As of January 1st, 2018 UnitedHealthcare Community Plan will no longer provide Medicaid and Long Term Care coverage in Delaware.   For questions about 2018 services, members can call their new Health Plan Member Service’s phone number, it is on their ID card. If members have questions related to any services prior to January 1, 2018, members can call United Healthcare Community Plan member services at 1-877-877-8159

This change doesn’t affect UnitedHealthcare Medicare, including Institutional Special Needs Plan (I-SNP) and Dual Complete Plan (DSNP) or UnitedHealthcare Commercial Plan members.

Healthcare Providers can continue to call Provider Services at 1-800-600-9007.  For questions regarding behavioral health, please call 1-877-614-0484.  For questions regarding Dental, please call 1-855-609-5152.

Please select the state where you practice.

Clinical Practice Guidelines 

 

When these medical policies are used to determine medical necessity, clinical guidelines will be applied in the following order:

1) State Medical Policies
2) UnitedHealthcare Medical Policies
3) Milliman Care Guidelines

UnitedHealthcare has developed Medical Policies, Drug Policies, and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.

View state medical policies below.
UnitedHealthcare Medical Policies are viewable here.
Medicare Medical Policies are viewable here.

 

Clinical Practice Guidelines

UnitedHealthcare Community Plan has compiled a list of evidence-based clinical guidelines, and the websites where they can be found, for our quality and health management programs.

We respect the expertise of the physicians and other health care professionals in our network and appreciate your help as we work together to offer our members better quality, better health outcomes and better cost.

If you have questions, please contact your Physician Advocate or call the number on the back of the member’s ID card.

View the Clinical Practice Guidelines (PDF 134.51 KB). 

Provider Advisory Committee Approval - July 27, 2017