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UnitedHealthcare Community Plan
UnitedHealthcare Community Plan

UnitedHealthcare Community Plan

Member Information

Important Information and Disclosures

Information about Renewing Your Coverage

Washington Apple Health 

Have you received information asking you to take action so that you can keep getting benefits?

We’re here to help you.

Call us toll-free at

1-866-686-9323, TTY 711.

Don’t let your health care coverage end. It’s too important.

You can also renew by contacting the Washington Health Benefits Exchange.

Online: wahealthplanfinder.org

Or call: 1-855-923-4633, TTY/TDD 1-855-627-9604.

Member Newsletters

Spring  2016 (English) (PDF 2.02 MB)
Spring  2016 (Russian) (PDF 2.02 MB)
Spring  2016 (Traditional Chinese) (PDF 4.39 MB)
Spring  2016 (Espanol) (PDF 720.53 KB)
Spring  2016 (Vietnamese) (PDF 2.06 MB)


Winter 2016 (Arabic) (PDF 1.91 MB)
Winter 2016 (English) (PDF 447.2 KB)
Winter 2016 (Russian) (PDF 879.26 KB)
Winter 2016 (Traditional Chinese) (PDF 2.28 MB)
Winter 2016 (Espanol) (PDF 483.24 KB)
Winter 2016 (Vietnamese) (PDF 499.31 KB)

Fall 2015 (Arabic)
(PDF 3.6 MB)
Fall 2015 (English) (PDF 2.01 MB)
Fall 2015 (Russian) (PDF 2 MB)
Fall 2015 (Traditional Chinese) (PDF 3.56 MB)
Fall 2015 Espanol) (PDF 474.73 KB)
Fall 2015 (Vietnamese) (PDF 1.98 MB)


Summer 2015 (PDF 1.92 MB) (Arabic)
Summer 2015 (PDF 687.12 KB) (English)
Summer 2015 (PDF 726.93 KB) (Russian)
Summer 2015 (PDF 2.38 MB) (Chinese)
Summer 2015 (PDF 675.09 KB) (Spanish)
Summer 2015 (PDF 724.74 KB) (Vietnamese)

Spring 2015 + Insert (PDF 3.62 MB) (Arabic)
Spring 2015 + Insert (PDF 1.32 MB) (English)
Spring 2015 + Insert (PDF 1.4 MB) (Russian)
Spring 2015 + Insert (PDF 4.66 MB) (Chinese)
Spring 2015 + Insert (PDF 1.31 MB) (Spanish)
Spring 2015 + Insert (PDF 1.34 MB) (Vietnamese)

Winter 2015 (Arabic) (PDF 1.94 MB) 
Winter 2015 (English) (PDF 654.92 KB) 
Winter 2015 (Russian) (PDF 686.7 KB) 
Winter 2015 (Chinese) (PDF 2.45 MB) 
Winter 2015 (Spanish) (PDF 635.81 KB) 
Winter 2015 (Vietnamese) (PDF 695.96 KB)

Fall 2014 (Arabic) (PDF 3.38 MB)
Fall 2014 (English) (PDF 2.15 MB)
Fall 2014 (Russian) (PDF 2.05 MB)
Fall 2014 (Chinese) (PDF 3.61 MB)
Fall 2014 (Spanish (PDF 2.05 MB))
Fall 2014 (Vietnamese) (PDF 2.09 MB)
Summer 2014 (Arabic) (PDF 3.04 MB)
Summer 2014 (English) (PDF 1.03 MB)
Summer 2014 (Russian) (PDF 1 MB)
Summer 2014 (Somali) (PDF 985.23 KB)
Summer 2014 (Spanish) (PDF 905.87 KB)
Summer 2014 (Vietnamese) (PDF 1.09 MB)
Spring 2014 (Arabic) (PDF 2.01 MB)
Spring 2014 (English) (PDF 681.89 KB) 
Spring 2014 (Russian (PDF 810.81 KB)) 
Spring 2014 (Somali)  (PDF 773.64 KB)
Spring 2014 (Spanish)  (PDF 604.56 KB)
Spring 2014 (Vietnamese) (PDF 829.7 KB)
Winter 2014 (Arabic) (PDF 2.06 MB)
Winter 2014 (English) (PDF 705.69 KB)
Winter 2014 (Russian) (PDF 822.1 KB)
Winter 2014 (Somali) (PDF 779.43 KB)
Winter 2014 (Spanish) (PDF 560.41 KB)
Winter 2014 (Vietnamese) (PDF 802.36 KB)

Fall 2013 (Arabic)
(PDF 2.09 MB)
Fall 2013 (English) (PDF 801.62 KB)
Fall 2013 (Russian) (PDF 1.1 MB)
Fall 2013 (Somali) (PDF 948.79 KB)
Fall 2013 (Spanish) (PDF 647.61 KB)
Fall 2013 (Vietnamese) (PDF 1.14 MB)
Summer 2013 (Arabic) (PDF 1.53 MB)
Summer 2013 (English) (PDF 815.93 KB)
Summer 2013 (Russian) (PDF 2.02 MB)
Summer 2013 (Somali) (PDF 845.69 KB)
Summer 2013 (Spanish) (PDF 1,018.33 KB)
Summer 2013 (Vietnamese) (PDF 1.96 MB)
Spring 2013 (English) (PDF 536.05 KB)
Spring 2013 (Español) (PDF 511.58 KB)
Spring 2013 (Russian) (PDF 2.59 MB)
Spring 2013 (Vietnamese) (PDF 2.43 MB)
Spring 2013 (Somali) (PDF 635.42 KB)
Spring (Chinese) (PDF 1.99 MB)

Advance Directives
How To Contact Us

If you have questions about your health plan, please call us. Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).
There will be people who can speak to you 24 hours a day, 7 days a week in English, Spanish and Vietnamese when you call.

