Companionship is important. Adult day care provides care and companionship for seniors who need extra help during the day. Caregivers also benefit, knowing their loved one is safe when they can't provide care.
Adult day care can provide:
Social connections and friendship.
Bathing and personal care.
Asthma and Allergies 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 help:
Live an active life.
We provide a case management to help members who need extra care. A case manager ensures the needed care and services are provided to help improve the member's health.
The case manager:
Understands the member's health and personal care needs.
Creates a care plan to match the member's health care needs.
Coordinates care among the specialists and the primary care doctor (PCP).
Arranges for care and services after the member leaves the hospital.
Choice of Doctor
Each member can choose a primary care physician (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.
The PCP is the main doctor for:
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.
Members Age 20 and younger:
Covered by Delaware Medicaid.
Please call 1-800-372-2022 for more information.
Children covered by Medicaid (age 0 up to 21st birthday).
Children covered by the Delaware Healthy Children Program (age 0 up to 19th birthday).
Members Age 21 and older:
Covered by UnitedHealthcare.
One cleaning (prophylaxis) and one periodic evaluation per year, one full mouth series x-ray per three years, removal of bony impacted wisdom teeth.
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.
Living a healthy lifestyle.
Emergency Response System
If you are at risk for a fall or sudden illness, an emergency call system can really help. It sends an urgent request for someone to check on you and help you.
Equipment and Supplies
Your health and safety at home are important.
Our plan covers medical equipment and supplies ordered by your doctor or case manager. This can include supplies like:
Walkers or wheelchairs.
Free classes to help improve your health or to address a condition.
Our plan includes classes on diabetes, nutrition and more.
Members who have diabetes are eligible to earn gift cards by:
Trouble hearing can affect everyday life in many ways. Our plan includes services and support to help members with their hearing.
Covered services include:
Exams, therapy and tests.
Hearing aids and batteries for members aged 20 and younger.
Home Meal Delivery
Good nutrition is essential to good health. Yet you may not be able to safely fix meals for yourself at home. So we'll arrange for home meal delivery.
This plan covers pays for all expenses related to a hospital stay, so you can rest and heal.
Hospitalization coverage includes:
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 at home.
Many of our members are living with a long-term health condition or disability. Others are coming out of the hospital after surgery or a serious illness. These members can receive extra support from our plan.
With approval, our plan covers:
An in-home medical visit.
Medical equipment like hospital beds, walkers or wheelchairs.
Help with day-to-day tasks like cleaning, cooking or dressing.
Disposable medical supplies.
Help with personal care or housekeeping.
Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.
We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.
Kidney Disease Care
Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do. Our plan includes:
Health education and support.
Organ transplant if needed.
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 you get the information needed to improve your health or be at your best.
You can receive information in your preferred language. Just ask. We also have people at member services who speak more than one language. Chances are, we have someone who speaks your language.
We're looking out for you. Member advocates can help solve problems, provide training and education, and work on issues that concern members.
Provide information about your plan.
Teach you to get the care you need.
Help with doctor issues or complaints.
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call and count on. We'll answer your questions simply and completely.
We can also help you find:
Home care providers.
Dentists and vision providers.
Adult day health centers.
Mental health is as important as physical health. That's why we have coverage for both.
Required care is 100% covered with no copay. This includes:
Substance abuse treatment
You will not have a copayment for care and services covered by our plan.
Care you receive from doctors.
Treatments at respected hospitals and clinics.
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.
Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury.
In these cases, a nurse will make home visits to:
Provide medical care.
Answer any questions and concerns.
Sometimes the basics are hard to do yourself after an illness or injury.
If needed, we provide someone to help with:
Covered Services Include
Insulin and diabetic supplies.
Smoking cessation agents, including OTC products.
Emergency contraception (6 per calendar year).
A pharmacy copayment may be required for some people, for some medications and pharmacy items.
There are no copays for the following members or services:
Consumers younger than 21 years old.
Consumers who are pregnant. Pregnant women are exempt during pregnancy and for the two months after the month in which the pregnancy ends.
Family Planning drugs and supplies like birth control pills.
Consumers eligible under the long term care nursing facility group or the acute care hospital group.