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If you have Medi-Cal benefits, your coverage will need to be renewed every year. The county will send you a Medi-Cal renewal form. Complete this form and return it to your local county human services agency. You can also visit or call your local human services agency. To find an office near you, visit the San Diego Health & Human Service Agency website.
If you lose Medi-Cal coverage, you may enroll in health insurance coverage through Covered California in the special-enrollment period due to a loss of coverage.
UnitedHealthcare Community Plan of California includes a range of benefits. Children, pregnant women, families, adults and seniors and people with disabilities may qualify based on income. View the benefits below to see what our plan covers.
Build a healthy future for you and your baby — and earn great rewards — through Healthy First Steps. This program helps keep you and your baby healthy during your pregnancy and your baby's first 15 months of life.
Healthy First Steps includes:
Do you have a serious health problem? If so, our case managers are in your corner. They will:
The care manager will stay with you throughout your medical journey. He or she will:
Each member can choose a primary care physician (PCP). Use the “Doctor Lookup” tool to see if your doctor is in our network.
Your PCP is your main doctor for:
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.
Diabetes Prevention Program is a covered benefit offered to our eligible members designed to assist in preventing or delaying the onset of Type 2 Diabetes by making lifestyle changes.
UnitedHealthcare Community Plan is pleased to offer a healthy lifestyle program at no cost to qualified members. The program can help you make small changes to live a healthy life, lose weight and lower your chance of developing type 2 diabetes.
To see if you qualify:
If you have chronic or high-risk illnesses, our disease management services are designed to support you.
We have special programs for:
Some members may need extra support to live safely at home.
Our plan covers medical equipment ordered by a member's doctor or care manager. This can include supplies like:
We provide the exams needed to help keep feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.
Our podiatry coverage includes:
UnitedHealthcare Community Plan of California covers Health Homes Program (HHP) services for Members with certain chronic health conditions. These services are to help coordinate physical health services, behavioral health services, and community-based long term services and supports (LTSS) for Members with chronic conditions.
You may be contacted if you qualify for the program. You can also call UnitedHealthcare Community Plan of California, or talk to your doctor or clinic staff, to find out if you can receive HHP services.
You may qualify for HHP if:
You do not qualify to receive HHP services if:
Covered HHP Services:
HHP will give you a care coordinator and care team that will work with you and your health care providers, such as your doctors, specialists, pharmacists, case managers, and others, to coordinate your care. UnitedHealthcare Community Plan of California provides HHP services, which include:
Cost to Member:
There is no cost to the Member for HHP services.
After surgery or a serious illness, you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. With approval from your doctor, our plan covers:
This plan pays for all expenses related to a hospital stay - the member will never be changed. Our plan covers:
And after leaving the hospital, you are not alone. We make sure the follow-up care is available to continue healing at home.
UnitedHealthcare offers services to help you talk with your doctor or other health care workers. You can get this service if you do not speak English or have hearing and speech barriers. You do not need a referral from your doctor to get these services.
Interpreter services are offered free of charge.
Knowing what’s wrong and finding it early can make all the difference. Our plan covers:
We’ll help you get the information needed to improve your health or be at your best.
You may be able to receive information in your preferred language or format, including Braille. Just ask. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language. All languages required by the State of California are covered, plus more.
Prescriptions and certain over-the-counter items are covered by our plan.
You may receive a prescription from a UnitedHealthcare doctor or specialist. You can fill your prescription at any UnitedHealthcare contracted pharmacy. Just show your State Benefit Identification Card (BIC) and your UnitedHealthcare Identification card to the pharmacy when you get your prescriptions filled.
We’re looking out for you. Our local member advocates can help solve problems, provide training and education, and work on issues that concern you.
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call. We’ll answer your questions simply and completely.
We can also help you find:
Just call 1-866-270-5785, TTY: 711 Monday - Friday, 7:00 am – 7:00 pm PT.
You pay nothing for covered services.
While your health care is low-cost or free, the care quality is high. You get:
UnitedHealthcare OMW™ (On My Way) is a mobile-friendly website aimed at helping young adults through the process of transitioning into adulthood. This interactive website also makes it fun to learn as you go. Register at www.uhcomw.com and begin the journey.
Mental Health is as important as physical health. That’s why we have coverage for both.
Mental Health Screening:
Outpatient Mental Health Services- Covered by UnitedHealthcare Community Plan of California:
Specialty Mental Health Services- Covered by County Mental Health Plan
Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide help with:
Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.
All recommended prenatal clinical visits and tests are covered by our plan.
At these visits, the clinic will:
Most people know the bad health effects of smoking. And they know they need to quit. We support our members to help them quit. The only thing they won’t get from us is a lecture.
Text4baby can help new and expecting mothers keep themselves and their babies healthy.
You’ll get text messages each week throughout your pregnancy and your baby’s first year. Each text contains health and safety tips for topics like:
Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.
Our plan covers limited visits for:
Rides can be scheduled at least 30 days in advance, and no later than 3 business days before your appointment. Scheduling your ride at least 3 business days in advance will help you to have the best experience. Urgent care and other urgent types of trips, like dialysis or chemotherapy, can be scheduled on the same day.
Members can get round trip transportation to and from health care locations as needed, including rides to:
Make sure your sight and hearing are at their best. Benefits include:
Well visits with your doctor can help keep you and your family healthy. These visits can catch health problems early, so they can be treated. Preventive services include:
To File a Complaint or Grievance, Download the GRIEVANCE FORM.
UnitedHealthcare Community Plan of California Medi-Cal
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