Eligibility
UnitedHealthcare Community Plan for Families
UnitedHealthcare Community Plan has Facilitated Enrollers who are ready to help you enroll in a managed care plan. No matter which plan you select to receive your healthcare from, the eligibility criteria is the same.
You could be Eligible for UnitedHealthcare Community Plan for Families if you:
- Already have Medicaid and are not in an excluded category. Call us, we can tell you if you are eligible to enroll.
For more information, please visit the State of New York's Medicaid site.
After enrollment into UnitedHealthcare Community Plan for Families, You Could Be Ineligible for UnitedHealthcare Community Plan for Families if You:
- Move out of the county or service area
- Have a change in income that makes you ineligible for UnitedHealthcare Community Plan for Families
- Join an HMO or other insurance plan through work
- Receive Medicare coverage
- Join a Long-term Home Health Care Program
- Are incarcerated
- You turn 65 years of age
You are "guaranteed" coverage by UnitedHealthcare Community Plan for Families during the first six (6) months of your enrollment – even if you are no longer eligible for UnitedHealthcare Community Plan for Families. The reasons for your losing eligibility must not be related to death, moving out of state, or incarceration. During this time you can get the services that our plan covers. Guaranteed coverage does not apply if you choose to leave UnitedHealthcare Community Plan for Families.
We Can Ask You To Leave UnitedHealthcare Community Plan for Families if You:
- Refuse to work with your primary care provider in regard to your care
- Don’t follow UnitedHealthcare Community Plan for Families rules
- Do not fill out forms honestly or do not give true information (fraud)
- Cause abuse (verbal/physical) or harm to plan members, providers or staff
- Act unlawfully
- Act in ways that make it hard for us to do our best for you and other members even after we have tried to fix the problems