain your benefits and coverage.
• Talk to you about special programs that are available to you.
• Connect you with a Clinical Coordinator if needed.
• Find resources located near you to help you with other problems like food, housing, transportation, employment, feeling safe or getting an education.
• Make sure you are aware of other State programs and services available to you, such as SNAP (Supplemental Nutrition Assistance Program) or WIC (Women, Infants and Children) program benefits.
• Help you update your personal contact information like address, phone number, or email.
• Make sure we know how you would like to be contacted (email, phone, or mail).
• Resolve issues with providers, including specialty care and behavioral health.
• Assist with challenges due to prior approval, payment for services, care delivery, and family welfare.

Remember, answers to any questions you have are just a click away at myuhc.com/CommunityPlan. Or you can call Member Services at 1-800-641-1902, TTY 711, 7:00 AM–7:00 PM CT (6:00 AM–6:00 PM MT), Monday–Friday

Mental Health and Substance Use Services

Sante konpòtmantal konsène fason ou santi ou ak fason ou aji. Yo rele sante mantal tou. Your behavioral/mental health is important. All Heritage Health members can get behavioral/mental health and substance use services. You may see any in-network behavior/mental health doctor without a referral for outpatient treatment.

You can get behavioral/mental health services without a referral from your Primary Care Provider. Sometimes it makes sense to talk to your Primary Care Provider about any behavioral/mental health problems you believe you may have. That way, your Primary Care Provider can help to refer you to an appropriate provider in our network. If you want to find a provider on your own, you can search for one at any time and make an appointment. You can also call Member Services at 1-800-641-1902, TTY 711, for help or visit liveandworkwell link.

Nou kouvri:

Behavioral/Mental Health Services 

• Terapi apa, an gwoup ak an fanmi 
• Sèvis sante konpòtmantal pasyan ekstèn 
• Sèvis sante konpòtmantal pasyan entène 
• Specialized behavioral health services for children with autism.
• Behavioral health rehabilitation services

Sèvis pou Twoub Itilizasyon Sibstans 

• Tretman pou opyoyid (medikaman pou doulè) pou pasyan ekstèn 
• Tretman rezidansyèl

Additional health resources can be found at myuhc.com/CommunityPlan. Jwenn ekilib, sipò ak swen ou bezwen pou viv pi ansante otan sa posib.

Sèvis pou Kriz Sante Konpòtmantal

E si mwen gen yon kriz sante konpòtmantal?

You are always covered for a behavioral health, mental health, and substance use emergency. An emergency means a condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated.

Sèvis dijans yo kouvri nenpòt kote Ozetazini. Si ou panse ou gen yon ijans ki mete lavi ou an danje, rele 911 oswa ale nan lopital ki pi pre adrès kote founisè ijans yo ka ede w.

As soon as it is possible, please call us to arrange for follow-up care after an emergency.

Sèvis pou Kriz:

Si ou panse pou gen yon ijans, kèlkeswa kote ou ye a, rele 911 oswa ale nan lopital ki pi pre adrès kote founisè ijans yo ka ede w. Dèke sa posib, tanpri rele doktè w oswa founisè sante konpòtmantal ou pou fè aranjman pou swen swivi apre ijans lan fini.

Si ou bezwen pale avèk yon moun, nou disponib pou ou. Si ou pa gen enpresyon li lè pou ou rele 911 men ou bezwen èd touswit, ou ka rele Liy Dirèk nou an pou Kriz Sante Konpòtmantal 24/7 nan 1-800-641-1902.

Sou entènèt: http://www.suicidepreventionlifeline.org

Kopeman

Ou p ap gen yon kopeman pou swen ak sèvis plan nou an garanti.

Liy Dirèk pou Enfimyè

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: 

• Koute sentòm yo.
• 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.

Over-The-Counter Drugs/Supplies

Select over-the-counter drugs and supplies are covered 100% with your doctor’s prescription.  

