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AmeriHealth Caritas Members Transitioning to Community Plan

Starting Dec. 1, 2017, UnitedHealthcare Community Plan will begin servicing IA Health Link members who were previously managed by AmeriHealth Caritas. If a member doesn’t present their new UnitedHealthcare Community Plan member ID card, please verify eligibility using their Medicaid State ID number. You may verify by calling the Eligibility and Verification Information System (ELVS) at 800-338-7752 or by signing in to their web portal here. You may also call UnitedHealthcare’s Provider Services at 888-650-3462. More information about the transition can be viewed on our Bulletins page. You can also use our tool for looking up in-network providers.

Please select the state where you practice.

Dual Complete (HMO-SNP) Program 



Effective January 1, 2018, UnitedHealthcare Community Plan of Iowa launches a new Dual Special Needs Plan (DSNP) – UnitedHealthcare Dual Complete (HMO-SNP), a Medicare Advantage program, in the following counties: Dallas, Jasper, Madison, Marshall, Polk, Story, Warren.

This is a Medicare Advantage plan for members who qualify for both Medicare and Medicaid. DSNPs are a specialized type of Medicare Advantage Prescription Drug Plan (MAPD) and must follow existing Centers for Medicare & Medicaid Services (CMS) rules. DSNPs must:

  • Adhere to required MAPD benefits

  • Limit enrollment to Medicaid recipients (dually eligible –

  • Medicare and Medicaid),

  • Provide Part D benefits, and

  • Offer targeted clinical programs, benefits, and services.

This web page is dedicated to information specific to the Dual Complete Medicare Advantage program. Look here for provider resources including the Administrative Guide, quick reference guide, provider directory, policies and news related to the Dual Compete Medicare Advantage program.

 

Resources

UHC On Air (PDF 263.27 KB)

Search for a Care Provider – Dual Complete Medicare Advantage Provider Directory 

Dual Complete Medicare Advantage Pharmacy Formulary

 

Documents

Administrative Guide

Dual Complete Medicare Advantage Quick Reference Guide  (PDF 273.92 KB)

Dual Complete Medicare Advantage Frequently Asked Questions (PDF 139.35 KB)

Understanding Iowa Dual Complete Medicare Advantage 
(PDF 264.27 KB)

 

Coverage Summaries and Reimbursement Policies

UnitedHealthcare Medicare Advantage Coverage Summaries

UnitedHealthcare Medicare Advantage Reimbursement Policies

Additional Medicare Advantage Policies

Medicare Advantage Prior Authorization Protocols

 

Link and UHCProvider.com

Use Link to perform secure transactions such as checking member eligibility and benefits, managing claims and requesting prior authorization. To sign in to Link, go to UHCprovider.com and click on the Link button in the top right corner. If you don’t aren’t registered yet, go to UHCprovider.com and select “New User” to begin registration.

To learn more about using Link, please visit UHCprovider.com/Link.