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UnitedHealthcare Community Plan of Virginia - Cardinal Care

NCQA Star Rating 4 out of 5 stars.

Medicaid

Keeping our families healthy is a top priority for UnitedHealthcare. UnitedHealthcare works with the State of Virginia to provide high-quality health care coverage. Our Cardinal Care Medicaid plan covers eligible families, pregnant women, infants, children and adults. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs.

UnitedHealthcare Community Plan of Virginia offers a range of benefits along with extras that other plans don’t cover. 

 

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Find medications covered by this plan.

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Benefits & features

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Preventive and routine care

Get the care you need to stay healthy — or to get better if you are injured or sick. Member benefits include: 

  • Choice of Doctor.  Find a doctor you trust in our network. 
  • Hospitalization.  You pay nothing for care in a hospital. 
  • Lab and X-rays.  Lab tests, x-rays and diagnostic imaging are covered. 
  • Medicines.  Fill prescriptions at local pharmacies. 
  • No Copays.  There are no copays for covered drugs. 
  • NurseLine.  Speak with a registered nurse 24/7. 
  • Pregnancy Care.  Extra care and support for both you and your baby. 
  • Shots and Vaccines.  Routine shots to help protect against illness. 
  • Therapies.  Physical or other therapy to help you be your best. 
  • Transportation.  We pay for rides to and from medical visits and the pharmacy. 
  • Virtual Care/UHC Doctor Chat. Chat with a doctor 24/7.  
  • Vision Care.  Covers eye exams and glasses every two years. Members under 20 may qualify for glasses every year. 
  • Well Visits.  Annual physical exams, checkups, shots and lab tests. 
  • Unlimited Doctor Visits.  See your doctor as often as needed. 
  • Urgent Care.  Convenient care for a sudden illness or injury. 

It’s not always easy to visit a doctor in person. Virtual visits (or telehealth) let you talk to a doctor 24/7 using your computer, tablet or smartphone. Telehealth is a good option to treat common conditions that have standard treatments. Here are some examples:

  • Cold, flu, and fever
  • Cough, aches, and sore throat
  • Allergies, skin rash, and irritation
  • Urinary tract/bladder infection
  • Ear infections
  • Sinus infections
  • Migraine/headache
  • And more

To download the app, search for “UHC Doctor Chat” on the App Store® or Google Play®, or visit www.uhcdoctorchat.com.

Mental health is as important as physical health. That's why we have coverage for both.  This includes:  

  • Comprehensive evaluation and assessment services 
  • Mental health, addiction, and recovery treatment 
  • Medication management 
  • Person-centered care planning and coordination 
  • You or a loved one may experience a mental health crisis and need extra support.  Benefits include: 
    • Short-term crisis response programs 
    • Referral and linkage to other community-based services 
    • Mental health case management 
  • Your child may also benefit from specialized care.  Services for qualifying members include:  
    • Home-based or community-based assessment and treatment 
    • Treatment foster care case management 
    • Therapeutic day treatment 
    • Residential treatment and therapeutic group homes 

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

Earn great gifts for you or your child by doing things like:

  • Completing well-child exams
  • Getting lab tests
  • Recording the family's health activities

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

  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • NurseLine℠ Call our nurses for advice 24/7.
  • Interpreters. An interpreter can go with you to medical visits.
  • Language Help. Translated medical materials are available at no cost.
  • Member Services. Your benefit questions are answered 24/7.

Below are a few additional benefits and services. Our full list can be found here.  English | Español

  • One Pass Fitness - Unlimited access for members age 18 and up to 300+ gyms and Premium YMCAs in Virginia over 20,000 digital on-demand and livestream classes
  • Sticks for Kicks Plus! - Vaccine incentives up to $50 at Footlocker or Walmart for members up to age 18
  • Pregnancy Support - Up to $100 in gift card rewards, connections to helpful information and community services, and extra support during and after pregnancy
  • Home meals delivered - 14 free meals conveniently delivered to a member's home after a hospital stay
  • Mental health support (AbleTo) - The #1 app for stress, anxiety and depression, with over 3.5 million users.
  • WW (Weight Watchers) vouchers - Attend 13 Weight Watchers meetings per year for qualified members ages 18 and up - at no cost
  • Housing transition assistance - $40 gift cards to reimburse housing application fees 
  • Routine vision - 1 routine eye exam every year for ages 20 and under; 1 routine eye exam every 2 years for ages 21+
  • Menstrual supplies - Eligible members ages 11–49 can receive free period- absorbing underwear
  • Rides to non-medical sites - Get round-trip rides to places of worship, grocery stores, public libraries, gym/fitness centers and other approved locations (12 round-trip rides per year)
  • GED support - GED support Study plans, online testing and free 24/7 tutoring for members who want to get a diploma
  • Boys & Girls Club - Registration/membership at no cost for members up to age 18; excludes summer camp
  • Smartphone - Free smartphone with unlimited minutes and texts, plus 10 GB of free mobile hotspot data
  • Asthma Support - Free hypoallergenic mattress cover and pillowcase for members with asthma

AbleTo

Interactive phone application to help manage stress, anxiety, and depression. For enrollment information please visit the AbleTo website.

