UnitedHealthcare Community Plan - MO HealthNet Managed Care

Nothing is more important than the health and well-being of you and your baby. That's why your MO HealthNet Managed Care benefit includes:

• Choice of Birth Centers. Pick from our large network of hospitals or birthing centers.
• Choice of Doctors. Find a doctor you trust for your pregnancy care.
• Prenatal Visits. Care for you before your baby is born.

If you or a family member has special health care needs, you can count on us. Our health plan will provide the extra care and services you need. Benefits include:

• Asthma Care. Exams and supplies are covered.
• Care Management. Get personal help managing health conditions.
• Disease Management. Focused care for those with critical health needs.
• Behavioral Health and Substance Use Services. Get caring help to meet your recovery goals.

Make sure your sight and smile are at their best. Your MO HealthNet Managed Care benefits include:

• Vision. Routine eye exams, plus frames and prescription lenses are covered.
• Dental. Cleanings, check-ups and dental work.

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Equipment and Supplies. In-home medical and safety equipment are covered.
• Home Health Care. Medical care in your home, if needed.

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

• Electronic breast pumps: Enrolled pregnant members are eligible for an electronic breast pump (limit one).
• Asthma support: Special supplies are available, including a hypoallergenic mattress cover and pillow case.
• Peer support specialists: Coaches can provide support for substance use disorder (SUD) recovery.
• Mom’s Meals: Post-delivery moms can receive 30 meals (2 meals per day for 15 days) delivered to their home. These requests can be made through your case manager or by calling member services.
• YMCA Memberships: Members up to age 17 years of age can receive a Youth Membership to their local YMCA.  Just go into your local Y and bring your member ID card to get signed up. Learn more here.
• One Pass: Members 18 and older will have access to this membership which gets them into over 300 gyms across Missouri including the YMCAs, Planet Fitness, Anytime Fitness, and many small local gyms. Information can be found at One Pass UHCMO | Rally Health or learn more here. 
• Transportation: Unlimited trips to doctors appointments, dental appointments, WIC, and pharmacy. In addition, members can get rides to grocery stores and food pantries, weight management classes or programs such as their YMCA or local gym, job and vocational training, and substance abuse services for pregnant members. Learn more here. Members and Members family and friends (when assisting the member with a ride) are eligible to submit for gas mileage reimbursement by filling out MTM’s GMR form.  You can find the form here. Remember, the form must be signed off by the correct medical personnel to receive reimbursement.
• AbleTo: an app that offers clinical solutions to dial down symptoms of stress, anxiety, and depression. Members can download the app, create an account and choose “upgrade through insurance”, and search for and select United Healthcare and enter the information on your insurance card.

Sometimes you might need a little extra help using your health plan. For those times, you can rely on us for assistance:

• Nurse Hotline^SM.S peak with a registered nurse 24/7.
• Member Services. Your benefit questions are answered Monday - Friday, 7:00 a.m. - 7:00 p.m. CT
• Language Help. Connect to a language or ASL interpreter through Member Services. We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

YMCA Benefit:  Members up to age 17 years of age can receive a Youth Membership to their local YMCA.  Just go into your local Y and bring your member ID card to get signed up. Learn more here.

One Pass Benefit:  Members 18 and older will have access to this membership which gets them into over 300 gyms across Missouri including the YMCAs, Planet Fitness, Anytime Fitness, and many small local gyms. Information can be found at One Pass UHCMO | Rally Health or learn more here. 

Transportation: Unlimited trips to doctors appointments, dental appointments, WIC, and pharmacy. In addition, members can get rides to grocery stores and food pantries, weight management classes or programs such as their YMCA or local gym, job and vocational training, and substance abuse services for pregnant members. Learn more here.

UHC Doctor Chat: As a UnitedHealthcare member, you can skip the waiting room and connect to doctors in seconds with the UHC Doctor Chat app. Doctors are available 24 hours a day, 7 days a week to answer any questions.  Learn more here.

Breast Pump Benefit: Members now call Aeroflow at 1-844-867-9890 and their dedicated mom and baby specialists will be able to assist you or visit aeroflowbreastpumps.com/united-qualify.

