Healthy Louisiana Plan

Get the assistance you need to make life a little easier, or to get better if you are injured or sick. That includes:

• Unlimited Doctor Visits for Children. Your child can see the doctor as often as needed.
• Unlimited Doctor Visits for Adults. See your doctor as often as needed.
• Well Visits. Annual checkups to help keep your family healthy.
• Chiropractor Services. Chiropractic visits for members who qualify.
• Shots and Vaccines. Routine shots help protect against illness. 
• Medicines. Fill your prescriptions at local pharmacies.
• Hospitalization. Necessary expenses related to a hospital stay are covered.

Nothing is more important than the health and well-being of you and your baby. That's why our plan benefits include:

• Choice of Birth Centers. Pick from our partner hospitals across Louisiana.
• Choice of Doctors. Find an OB-GYN you trust in our network.
• Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  
• Prenatal Visits. Care for you before your baby is born.
• Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

If you have asthma, diabetes or another long-term condition such as substance use disorder, you can depend on us. Our plan makes sure you get the care, support and services you need. Benefits include:

• Asthma and COPD Care. Exams, testing and supplies are covered.
• Care Management. If you qualify, get personal help managing health conditions.
• Diabetic Support. Medicine, needles and wipes for managing diabetes.
• Mental Health. Counseling and other treatments are covered.
• Disease Management. Focused care for those with critical health needs.

We help you keep your smile, sight and hearing at their best. Benefits include:

• Dental. Covered cleanings, checkups and dental work are provided by MCNA Dental (Managed Care of North America) or DentaQuest for members under the age of 21. We also offer coverage (up to $500 per year)  for adults 21 and over, including dental exams, cleanings, and x-rays through a value-added benefit offered by UnitedHealthcare Community Plan.
• Vision. Routine exams and glasses and contacts are covered for members under the age of 21. 
• Hearing. Tests, exams and hearing aids are covered for members to age 21.

* Value added benefit offered by UnitedHealthcare Community Plan.

Get the medical care and equipment you need to live safely at home. Benefits may include:

• Equipment and Supplies. In-home medical and safety equipment are covered for medically necessary equipment.
• Home Health Care. Medical and personal care at home, if necessary.

Sometimes you might need a little extra help using everything our health plan offers. For those times, you can rely on:

• Language & Interpreter Help. We provide free services, such as information in other languages, large print, Braille and American Sign Language. You can also ask for an interpreter. Call member services for information. 
• Member Services. Get help with understanding your benefits and get your questions answered.
• Transportation. We provide rides to and from medical visits.

Do you or a loved one have a serious health problem or a high-risk pregnancy? If so, our case managers are in your corner. They will:

• Explain medical terms in plain language.
• Coordinate your doctor appointments.

The case manager will stay with you or your loved one throughout the medical journey. He or she will:

• Think beyond your medical needs.
• Assess home situation and help where possible.
• Make sure you have support at home.

So you can focus on getting better.

Members can choose a primary care provider (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.

The PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.

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.

Where you have your baby is an important choice. That's why you can pick from partner hospitals across Louisiana.

We encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you have your baby.

Whether chiropractor services are your primary or alternative treatment method, you're covered. This benefit is available for members under the age of 21. A referral from your primary care physician is required.

Members over the age of 21 who are managing pain can get up to six (6) visits per year with an in-network chiropractor.

Regular checkups help keep teeth and gums strong and healthy. Healthy Louisiana members under the age of 21 get:

• 2 exams per year.
• Cleanings and x-rays.
• Fluoride treatments.

These services are offered through MCNA Dental (Managed Care of North America) and DentaQuest.

Members age of 21 and above get up to $500 in coverage for:*

• Regular exams.
• Cleanings and x-rays.

*This is an added benefit offered by UnitedHealthcare Community Plan.

If you have diabetes, we'll make life a little easier for you. 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:

• Planning healthy meals.
• Managing stress.
• Living a healthy lifestyle.

Members age 21 and above who qualify as well as complete HbA1c labs and LDL-C screenings may be eligible for a yearly $50 voucher to use toward a purchase from a catalog of over the counter health products. This is an added benefit offered by UnitedHealthcare Community Plan.