Boys and Girls Club

Free registration fee at a participating Boys and Girls Club of America.

  • For all school-aged members between the ages of 5 and 18
  • Present your United ID card at the time of registration

Call Member Services for participating clubs.

Care manager

Care management, as needed

  • If you have significant health care needs, you will receive care management. Care management helps to improve the coordination between your different providers and the services you receive.
  • A care manager is someone from UnitedHealthcare Community Plan with special health care expertise who works closely with you, your providers, family members, and other people in your life to understand and support your needs and goals.

Chiropractic services

We cover chiropractic services for Medicaid members under age 21 when medically necessary. Members over age 21 can get up to six visits a year with an in-network chiropractor.

Choice of doctor

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

Your PCP is your main doctor for:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

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.
 

Dental care

Dental care is managed by DMAS. The Dental Benefits Administrator, DentaQuest, provides dental services for adults and children. For more information, call Member Services at 1-844-368-7151, and say "Dental" when prompted or visit  dmas.virginia.gov/dental

Diabetes care

If you have diabetes, we'll help 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

Eye care

Your vision and eye care is important. Vision care covers eye exams and glasses every two years. Members under 20 may qualify for glasses every year.

Visit March Vision or call 855-476-2724 for more information.

Free round-trip rides (social trips)

We offer round trips rides at no cost to you to places of worship, gyms, Department of Motor Vehicles, grocery stores, and Medicaid eligibility offices.

Free smartphone

Free smartphone with unlimited minutes and texts; 10 GB of free mobile hotspot data

Hospitalization

Our plan covers:

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

And after leaving the hospital, a member is not alone. We make sure the follow-up care is available to continue healing at home. We offer up to 14 free meals after your hospital stay.

Member services

Sometimes you might need a little help understanding your health care options. You can call Member Services at 1-844-368-7151, Monday – Friday, 8 am - 8 pm, local time. We will be happy to help.
 

No copays

There are no copayments for:

  • Preventive care
  • Annual checkups

There is never a copayment for prescription drugs, medical, or vision care.

While your family’s health care is low-cost or free, the care quality is high. You get:

  • Visits to doctors in our network
  • Treatments at hospitals and clinics
  • Prescription drugs and over-the-counter medicines
     

Nurse hotline

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-877-440-9407 (TTY 711).

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.

OnePass fitness benefit

Free access to 300+ gyms/local YMCAs and over 14,000 virtual fitness options for members age 18+

Pregnancy care

  • Choice of doctors.  Find a doctor or 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. 
  • Community Doulas.  Community Doulas are community based and offer emotional, physical and informational support services to pregnant women throughout their pregnancy, at labor and delivery and after delivery.  You just need a referral from a provider. 
  • Text4baby.  Receive text messages with helpful tips and reminders. 

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.

Transportation

Whether you live in the city or in the country, rides are available. Our plan provides up to 12 round trips to and from plan locations. This includes trips to and from the pharmacy to fill your prescriptions.

Member resources

Below you'll find helpful information about UnitedHealthcare Community Plan of Virginia - Cardinal Care. We want to help you get the most from your health plan. 

Member resources (opens modal window)

Enrollment information

UnitedHealthcare Community Plan of Virginia - Cardinal Care plan specialists can answer questions.

Call us:
1-844-752-9434 / TTY: 711

8 am to 8 pm, local time, Monday - Friday

Enroll in plan (Opens in a New Tab)
Get the details

Visit the Virginia Department of Medical Assistance Services (DMAS) site or on the DMAS' broker site for more information on eligibility and enrollment.

Virginia Department of Medical Assistance Services (DMAS)

Virginia DMAS Enrollment Site for Brokers

Member information

Already a member of UnitedHealthcare Community Plan of Virginia - Cardinal Care? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Member website 

Do you have other format needs?

Call us today to let us know if you need information in a different format. We offer our materials in other languages, large print, audio files, and Braille at no charge. Call the Member Services number on the back of your card. We will send it to you within five (5) business days at no charge. 

 


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: 10.18.2024 at 09:45 AM CDT

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.