Clinical Practice Guidelines

Posted June 16, 2015

UnitedHealthcare Community Plan has practice guidelines that help providers make healthcare decisions. These guidelines come from nationally recognized sources. UnitedHealthcare Community Plan has practice guidelines for conditions including:

· Asthma

· Attention deficit hyperactivity disorder (ADHD)

· Bipolar disorder

· Chronic obstructive pulmonary disease (COPD)

· Depression

· Diabetes

· Heart disease

· Heart failure

· High blood pressure

· Obesity

· Prenatal care

· Pediatric preventive healthcare

· Substance abuse disorders

· Transplants

Click here (PDF 211.79 KB) to view the entire list of guidelines or call our Member Services at 1-877-542-8997 (TTY: 711) to request a printed copy.


Medical Assessment Technology Committee Approval May 7, 2015

CMO Approval of web links June 16, 2015.

Notice of Privacy Practices

We have a Notice of Privacy Practices that tells you how health information about you may be used and shared. We are required by law to let you know that the Notice is available, and how you can get a copy of it. View a copy of our Notice of Privacy Practices

Your Rights and Responsibilities

You have certain rights and responsibilities when you enroll. It is important that you fully understand both your rights and your responsibilities. For detailed information about your rights and responsibilities download here in English (PDF 172.36 KB) or  Español (PDF 560.3 KB).

Filing a Grievance

If you are not happy with the service UnitedHealthcare Community Plan has provided, you can file a grievance. Download Grievance and Appeals in English (PDF 213.54 KB) or Español. (PDF 157.69 KB)

Conversion Rights

Members have the right to obtain a conversion agreement to continue health and medical benefits upon termination of Medicaid eligibility.

If you have questions or to obtain a conversion agreement, please call us. Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).

Medical Prior Authorizations 

We require prior authorization on all out-of-network referrals. The request is generally processed like any other authorization request. The nurse reviews the request for medical necessity and/or service. If the case does not meet criteria, the nurse routes the case to the Medical Director for review and determination. Out-of-network referrals are generally approved for, but not limited, to the following circumstances:

  • Continuity of care issues
  • Necessary services are not available within network.

Out-of-network referrals are monitored on an individual basis. Trends related to individual physicians or geographical locations are reported to Network Management for review.

To find out if a prior authorization request has been approved, check with your provider or call member services, at 1-877-542-8997 (TTY: 711). If the prior authorization request is denied, you will be notified in writing, including your right to appeal this decision.

Member Advisory Counsel

We have a Member Advisory Council and it gives members a chance to share their thoughts and ideas with us. The council members will be able to provide feedback on the way we deliver services, discuss any concerns, and hear about upcoming programs. A parent, foster parent or guardian of a member may also participate.

If you are interested in learning more, please call us toll-free, at 1-877-542-8997.  If you are hearing or speech impaired, please call TTY: 711.

Translation Resources

UnitedHealthcare Community Plan provides member materials to you in a language or format that makes it easier for you to understand. Our provider network includes many doctors who are multilingual. Our provider directory shows which languages doctors speak. Additionally, many of our Member Services representatives speak multiple languages, so when you call they will be able to help you or connect you with our interpreter service which covers more than 170 languages.

If you have trouble hearing over the phone you can use a text telephone. This free service allows persons with hearing or speech disabilities to place and receive telephone calls. Call 711, give them the Member Services number 1-877-542-8997, and they will connect you to us. You can also get information in large print, Braille or audio tapes.

Our toll-free Member Services number is 1-877-542-8997 (TTY: 711).

Forms

Pharmacy Direct Member Reimbursement Form (PDF 90.88 KB)

Authorized Representative  
Click here (PDF 39.25 KB) for the Appointment of Authorized Representative Form. This form lets a UnitedHealthcare Community Plan member choose someone to help or act on their behalf.

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Questions?

Ready to get started?

Call Us:
1-877-542-8997
TTY: 711

M-F 8-5 PST

Lookup Tools

Doctor Lookup

Search for doctors, hospitals, behavioral health and other specialists.

Download Directories
Behavioral Health Lookup

Search for behavioral health providers and resources.

View Drug List

Find medications covered by this plan.

Pharmacy Lookup

Find a pharmacy near you.

Vision Center Lookup

Search for a vision center.

Dentist Lookup

For more information on your covered dental benefits contact:

Health Care Authority/ProviderOne

1-800-562-3022

To find a provider that takes Apple Health visit fortress.wa.gov

Member Information

Member Website

Already a member? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Medical Benefits Book

More Resources

Member Page

View more news, updates and resources for members.

Member Information

Member Website

Already a member? You have access to our member-only website. Print ID cards, chat with a nurse online, and more.

Member Benefits Book