Ale nan kontni prensipal la
Kontni Prensipal

UnitedHealthcare Community Plan

Medicaid

Plan Medicaid TennCare nou an ofri anpil kalite avantaj. Timoun, fanm ansent, granmoun ak moun ki granmoun aje oswa ki gen yon andikap gendwa kalifye selon revni. View the benefits below to see all that our Tennessee Medicaid plan offers.

Plan sa a disponib kèlkeswa kote w ap viv nan Tennessee.

More information on eligibility and enrollment can be found on the TennCare website.

View and manage health benefits online with TennCare Connect. For more information, visit tenncareconnect.tn.gov.

We obey federal and state civil rights laws.  We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion, or sex.  Do you think we did not help you or you were treated differently because of your race, color, birth place, language, age, disability, religion, or sex?  You can file a complaint by mail, by email, or by phone. Download and print the information (PDF 30.64 KB) or see below:

UnitedHealthcare Community Plan
Attn: Appeals and Grievances
P.O. Box 5220
Kingston, NY 12402-5220
Phone: 800-690-1606 TTY: 711

Health Care Finance and Administration
Office of Civil Rights Compliance
310 Great Circle Road, Floor 3W
Nashville, Tennessee 37243
Email: HCFA.Fairtreatment@tn.gov
Telefòn: 855-857-1673 (TRS 711)

You can get a complaint form online at:
http://www.tn.gov/hcfa/article/civil-rights-compliance

You can get a complaint form online at:
http://www.hhs.gov/ocr/office/file/index.html

Or you can file a complaint online at:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

U.S. Department of Health & Human Services
Office for Civil Rights

200 Independence Ave SW, Rm 509F, HHH Bldg.
Washington, D.C. 20201
Phone: 800-868-1019 (TDD): 800-537-7697

Avantaj & Karakteristik

Swen pou moun ki ansante ak Moun ki malad

Get the care you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get support to keep you and your baby healthy. Avantaj pou Manm yo gen ladan:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • Nurse Hotline. Speak with a registered nurse 24/7.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Lab and X-rays. Lab tests and x-rays are covered.

Pa gen anyen ki pi enpòtan pase sante ak byennèt oumenm ak tibebe w. Se poutèt sa plan avantaj TennCare Medicaid nou yo gen ladan:

  • Choice of Doctor. Find an OB/GYN you trust in our network.
  • Vizit Prenatal. Swen pou oumenm anvan tibebe w fèt.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Choice of Birth Centers. Pick from hospitals all across Tennessee.
  • Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

Si ou gen opresyon, dyabèt oswa yon lòt pwoblèm alontèm, ou ka konte sou nou. Our TennCare Medicaid plan makes sure you get the care and services you need. Avantaj yo gen ladan yo:

  • Mental Health. Counseling and other treatments are available.
  • Care Management. Personal support from an experienced professional.
  • Population Health Services. Help to manage your ongoing health or chronic condition.

Make sure sight, teeth and hearing are at their best. Avantaj yo gen ladan yo:

Vizyon.

  • For adults age 21 and older- vision services are limited to medical evaluation and management of abnormal conditions and disorders of the eye. The first pair of cataract glasses or contact lens/lenses after cataract surgery are covered.
  • Children under 21 years old- can have their eyes checked and get eyeglass lenses and frames as medically necessary. If the eyeglass lenses or frames are broken or lost, we will replace them as medically necessary.
  • TennCare will pay for other vision care if it is medically necessary. Contacts are covered only if they are medically necessary.
  • Children do not have to see their PCP before seeing their eye doctor, the eye doctor must be in our Provider Directory.

Dantè.  

