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UnitedHealthcare Community Plan — Indiana PathWays for Aging

Medicaid

Indiana PathWays for Aging is an Indiana health coverage program for Hoosiers aged 60 and older who are eligible for Medicaid. Research shows that most older adults – 75% or more – want to age at home and in their communities. Indiana PathWays for Aging makes it possible for Hoosiers to age their way. Our plan offers more choices for people to get nursing facility level of care at home or in a community setting, while living independently. Note that a nursing home might be the right choice for some. 

FSSA has contracted with UnitedHealthcare to administer the Indiana PathWays for Aging program. UnitedHealthcare is your health plan. 

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  • UnitedHealthcare Community Plan — Indiana PathWays for Aging Steps to enroll

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Benefits & features

If you are a new Indiana PathWays for Aging program member, getting connected during your first 30 days is very important. Here is a to-do list. When you complete this list, it lets us know your choices when it comes to managing your health:  

  1. Check your voice mail and call us back. We will be trying to reach you by phone or in person during your first 4 weeks with UnitedHealthcare Community Plan. If you do not answer the phone from unknown numbers, we get it. It makes sense not to trust people who are asking personal questions over the phone. That is why we encourage you to call us at 1-800-832-4643 / TTY 711. We can also meet you in a public place or visit you where you live. 
  2. Complete your health needs screening. This is an important first step. It helps you let us know how you are doing today. Call Member Services at 1-800-832-4643 / TTY 711 and ask to take your health needs screening. If you complete this in the first 30 days, you will get to choose a reward from our member rewards catalog. 
  3. Let us know how you want to hear from us. This includes mail, email, and texting options. We can also help you set a large print, braille, or other format choice. If English is not your first language, we will send materials in your language. You can share these preferences right after you take your health needs screening. 
  4. Choose a Primary Medical Provider (PMP). As soon as you can, it is important to choose a Primary Medical Provider (PMP). This is your main provider. who sees you for annual checkups, routine sick or well visits, and immunizations (shots).  Here are the options for choosing your PMP:
    • Log into your member portal at MyUHC.com/CommunityPlan.
    • You can use our provider search tool to view all of the providers in our network. 
    • Call Member Services for help finding a PMP. We can also email or send you a list of providers to choose from. 

You should also:

  • Schedule an appointment with your PMP.  You should see your PMP as soon as possible after becoming an Indiana PathWays for Aging member. 
  • Connect with your Care Coordinator. Call Member Services to get started. Your Care Coordinator is “your go-to person” here at UnitedHealthcare. Your Care Coordinator listens to you. They share options that support your way, to live life your way. Our goal is to see you live as independently as possible, for as long as possible. 
  • Ask questions! We want to hear from you. Get connected to resources, programs, and services. Call Member Services to find out about all the extras we offer here at UnitedHealthcare. We want to make this a pleasant and easy experience for you. 

 

UnitedHealthcare will help you understand all of your health coverages and benefits. We support coordination of all services under Medicare, Medicaid, or private health insurance. This includes traditional Medicare, a different Medicare Advantage plan, Chronic Condition Special Needs Plans (C-SNPs), and Institutional Special Needs Plans (I-SNPs). 

We make sure that services are covered and provided by the Indiana PathWays for Aging program when members are eligible for both Medicare and Medicaid services. We will work with Medicare payers, Medicare Advantage plans, and your providers to coordinate the care and benefits. We work with all relevant state and social service agencies and community-based organizations (CBOs) as needed to better identify and address both medical and social needs. 

Mental health services are covered and do not need a referral. This includes office visits, inpatient, and outpatient services. See the member handbook for details. 

 

Each UnitedHealthcare member in this program has a single person as a main point of contact. This is the Care Coordinator. The Care Coordinator is trained to understand all programs, services, benefits, and coverages available in Indiana. When members share, the Care Coordinator listens. They support goals and remove barriers. A Care Coordinator gives members, and those who support them, peace of mind as they navigate the health care system.

Chiropractic care is covered with some limits. See the member handbook for details.

Routine dental services are covered. UnitedHealthcare offers extra dental services like X-rays, fluoride, gum disease treatments, and virtual dental visits.

For emergency care, members should call 911 or go to the nearest emergency room (ER). Do not call us before calling 911. Emergency transportation is covered.

Please click the Member Resources section of this website to learn more about our free programs and services. Some of these are only available to UnitedHealthcare members. 

Up to 6 routine foot care visits are covered each year. Some services need prior approval. Please see the member handbook for details.

Home and Community-Based Services (HCBS) include services such as adult day services, home-delivered meals, homemaker and other supports that allow you to live as independently as possible, for as long as possible. Please see the member handbook for details.

Coverage is available to home health agencies for medically necessary skilled nursing services provided by a qualified nurse, as well as home health aide services. See the member handbook for details.

Whether it is for a procedure that is done the same day (outpatient) or includes an overnight stay (inpatient), hospital services are covered. 

We want members and their families to enjoy safe and affordable housing. We can help with a plan to improve a current home or plan a move to a different home. A Care Coordinator will work to collect goals and share options that address the needs of our members. 

Many members have friends and family who often help out or check in on them. We have programs to help the people who help our members. Talk to a Care Coordinator to learn more.

Long-term care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for long-term care.

Coverage is available for medical supplies, equipment, and devices that can be used in the home. A Care Coordinator can help arrange for needed equipment and supplies.

Nursing home care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for nursing home care.  This can be approved for a short-term or a long-term stay.