If you have a chronic health condition like asthma or diabetes, UnitedHealthcare Community Plan has a program to help you live with your condition and improve the quality of your life. These programs are voluntary and available at no cost to you.

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

Our plan covers medical equipment ordered by your doctor or provider. Some examples include:

• Hospital beds.
• Oxygen tanks.
• Wheelchairs or walkers.

We provide the exams needed to help keep your feet in great shape. And for those with diabetes or a circulatory condition, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

• Office visits.
• Certain radiology and lab procedures.
• Other diagnostic procedures.

Take free classes to help improve your health or to address a condition. Our plan includes classes on diabetes, nutrition and more.

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. *

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Connect with community resources such as Women, Infants and Children (WIC) services.

* Value added benefit offered by UnitedHealthcare Community Plan

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect the hearing of members under the age of 21.

Our plan covers:

• Exams and tests.
• Hearing aids and batteries.

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.

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

Our plan covers:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

And after leaving the hospital, our members are not alone. We make sure they get follow-up care to continue healing at home.

Both doctor and patient need to understand one another. If needed, we can arrange for a medical interpreter to be at medical appointments.. Our member services team has interpreters who speak over 170 languages. We also offer American Sign Language (ASL).                                            

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

• Labs and testing.
• X-rays, scans and other imaging.

We make sure our members get the information needed to help improve their health.

You can receive information in your preferred language. Just ask. We also have people at our customer service centers who speak more than one language. Over 170 languages are supported. Call Member Services for help with interpreters and American Sign Language. They can also help if you need information in large print, Braille or audio files on a CD or flash drive. 

Our plan includes prescription drugs and refills. Some members may have a small copayment.

And we make getting your medicine easy. You can fill your prescriptions at the network pharmacy of your choice, including local pharmacies and mail order pharmacies. 

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We'll answer your questions simply and completely.

We can also help you find:

• Home health providers.
• Dentists and vision providers.
• Adult Health Services.

Mental health is as important as physical health. That's why we cover both.

Coverage includes:

• Behavioral health services.
• Substance use treatment.
• Certain medications.

Medical questions and situations come at inconvenient times. For questions about health, you can call a trained nurse 24/7. 

Our Nurse Hotline nurses will:

• Listen to the symptoms.
• Provide guidance on self-care.
• Advise the member about getting care at a doctor visit or an urgent care center.
• Help know when to go to the emergency room.

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.

The basics can be hard to do if you have a disability or you've had a serious illness or injury.

We can help. A few examples include: 

• Dressing.
• Bathing.
• Feeding.

Long-term personal care is available for members 21 or older with disabilities.

A pregnancy is a journey that's better with the help of friends, family and a pregnancy doctor, or OB/GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

• Make sure mom and baby are healthy.
• Explain what to expect at each stage of pregnancy.
• Answer questions.

Routine shots help keep you healthy. Our plan covers:

• Pneumonia, influenza and shingles shots.
• Tetanus, Diphtheria and Whooping Cough vaccines.
• Other recommended shots and vaccines.

Our plan provides rides to and from health care locations. That includes trips to:

• Doctor and therapy visits.  
• Health departments.
• Vision clinics.

There may be times when your health requires regular visits to a doctor or specialist). Our plan does not limit the number of times children or adults can see their doctors. This includes sick visits, well visits and specialists. For children, EPSDT screenings are also covered. This way you get care when you need it. And the doctor can see how your health is progressing.

With Healthy Louisiana, members under the age of 21 receive:

• Regular eye exams.
• Eyeglass frames.
• Prescription lenses.

Members over the age of 21 can get:*

• One routine eye exam every two years with no copay.
  
• $100 allowance for frames/lenses or $105 allowance for contact lenses every two years.

* This is an added benefit offered by UnitedHealthcare Community Plan.

Unlimited well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated.

Preventive services cover:

• Checkups for adults and children.
• Well-baby care.
• Care for women expecting a baby.
• Routine shots and tests.
• Mammograms.

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.

Some members may also qualify for weight management classes, including (WW) Weight Watchers. *

* Some limitations may apply.

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.