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Kentucky Medicaid Plan Lookup Tools

As a member of UnitedHealthcare Community Plan, one of the first things you will want to do is to choose a Primary Care Provider (PCP). Your PCP will provide and coordinate all your healthcare, including referrals to specialists. If you need special care that your PCP can’t give, he or she will help you find a specialist. If you do not choose a PCP, we will select one for you, which you can change later.

In addition one of our behavioral health providers will take care of your mental health and drug and alcohol treatment needs. If you need counseling, testing or need to see a behavioral health specialist, we will coordinate your behavioral health care needs.

Provider Directories

Please feel free to call our Member Services line, at 1-866-293-1796 (TTY: 711) and we will be happy to help you find or change your PCP.

To find a PCP or a Specialist in our network, please visit these online directories for complete information, including names, addresses, specialties, new patient’s availability and languages spoken. If you would like us to provide you with a printed version at no cost, please call us, at 1-866-293-1796 (TTY: 711).

Search for a Provider (Opens in a New Tab)

Emergency and Urgent Care

The Emergency and Urgent Care List tells you what a real emergency is and provides a list of many urgent care centers that you can use. You can use these centers when you are sick or need medical care right away and your PCP is not available, but it's not a life-threatening situation. Urgent care centers are usually open in the evenings and on weekends.

Emergency rooms (ERs) are for major injuries or sudden sicknesses that may be life threatening and need medical care right away. In an emergency, you should call 911 or go to an ER immediately.

Behavioral health care includes mental health (your emotional, psychological, and social well-being) and substance (alcohol and drugs) use disorder treatment and rehabilitation services. All members have access to services to help with mental health issues like depression or anxiety, or to help with alcohol or other substance use disorders.

Talk to your PCP today about any health or behavioral health problems you have. Your PCP will refer you to a behavioral health provider with UnitedHealthcare Community Plan. They can refer you to specialists, and other facilities, such as hospitals and substance abuse and treatment services.

There are some treatments and services that need preapproval before you can get them. To learn more, talk to your doctor.

Search for a Behavioral Health Provider

Required care is 100% covered. If you need behavioral health care, your PCP and UnitedHealthcare Community Plan can help coordinate your care.

We cover:

  • Behavioral Health Services
  • Services to help figure out if you have a mental health need (diagnostic assessment services)
  • Individual, group and family therapy 
  • Mobile crisis management services 
  • Facility-based crisis programs 
  • Specialized behavioral health services for children with autism 
  • Outpatient behavioral health services 
  • Outpatient behavioral health emergency room services 
  • Inpatient behavioral health services 
  • Research-based intensive behavioral health treatment 
  • Partial hospitalization 
  • Other Supportive Services such as: Peer Supports, Comprehensive Community Supports and Targeted Case Management

Substance Use Disorder Services

  • Outpatient opioid treatment
  • Outpatient withdrawal management
  • Non-hospital medical withdrawal management
  • Alcohol and drug abuse treatment center withdrawal management crisis stabilization
  • Peer Support Services and Targeted Case Management

Additional health resources can be found at [link to liveandworkwell.com/ky] Find the balance, support and care you need to live the healthiest life possible.

If you believe you need access to more intensive behavioral health services that UnitedHealthcare Community Plan of Kentucky does not provide, talk with your PCP or call Member Services 1-866-293-1796.

Member Handbook

Search for drugs covered by UnitedHealthcare Community Plan (Opens in a New Tab)

The UnitedHealthcare Community Plan Preferred Drug List (PDL) is a list of covered prescription drugs, and drugs needing prior authorization for enrollees in Kentucky Medicaid. Prior authorization is when your doctor has to call us before giving you the prescription to see if we will cover it.

Preferred Drug List for Kentucky Medicaid

Direct Member Reimbursement (DMR) Form

Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call 1-800-905-8671 TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Nurseline Disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.

UnitedHealthcare Connected™ for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) information, please contact our Member Services at 1-844-445-8328 (TTY 711) from 7 a.m. to 8 p.m. Monday through Friday (voice mail available 24 hours a day/7 days a week) for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare® Connected™ de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-844-445-8328 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana).

UnitedHealthcare Connected™ (Medicare-Medicaid Plan)

UnitedHealthcare Connected (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected Benefit Disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

UnitedHealthcare Senior Care Options (HMO SNP) Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Availability of Non-English Disclaimer

ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 1-800-905-8671 TTY 711.

ATENCIÓN: Si habla [ingrese el idioma], hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Llame al 1-800-905-8671 TTY 711.

Star Ratings Disclaimer

Medicare evaluates plans based on a 5-Star rating system.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

NCQA

UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connected’s Model of Care.

Important Provider Information

The Choice is Yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper Directory Requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate Information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UHC Members should call the number on the back of their ID card, and non-UHC members can call 888-638-6613 TTY 711.

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Last Updated: 10.27.2020 at 03:42 PM CDT

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