There are limits when getting services outside of Indiana. Please see the member handbook for details. If members are experiencing an emergency, visiting an emergency room is covered.

Prescribed medications are covered. All health plans follow the same rules about the medications that are covered as part of the Indiana PathWays for Aging program. The same list of approved medications is used. This is called the Preferred Drug List, or PDL.

Most office visits are covered. See the member handbook for details.

When it is time to renew benefits and coverage, this is called redetermination. The Indiana Family and Social Services Administration (FSSA) will mail you a “Notice of Renewal” reminder, which may ask you for information. Carefully read the directions that come with your renewal form. You may be required to sign the form and return it with some information, or you may only need to review the form and report if any of the information has changed within the last year. If it is all correct, you will not have to respond. You must remain Medicaid eligible to stay in the Indiana PathWays for Aging program.

There are rules for staying in a rehabilitative unit. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

Rehab stays are short-term. The stay could be needed for addiction recovery. It could also be a stay that includes therapies related to physical recovery.

Members can get residential treatment if they are getting help due to alcohol or drug use. This includes overnight stays in a facility. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

For members who do not drive or have trouble finding a ride, transportation is covered. UnitedHealthcare members have free transportation (ride) benefits for:

  • A provider visit or health care appointment
  • Pharmacy trips
  • Urgent (upon approval) and recurring appointments
  • Eligibility redetermination appointments with the state
  • Curbside grocery pickup or food bank visits
  • Health-related education classes
  • Local fitness centers
  • State or county agency appointments
  • Parole meetings

There are additional options available for members who are eligible for the HCBS Waiver. These rides must be part of the member’s service plan. The member’s Care Coordinator will make sure needed transportation is on the service plan.

Routine vision care is covered. UnitedHealthcare offers 1 free eye exam each year. We also offer an allowance for the cost of glasses or contact lenses once a year.

Hospital Services

Whether it is for a procedure that is done the same day (outpatient) or includes an overnight stay (inpatient), hospital services are covered. 

Housing Stability

We want members and their families to enjoy safe and affordable housing. We can help with a plan to improve a current home or plan a move to a different home. A Care Coordinator will work to collect goals and share options that address the needs of our members. 

Informal Helper Support

Many members have friends and family who often help out or check in on them. We have programs to help the people who help our members. Talk to a Care Coordinator to learn more.

Long-Term Care

Long-term care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for long-term care.

Medical Equipment and Supplies

Coverage is available for medical supplies, equipment, and devices that can be used in the home. A Care Coordinator can help arrange for needed equipment and supplies.

Nursing Home Care

Nursing home care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for nursing home care.  This can be approved for a short-term or a long-term stay.

Out-of-State Medical Services

There are limits when getting services outside of Indiana. Please see the member handbook for details. If members are experiencing an emergency, visiting an emergency room is covered.

Pharmacy

Prescribed medications are covered. All health plans follow the same rules about the medications that are covered as part of the Indiana PathWays for Aging program. The same list of approved medications is used. This is called the Preferred Drug List, or PDL.

Provider Visits

Most office visits are covered. See the member handbook for details.

Redetermination

When it is time to renew benefits and coverage, this is called redetermination. The Indiana Family and Social Services Administration (FSSA) will mail you a “Notice of Renewal” reminder, which may ask you for information. Carefully read the directions that come with your renewal form. You may be required to sign the form and return it with some information, or you may only need to review the form and report if any of the information has changed within the last year. If it is all correct, you will not have to respond. You must remain Medicaid eligible to stay in the Indiana PathWays for Aging program.

Rehab Center Stays

There are rules for staying in a rehabilitative unit. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

Rehab stays are short-term. The stay could be needed for addiction recovery. It could also be a stay that includes therapies related to physical recovery.

Substance Abuse Treatment

Members can get residential treatment if they are getting help due to alcohol or drug use. This includes overnight stays in a facility. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

Transportation

For members who do not drive or have trouble finding a ride, transportation is covered. UnitedHealthcare members have free transportation (ride) benefits for:

  • A provider visit or health care appointment
  • Pharmacy trips
  • Urgent (upon approval) and recurring appointments
  • Eligibility redetermination appointments with the state
  • Curbside grocery pickup or food bank visits
  • Health-related education classes
  • Local fitness centers
  • State or county agency appointments
  • Parole meetings

There are additional options available for members who are eligible for the HCBS Waiver. These rides must be part of the member’s service plan. The member’s Care Coordinator will make sure needed transportation is on the service plan.

Vision Care

Routine vision care is covered. UnitedHealthcare offers 1 free eye exam each year. We also offer an allowance for the cost of glasses or contact lenses once a year.

Member resources

Member resources (opens modal window)

Individual & Family ACA Marketplace Plans Disclaimer
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The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. By responding to this offer, you agree that a representative may contact you.

*To qualify for a $0 monthly premium, you must meet household income requirements for Advanced Premium Tax Credits.

**$0 cost-share for network periodic oral evaluation 2 times per consecutive 12 months. Adult dental benefit coverage is limited to a $1,000 benefit maximum per plan year. Coverage for routine vision exam and eyewear is limited to once every 12 months. If you opt to receive vision care services or vision care materials that are not covered benefits under this plan, a participating vision care provider may charge you their normal fee for such services or materials. Coverage may not be available on all plans or in all states. For costs and complete details of coverage, contact your insurance agent or the company, as applicable.

Last Updated: 12.18.2024 at 11:39 AM CST

Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.