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UnitedHealthcare Rhody Health Partners ACA Adult Expansion

CMS Rating not applicable

Medicaid

The Affordable Care Act (ACA) expanded health coverage to certain adults age 19 or older and under 65.  The UnitedHealthcare Rhody Health Partners ACA Adult Expansion plan is for certain Adults aged 19-64 with no dependent children with an income at or below 133 percent Federal Poverty Level - You have to earn less than $15,654 per year or earn less than $1,305 per month and are a United States citizen or a legal permanent resident under 65 meeting income eligibility guidelines.

You are able to enjoy the many benefits and services that we have to offer, call us today to learn about all these benefits.  We will work with your doctors to give to you the quality of care you deserve.

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  • UnitedHealthcare Rhody Health Partners ACA Adult Expansion Steps to enroll

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Benefits & features

Member Handbook

Annual Notice of Change in Benefits

2018

Benefits Summary

Benefits

Listed below is a comprehensive list of professional health care services. Please review these services to find out which ones are covered by this health plan.

  • Inpatient Hospital Care
  • Outpatient Hospital Services
  • Physical Therapy
  • Language Therapy
  • Speech Therapy
  • Hearing Therapy
  • Respiratory Therapy
  • Physician Services
  • Family Planning Services
  • Prescription Drugs
  • Non-Prescription Drugs
  • Laboratory Services
  • Radiology Services
  • Diagnostic Services
  • Mental Health and Substance Abuse Outpatient
  • Mental Health and Substance Abuse Inpatient

* For further details, see the Rhody Health Partners Benefits Summary

In addition to the services listed above, all Rhody Health Partners Members will receive the following mental health and substance abuse services Out-of-Plan:

Mental Health

  • Psychiatric Rehabilitation Day Programs
  • Community Psychiatric Supportive Treatment
  • Crisis Intervention for individuals with SMPI enrolled in Community Psychiatric Supportive Services
  • Clinician's services delivered at a Community Mental Health Center for individuals with SPMI enrolled in CPST - CSP
  • RI-Assertive Community Treatment I and II

Substance Abuse

  • Community-based narcotic treatment
  • Community based detoxification
  • Residential Treatment

The following services are not covered by the Health Plan or Medicaid Fee for Service

  • Experimental Procedures
  • Abortion Services except to preserve the life of the women, or in cases of rape or incest
  • Private rooms in hospitals (unless medically necessary)
  • Cosmetic surgery
  • Infertility Treatment Services
  • Sexual and erectile dysfunction medications
  • Medical Assistance Program Fee Schedule

Waiver Services
If you are enrolled in a Medicaid Waiver you may have additional benefits available to you through Medicaid Fee for Service. UnitedHealthcare Care Managers at 1-800-672-2156 or Hard of Hearing 711 can help you access these services.

Other Member Programs

Optum Behavioral Health (OBH)
OptumHealth can help you find solutions that relieve the pressures and demands of everyday life. OptumHealth focuses on prevention and education to guard against problems before they start.

Member resources

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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.