UnitedHealthcare Community Plan

Children's Special Health Care Services

The Children Special Health Care Services program is for children and young adults with special health or developmental challenges. Our plan provides extra services and support to help manage your child's care needs. If you are enrolled in Medicaid, you may qualify for this additional coverage.

Download more information about the CSHCS program here: Children's Special Health Care Services (CSHCS) Program.

Asthma and COPD Care

Do you have trouble managing asthma, allergies or COPD symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:

• Manage flare-ups.
• Reduce symptoms.
• Help you or your child stay active.

Asthma Care

Does your child have asthma or respiratory allergies? A nurse who specializes in breathing issues can really help childhood breathing problems. Your child's nurse will

• Get to know your child
• Learn his or her triggers and activities.
• Develop a customized treatment plan.

Care Management

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

• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records.

Your care manager will stay with you on your medical journey. He or she will:

• Think beyond your medical needs.
• Make sure you have support at home.

So you can focus on getting better.

Choice of Doctors

You or your child gets a primary care provider (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

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

Referrals to specialists for certain conditions.

Choice of Birth Center

Where you have your baby is an important choice. That's why you can pick from nearly 100 hospitals across Michigan.

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.

Customer Services

Understanding your health care options can be confusing. Now you have someone you can call. We can answer your questions simply and completely.

We help you find:

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

We also have people who speak more than one language. Chances are, we have someone who speaks your language.

Diabetic Support

If you have diabetes you may need insulin, needles, wipes and glucose strips. We cover all that and more.

Our plan also steps up with services to help you manage your diabetes including:

• Coordinating doctor care.
• Dedicated team to help you understand your condition and manage it.

Equipment and Supplies

Your health and safety at home are important.

Our plan covers medical equipment ordered by your doctor. This can include items like:

• Hospital beds.
• Oxygen tanks.
• Walkers or wheelchairs.

Healthy First Steps®

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.

Hearing Services

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to determine whether a hearing problem exists.

We cover:

• Exams, therapy and tests.
• Hearing aids are covered for Members under age 21.

Hospitalization

This plan pays for medical expenses related to a hospital stay.

Our plan covers:

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

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing.

Lab and X-rays

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

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

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

Language Help

We have people at our member services who speak more than one language. Chances are, we have someone who speaks your language.

Medicines

Our plan includes prescription drugs and refills.

We also cover many medically needed, over-the-counter medicines with a written order from your doctor. There is no copay for these medicines.

And we make getting your medicine easy. You can fill your prescriptions at:

• Network pharmacies.

Mental Health

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

Short-term required care is covered with no co-pay. This includes:

• Behavioral therapy.
• Medications.

No Copays

You will not have a copayment for most care and services covered by our plan. That means you will pay nothing for covered services, including:

• Preventive care.
• Annual checkups.
• Routine vision care.

Nurse Visits

Sometimes you may need continued care after you leave the hospital or urgent care. If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:

• Provide medical care for you.
• Answer your questions and concerns.

Pregnancy Care

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

• Prenatal Visit.
• Healthy First Steps®.
• Transportation.
• Wellhop for Mom & Baby. 
• Dental Services.

Prenatal Visits

Your pregnancy is a journey you'll want to make 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 you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.
• Get dental coverage as a pregnant member, during and for a full year after delivery. 

Quitting Tobacco

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Shots and Vaccines

Routine shots help protect against illness. So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

Social Services

Many communities offer additional benefits for children with special care needs. Social Services helps members connect to local programs and services, such as:

• WIC and financial support.
• School services.
• Respite care.

Download more information about social services benefits here.

Speech Therapy

Speech therapy visits and exercises can help those who have difficulty speaking. At your doctor's request we will cover short-term, medically needed physical, occupational, speech and other therapy visits each year.

Therapy Services

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.

Our plan provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.

With a doctor's request your coverage includes short term physical, occupational, speech and/or other therapy visits each year.

Transportation

Our plan provides a ride for you to and from health care locations. That includes rides to:

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

You can also be reimbursed for gas for driving to and from health care visits:

ModivCare Member Gas Reimbursement Instructions
ModivCare Mileage Reimbursement App
ModivCare Member Gas Reimbursement Form
ModivCare Standing Order Form

To learn more visit https://www.mymodivcare.com

Unlimited Primary Care Provider/PCP Visits

There may be times when your health requires repeated doctor visits. Our plan does not limit the number of times you can see your primary care provider. This way you get the care you need when you need it. And your doctor can see how your health is progressing.

Vision Care

Regular eye exams and glasses, if needed, can help you see more clearly. We also include:

• Prescription lenses.
• Designer-style frames.

Call Member Services at 1-800-903-5253 for vision services and providers.

Well Visits

Well visits with your doctor can help keep you healthy. These visits can catch health problems early, so they can be treated. Preventive services include:

• Checkups for adults and children.
• Routine shots and tests.
• Mammograms and Pap Smears.
• Well-baby care.
• Colorectal Screenings.

There are no copayments 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.