  • Dental care for adults age 21 and older is covered with limits. Dental care includes benefits like checkups, x-rays, oral treatments and more. See your Dental Benefits Manager (DBM) Handbook for limits. Your dental plan for your teeth is called DentaQuest.  They can help you if you have questions about dental care.  To find a DentaQuest dentist, go to http://www.dentaquest.com/state-plans/regions/tennessee/.  Then click Find a Dentist.  Or you can call them at 855-418-1622. It’s a free call.
  • Dental Care for Children (for teeth) You also have a dental plan for your teeth called DentaQuest.  Their phone number is 1-855-418-1622.  You can call DentaQuest to find a dentist.  Or, if you have questions about caring for your child’s teeth, you can call them.  It’s a free call.
  • Children’s teeth need special care.  Children under age 21 should have a checkup and cleaning every six months.  Children need to start seeing a dentist the time the first tooth comes in the mouth, or no later than the first birthday.
  • TennCare will pay for some other dental care if it is medically necessary.  Braces are covered only if they are medically necessary and only for children.
  • You do not need to see your PCP before you go to a dentist.  But, you will need to go to a DentaQuest dentist. 

Members who qualify can get the medically necessary equipment and help needed to live safety at home. Avantaj yo gen ladan yo:

  • Equipment and Supplies. In-home medical safety materials are covered.
  • Nurse Visits. Short-term medical care while recovering at home.
  • Care Coordinator. Someone to get you the services to live safely at home.

Gendèfwa, ou ka bezwen yon ti èd anplis pou w itilize plan sante w la. Lè sa yo, ou ka konte sou:

  • Nurse Hotline℠. Speak with a registered nurse 24/7.
  • Language Help. Connect to a translator through Member Services.
  • Member Services. Someone to help you understand how to use your benefits.
  • Quitting Tobacco.  Coaches, supplies and medications to help you quit using tobacco.  
  • Weight Control. Support and treatment to reach a healthy weight.
  • Health Education. Free classes to help improve your health.

Èske oumenm oswa timoun ou gen yon pwoblèm sante ki grav? Then our care managers are in your corner. Yo pral:

  • Esplike tèm medikal yo nan yon langaj ki senp.
  • Kowòdone randevou kay doktè.
  • Bay ekip swen an dosye medikal yo.

Your care manager will stay with you or your child throughout the medical journey. Li pral:

  • Reflechi sou bagay ki piplis pase bezwen medikal imedya.
  • Asire gen sipò nan kay la.

Kote ou fè tibebe w lan se yon chwa ki enpòtan. That’s why you can pick from hospitals all across Tennessee.

We encourage you to tour the hospital’s birthing center. Nan fason sa a, ou pral abitye avèk li. And you’ll be more relaxed when you have your baby.

Ekipman ak Founiti

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

Sante ak sekirite lakay ou enpòtan.

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

  • Kabann lopital.
  • Tank oksijèn.
  • Wòkè oswa chèz woulant.

Edikasyon Lasante

Free classes to help improve your health or address a condition.

Our plan includes classes on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

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).

Ospitalizasyon

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

Sa gen ladann:

  • 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.

Internet

Do you know about the Affordable Connectivity Program? It’s a new program that helps pay for high-speed internet.  You can use the internet for work, school, healthcare, and more. What do you get with this program?  You may get up to $30 per month off your internet bills.  There is also a one-time $100 discount off a laptop, tablet, or computer. Who can get this program?  Any household that has at least one person enrolled in Medicaid.  How do you get this program?  You must enroll to get it.  Go online to getinternet.gov and enroll today.

Aprann plis

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. Gen anpil chans ke nou gen youn moun ki pale menm lang avèk ou.

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

Ou ka resevwa enfòmasyon nan lang ou pi pito a. 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.

Sèvis pou Manm

Understanding your health care options can be confusing. We can answer your questions simply and completely.

We help you find:

  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

Sante mantal

Sante mantal toutosi enpòtan ke sante fizik. That’s why we have the same coverage for both.

Swen obligatwa kouvri a 100% san kopeman. Sa gen ladann:

  • Terapi pou sante mantal.
  • Substance abuse treatment.
  • Medikaman.

Kopeman

Members have no copayments for:

  • Swen prevantif.
  • Annual checkups.

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 for you.
  • Reponn kesyon w ak enkyetid ou.
  • Home health. Home nursing care limited to 125 visits per calendar year.

Liy Dirèk pou Enfimyè

Medical questions and situations can sometimes come at inconvenient times. When you have questions about your health or your child’s health, you can call a trained nurse 24/7.

Enfimyè nou yo ki nan Nurse Hotline la pral fè: 

  • Tande ki sentòm ou di l ki prezante.
  • Gide pou pran swen tèt ou.
  • 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.

