California – UnitedHealthcare Community Plan of California – Medi-Cal Plan - Glossary of Health Care Terms - UnitedHealthcare Community Plan

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UnitedHealthcare Community Plan of California – Medi-Cal

Glossary

 

A

Advance Directive - A decision about your health care that you make ahead of time in case you are ever unable to speak for yourself. This will let your family and your doctors know what decisions you would make if you were able to.

Authorization - An O.K. or approval for a service.

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B

Benefits - Services, procedures and medications that UnitedHealthcare Health Link will cover for you.

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C

Clinical Care Management - One-on-one help by a nurse providing education and coordination of UnitedHealthcare Health Link benefits, tailored to your needs.

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D

Disenrollment - To stop your membership in UnitedHealthcare Health Link.

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E

Emergency - When you reasonably believe that your health is in serious danger or you are in a life threatening situation.

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F

Federal Poverty Level (FPL) - Poverty income thresholds by family size that are annually updated by the Census Bureau.

Fraud - An untruthful act – an example is someone other than you using your UnitedHealthcare Health Link member ID card and pretending to be you.

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G

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H

Home Health Agency - A company hired by UnitedHealthcare to provide care for you in your home.

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I

ID card - Identification card – a card that says you are a UnitedHealthcare Community Plan of California member. You should have this card and the BIC with you at all times.

Informed Consent - You agree to all medical treatments.

Inpatient - When you are admitted into a hospital for a length of time.

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J

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K

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L

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M

Medical Necessity - Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.

Member - A person who is eligible for UnitedHealthcare Community Plan of California.

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N

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O

Outpatient - When you have a procedure done that does not require a hospital stay overnight.

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P

Provider - Any medical professional that UnitedHealthcare has contracted with to take care of you.

Provider Directory - A list of providers who participate with UnitedHealthcare to help take care of your health care needs.

Primary Care Physician (PCP) - A doctor you choose to be your family physician. They have their own private practices or work at Federally Qualified Health Centers and local clinics.

Prior Authorization - The process for any service that needs an O.K. from UnitedHealthcare before it can take place.

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Q

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R

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S

Special Needs Unit (SNU) - A voluntary service offered by UnitedHealthcare that can give you extra help in understanding and using your benefits if you have a disability or other special need.

Specialist - A doctor that has specific, detailed training in one certain medical field.

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T

Treatment - The care that you may receive from doctors and facilities.

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U

Urgent care - When you need care, treatment or medical advice within a 24-hour time period.

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V

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W

WIC - Women, Infants and Children program, a supplemental nutrition program that provides nutritious food, education support and health care referrals for women, infants and children.

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X

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Y

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Z

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UnitedHealthcare Community Plan of California – Medi-Cal