Do you or a family member have trouble managing asthma symptoms?
You will get a customized treatment plan and medicine to:

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

Earn great rewards:

• The Babyscripts program rewards you for going to your prenatal and postpartum visits
• Earn up to 3 rewards in all
• Get a gift card just for signing up

To sign up, visit the Apple App Store® or Google Play™ store on your smartphone. Download the Babyscripts myJourney app. Or call 1-800-599-5985, 8 a.m.–5 p.m., Monday–Friday. It’s that simple.

Inpatient, residential and outpatient services for behavioral health and substance use are covered. The type, amount and length of services provided will be based on the level of your needs. These services are part of your MO HealthNet Managed Care benefits.

When a member has complex health care needs, a care manager can really help. He or she will:

• Work with you and family members and friends on a plan of care.
• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records. 
• Make a referral to community social service programs.

Where you have your baby is an important choice. That's why you can pick from our large network of hospitals or Birthing Center.

We also encourage you to tour the hospital's birthing center. This way you will be familiar with it and be better informed when you have your baby.

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

The PCP is the main doctor for:

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

If you have chronic or high-risk illnesses, our disease management services are designed to support you.

As a UnitedHealthcare member, you can skip the waiting room and connect to doctors in seconds with the UHC Doctor Chat app. Doctors are available 24 hours a day, 7 days a week to answer any questions.  Learn more here.

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

MO HealthNet Managed Care covers medical equipment ordered by the doctor or care manager. This can include supplies like:

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

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

MO HealthNet Managed Care covers:

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

MO HealthNet Managed Care covers expenses related to a hospital stay, so our members can rest and heal.

Hospitalization coverage includes:

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

And after leaving hospital, we can provide transitional care services. MO HealthNet Managed Care makes sure you get follow-up care to continue healing at home.

You and your doctor need to understand each other. We have interpreters for you if your provider does not speak your language. We also have qualified American Sign Language interpreters available. This is provided at no cost to you when you speak to us, your provider, or Nurse Hotline.^SM

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Knowing what's wrong and finding it early can make all the difference. MO HealthNet Managed Care covers:

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

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

Members can get printed information in their preferred language. You will get member materials in English and Spanish. We can give you member materials in a language or format that is easier for you to understand. We also have qualified American sign language interpreters available. Just ask.

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Sometimes you might need a little help understanding your health care options. Call us. We'll answer your questions simply and completely.

We help you find:

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

You will not have a copayment for care and services covered by MO HealthNet Managed Care.

This includes in network services:

• Visits to doctors
• Treatments at hospitals and clinics.
• Behavioral Health and Substance Use.
• Home medical equipment and supplies to help you be at your best.

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.

Our nurses will:

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

All pharmacy benefits are covered by MO HealthNet Fee-for-Service. For more information:

Please contact 1-800-392-2161 or visit the MO HealthNet website at www.dss.mo.gov.

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.

At these visits, the clinic will:

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

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. UnitedHealthcare Community Plan covers counseling when you enroll with Quit for Life. Medication for smoking cessation is available. Call 1-800-784-8669.

Routine shots help protect members and their family from illness. MO HealthNet Managed Care covers:

• Pneumonia, influenza and shingles shots.
• Vaccines and Immunizations. Routine shots to help keep your child healthy.
• Other recommended shots and vaccines.

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

For children under age 21 and for pregnant women, MO HealthNet Managed Care provides:

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

Covered when ordered by a network physician.

Members get unlimited trips to the following:

• Doctors and providers
• Dentists
• Pharmacies
• WIC
• Grocery stores
• Food pantries
• Weight management classes or programs
• YMCA or local gym
• Job and career training
• If you’re pregnant, substance abuse services
• Learn more here
  Members and Member’s family and friends (if helping the member with a ride) can submit a form for gas mileage reimbursement. You can find the form here. Note: The form must be signed off by the correct medical personnel to receive reimbursement.
   

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.

You'll get the care, eyeglasses and treatment that help you see better. Coverage includes:

• One eye exam every 24 months for members 21 and over.
• One eye exam every 12 months for children under 21 and pregnant women.
• One pair of frames and lenses ever 24 months.

This benefit is offered by MARCH Vision Care.

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.

There are no copayments for preventive care.