UnitedHealthcare Community Plan QUEST Integration is a managed care plan offered through Hawai‘i’s Department of Human Service Med-QUEST. UnitedHealthcare Community Plan is a health plan for members who are eligible for State-assisted Medicaid benefits. That includes pregnant women, children, adults, seniors, those who have special needs, and families. With UnitedHealthcare Community Plan QUEST Integration, you are on a better path to your health care.
Our primary goal is to help you stay healthy and independent. The UnitedHealthcare Community Plan QUEST Integration plan offers medical and behavioral health services including, vision, drug, and supplies. Call UnitedHealthcare Community Plan QUEST Integration today to find out more about how you can get skilled guidance and service coordination.
Our local staff will work with you to coordinate your services and specific needs. We will help guide you through the complex health care system and work with your doctors and family members to help you meet your health-related goals. UnitedHealthcare Community Plan is here for you, every step of the way.
UnitedHealthcare Community Plan has been doing care management for a long time.
Trust your family’s health with UnitedHealthcare Community Plan.
UnitedHealthcare Community & State, UnitedHealthcare Employee & Individual, and UnitedHealthcare Medicare & Retirement members covered under Medicaid, Medicare, and Part D prescription drug plans.
Due to Hurricane Flossie approaching Hawai‘i, UnitedHealthcare is authorizing a one-time override of the refill too soon (RTS) edit for members who reside in or may be visiting the following areas. These members may be in need of medication when traveling and mail delivery could be compromised.
This authorization should allow impacted UnitedHealthcare Community & State, UnitedHealthcare Employee & Individual, and UnitedHealthcare Medicare & Retirement members covered under Medicaid, Medicare, and Part D prescription drug plan to obtain early refills of their prescription medications if they have refills remaining on file at a participating retail or mail-order pharmacy.
This policy will be reinforced through the dates listed below, unless conditions continue to warrant.
|Line of Business||Response Type||Timeframe||Membership Type|
07/31/2019 – 08/14/2019
07/31/2019 – 08/14/2019
Fully Insured (including NIHPs) and ASO Business
|UHC M&R||Self-Identify||07/31/2019 – 08/14/2019||Fully Insured and ASO
If you should receive a call from a member impacted by this emergency, please follow the standard process for administering refills during a disaster. The OptumRx Help Desk is available to assist in this process should it be needed.
UnitedHealthcare Community Plan provides free aids and services to people with disabilities to communicate effectively with us, such as: written information in other formats (large print, audio, accessible electronic formats, other formats). If you need these services, contact us toll-free at 1-888-980-8728 (TTY: 711). We will provide you with the requested information, at no cost to you within five (5) business days.
This plan is available in all counties.
If you have diabetes, we'll make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best.
Some members may need extra support to live safely at home.
Our plan covers medical equipment ordered by your child's doctor or case manager. This can include supplies like:
An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.
You can earn great gifts for you or your child by doing things like:
Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.
After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:
Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.
We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.
Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.
Our plan includes:
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 can get information in another language. Just ask. This is provided at no cost to you.
We're looking out for you. Member advocates can help solve problems, provide training and education, and work on issues that concern members.
Mental health is as important as physical health. That's why we have coverage for both.
Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.
Our nurses will:
Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:
Healthy eating goes a long way to helping you stay at your best. A nutritionist can meet with you to review your eating habits and food choices.
You'll come away with new ideas for:
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 help improve your health or be your best.
Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:
A pregnancy is a journey that’s better 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 while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture.
After a serious illness, surgery or injury you may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:
Do you have family members or friends who care for you at home?
If so, we want to support their hard work too. That's why we provide respite care to give your caregivers a rest. Respite care offers caregivers time away from their loved one who is ill or has special care needs.
Routine shots help protect you from illness.
So, our plan covers:
Many communities offer additional benefits for children in this plan. Social Services helps members connect to these local programs and services, such as:
Speech therapy visits and exercises can help those who have difficulty speaking.
Prior authorization needed except for physical, occupational, or speech therapy.
Text4baby can help new and expecting mothers keep themselves and their babies healthy.
You'll get text messages throughout your pregnancy and your baby's first year. Each text contains health and safety tips for topics like:
So you and your baby can make a great start on life.
Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.
Our plan provides:
There may be times when your or a family member’s health requires repeated visits to a primary care provider (PCP). Our plan does not limit the number the number of times you can see your PCP. This way you get care need when you need it. And your doctor can see how your health is progressing.
You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:
Well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated. Preventive services include:
There are no copayments for preventive care.
UnitedHealthcare Community Plan QUEST Integration Program
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