Your health care costs may include non-prescription medicines and supplies like aspirin, cough medicine or diabetic testing supplies. Covered 100% with your doctor’s prescription.

Famasi

Our plan includes prescription drugs and refills, and we make getting your medicine easy. Medicare and other insurance copays may apply. Ou ka egzekite preskripsyon ou nan:

• Famasi lokal.
• Sèvis ki fè livrezon adomisil.

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.

90 Day Supply

You will be able to get a 90-day supply of select prescription medications from a retail pharmacy. Avèk yon pwovizyon pou 90 jou, ou p ap bezwen jwenn yon renouvèlman medikaman chak mwa. You’ll have three months between refills.

• Talk with your pharmacist - Your pharmacist can call your doctor to get a new prescription for a 90-day supply. 
• Talk with your doctor - Your doctor can write you a new 90-day supply prescription for the medicine above. We’ve let your doctor know about this change to your pharmacy benefit.  

If you have any questions, please call Member Services at 1-800-641-1902, TTY 711, 7:00 AM–7:00 PM CT (6:00 AM–6:00 PM MT), Monday–Friday

Prenatal Visits

Your pregnancy is a journey you’ll want to make with the help of friends, family and a pregnancy doctor.

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. 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. 

Swen Rezidansyèl

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. 

Sa ki genyen se:

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

Piki ak Vaksen

Routine shots help protect members and their family from illness. Plan nou an kouvri:

• Vaksen kont nemoni, grip ak zona.
• Vaccines and Immunizations.  Routine shots to help keep your child healthy.
• Lòt piki ak vaksen ki rekòmande yo.

Sèvis Terapi

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.

Sèvis Transpò

Si ou bezwen yon kous, avantaj ou yo gen transpò nan yo. We cover trips for Nebraska Medicaid coverable services within a 20-mile radius of your home. Sa yo gen ladan: medical, mental health, dental and vision appointments along with trips to the pharmacy.

Si ou swiv règ senp sa yo, yo pral ede ou jwenn yon kous: 

• Rele 3+ jou ouvrab davans 
• Call Transportation Services at 1-833-583-5683 (TTY 1-866-288-3133) 7:00 a.m.–7:00 p.m. CT (6:00 a.m.–6:00 p.m. MT), Monday–Friday or visit www.modivcare.com.
• Have your Medicaid ID card available. 
• Know the name and address of your health care provider and the date and time of your appointment. 
• Se pou ou byen presi sou kote ou bezwen yon kous 
• If you’re not sure how long your appointment will take, the return ride will be scheduled for “Call for Pickup.” That means you need to give Transportation Services a call when you’re ready to go home at 1-833-583-5683 (TTY 1-866-288-3133).   
• Si doktè ou an ba ou yon preskripsyon ou ka kanpe nan famasi a pou pran li 
• Let us know if you have special needs like a wheelchair, cane, or walker. 
• Members under the age of 13 must have a parent or guardian with them. 
• Transportation may be limited to a provider near you.
• If you cancel your visit, call 1-833-583-5683 to cancel your ride.

You may also qualify for a bus pass. Give Modivcare a call to schedule a ride or ask questions about getting transportation services.

Sèvis sa a se pou kous ki planifye davans yo ye. Si ou gen yon ijans ki mete lavi ou an danje rele 911. Y ap bay yon anbilans si yo dwe voye ou lopital.

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.

Swen pou vizyon

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

·  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.

Vizit pou moun ansante

Vizit konsiltasyon kay doktè pou moun an sante ka ede kenbe ou an sante. Vizit konsiltasyon sa yo ka ede detekte pwoblèm sante bonè, pou yo sa trete yo. Sèvis prevantif gen ladan yo:

• Tchekòp pou granmoun ak timoun.
• Piki ak tès woutin.
• Mamogram.

Pa gen okenn kopeman pou swen prevantif yo.