Prenatal Visits

A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

Nou garanti tout vizit nan klinik prenatal ak tès ou ki rekòmande yo.

Nan vizit sa yo, klinik la ap:

  • Asire oumenm ak tibebe w la ansante.
  • Eksplike kisa pou w atann nan chak etap gwosès ou.
  • Reponn kesyon w yo.

Primary Care Provider

You can have one main person for your health care. He or she can be a doctor, a nurse practitioner, or a physician’s assistant. This person is called your Primary Care Provider (PCP). 

PCP w la se doktè prensipal ou pou:

  • Swen prevantif.
  • Tretman si w malad oswa blese.
  • Rekòmandasyon kay espesyalis pou sèten pwoblèm medikal.

To change your PCP:

  1. Find a new PCP in the UnitedHealthcare Community Plan network. To find a new PCP you can look in our Provider Directory, you can go online at
    myuhc.com/CommunityPlan, or call 1-800-690-1606.
  2. Then call the new PCP to make sure that he or she is in the UnitedHealthcare Community Plan provider network. Be sure to ask if he or she is taking new patients.
  3. If the new PCP is in our network and taking new patients, fill out the PCP Change Request in Part 8 of your Member Handbook and mail it back to us. Or you can call us at
    1-800-690-1606 to tell us the name of your new PCP.

Sispann itilize tabak

Ou konnen move efè fimen gen sou sante w.

Ou konnen fòk ou kite fimen. Nou ba w sipò pandan w ap kite avèk èd akonpayatè ak founiti. Sèl bagay ou p ap jwenn nan men nou, sèke nou pa pral fè moral ou.

Piki ak Vaksen

Vaksen woutin yo ede kenbe w ansante. Kidonk, plan nou an kouvri:

  • Piki ak vaksen yo rekòmande.
  • Piki kont lagrip.

Sèvis Transpò

In case of emergency call 911

Important tips for setting up a ride- Please review Tennessee Carriers website- Rider Information Riders | Tennessee Carriers (tenncarriers.com)

  • Rele 1-866-405-0238, TTY 711 pou òganize kous la 
  • Call at least seventy-two (72) hours in advance of your appointment whenever possible
  • If the time for your return trip home was not already scheduled, you are responsible for calling to tell the transporter that you are ready to be picked up for your trip home
  • If you cancel your appointment/visit, call 1-866-405-0238 to cancel your ride 
  • Se pou gen kat ID Medicaid ou disponib 
  • If you have more than one appointment on the same day, you can get a ride to all covered services. Please give Tennessee Carriers information for each appointment
  • Konnen adrès founisè swen sante ou epi dat ak lè randevou ou an 
  • Se pou ou byen presi sou kote ou bezwen yon kous 
  • Si doktè ou an ba ou yon preskripsyon ou ka kanpe nan famasi a pou pran li 
  • Fè nou konnen si ou gen bezwen espesyal tankou yon chèz woulant 
  • Any minor requesting transportation without an accompanying adult will be handled on a case-by-case basis 
  • If you wish to bring someone with you to your appointment, you can have someone ride with you. This is sometimes called an escort. An escort is someone over the age of 12. Please let Tennessee Carriers know you’ll have an escort riding with you
  • If you’re going to an appointment and need to take your child with you, he or she won’t count as your escort

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

  • Screening for obesity.
  • Support for healthy diet and exercise choices.
  • Health coaching.

Vizit pou moun ansante

Vizit konsiltasyon kay doktè pou moun an sante ka ede kenbe ou an sante. These visits can help catch health problems early so they can be treated. Sèvis prevantif gen ladan yo:

  • Tchekòp pou granmoun ak timoun.
  • Swen pou tibebe ki ansante.
  • Swen pou fanm ki pral fè yon tibebe.
  • Piki ak tès woutin.
  • Mamogram.

You will not have a copayment for preventive care.

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.

Resous pou Manm

Healthier Tennessee is a priority of the Governor’s Foundation for Health & Wellness, involving action promoting healthier behaviors in schools, workplaces and in places of worship. More information is available at www.healthiertn.com

Gade Resous ki Disponib yo (louvri yon fenèt modal)
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