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UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

Medicare

H9239-001

Our UnitedHealthcare Connected®  for One Care (Medicare-Medicaid) Plan is for adults ages 21 - 64 with disabilities who are eligible for both Medicare and MassHealth. The plan offers members a customized care plan and a single point of contact for all Medicare and MassHealth services.

Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Plymouth, Suffolk, and Worcester.

Note that One Care is available in Essex county in the following zip codes: 01810, 01812, 01830, 01831, 01832, 01833, 01834, 01835, 01840, 01841, 01842, 01843, 01844, 01845, 01885, 01899,  01901, 01902, 01903, 01904, 01905, 01906, 01907, 01908, 01910, 01922, 01923, 01937, 01940, 01945, 01947, 01949, 01960, 01961, 01969, 01970, 01971, 01985, 05501, 05544

Benefits & Features

Well and Sick Care

If you just need a checkup or if you are injured or sick, you will have access to the care that includes:

  • Unlimited PCP Visits. See your doctor as often as needed.
  • NurseLine. Speak with a registered nurse 24/7.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Therapy Services. Physical and other needed therapies are covered.

If you have asthma, diabetes or another chronic condition, you can depend on us. Our plan helps you get the care, support and services you may need. Benefits include:

  • Mental Health and Substance Abuse Services. Counseling and other treatments are covered.
  • Care Management. Personal support from an experienced professional.
  • Asthma Care. Exams, testing and supplies are covered for asthma and other lung diseases.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.

We help members keep their vision, smile and hearing in good shape. Benefits include:

  • Vision Care. You are covered for one pair of contact lenses or eyeglasses (lenses and frames) every 2 years.
  • Dental. Our plan provides access to dental benefits that includes preventive, restorative, and emergency oral health care. Your coverage includes up to two cleanings per calendar year.

You get medical care and equipment you may need to live safely at home. Benefits include:

  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Care Coordinator. Someone to get you the services after surgery or illness.
  • Home Health Care. Medical and personal care in your home, if needed.

Sometimes members need a little extra help using their health plan. For those times, they can rely on:

  • Transportation. Medical transportation is covered along with limited non-medical transportation.
  • Member Engagement Center. Someone to help you get the most from your plan.
  • Language Help. Our plan has people who can answer questions in different languages.
  • Personalized care plans and opportunities to access additional benefits to help you meet your goals.
  • Personal Navigator through our Member Engagement Center to handle your customer service needs
  • Access to Advocates who specialize in housing, employment, and caregiver resources and benefits.

Companionship is important. Adult day care provides care and companionship for members who qualify for extra help during the day. Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

If you use or need long-term services and support in the community (such as day rehabilitation, adult foster care, or personal care assistance), you can choose a Long-Term Supports (LTS) Coordinator to meet with you and help evaluate your health and wellness needs. The LTS Coordinator will be part of your Care Team and will tell you about the different kinds of services available and help find the best long-term services and programs for you.

Asthma and COPD Support

The plan covers pulmonary-rehabilitation programs for members who have moderate-to-very severe chronic obstructive pulmonary disease (COPD). The member must have an order for pulmonary rehabilitation from the doctor or provider treating the COPD.

Prior authorization may be needed. Please contact your Care Coordinator

Choice of Doctor

From regular checkups to preventive health screenings, we want to make sure you get access to the right care at the right time.

You get a primary care physician (PCP) who is your main doctor. If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

  • Preventive care
  • Treatment if you are sick or injured
  • Referrals to specialists for certain conditions
  • Denture and denture repair 

Dental Care

Our plan provides access to dental benefits that includes preventive, restorative, and emergency oral health care. Your coverage includes up to two cleanings per calendar year. You must go to a participating dental provider for all covered dental services. Some services may require a prior authorization by UnitedHealthcare Connected®  for One Care. Your dentist will need to submit a prior authorization directly to UnitedHealthcare Dental, our dental benefit administrator.

Equipment and Supplies

The health and safety of our members at home are important.

Our plan covers some medical equipment ordered by a member's doctor or case manager. This can include:

  • Walkers
  • Wheelchairs
  • Hospital beds

Foot Care

We provide the exams and treatments needed to help keep your feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

  • Routine foot exams
  • Tips about foot care and choosing the right shoes
  • Therapeutic shoes and inserts for members with diabetes

Hearing Care

Trouble hearing can affect a person’s everyday life in many ways. Our plan includes services and support to help protect hearing.

We cover:

  • Exams, therapy and tests
  • Hearing aids and accessories

Hospitalization

This plan pays for most expenses related to a hospital stay. This way you can rest and heal.

Our plan covers these services and more:

  • Nursing care
  • Room and board
  • Supplies and equipment
  • Treatment and therapies
  • Diagnostic tests and exams

And after leaving the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.

In-Home Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

  • Dressing
  • Bathing
  • Feeding

Language and Interpretation

You and your doctor need to understand one another. We can explain information in English or in your native language. If you are visually or hearing impaired, special help can be provided.

Medicines

Our plan includes prescription drugs and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.

You pay only a co-pay amount, if needed, and you can get your prescription drugs at any in-network pharmacy.

Member Engagement Center

Sometimes you might need a little help understanding your health care options.  We’ll answer your questions simply and completely. Contact the Member Engagement Center 1-866-633-4454, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.

We can also help you find:

  • Home care providers
  • Dentists and vision providers
  • Adult Day Health Centers

Mental Health

Get help with personal problems that may affect your mental or physical health. These may include depression, anxiety or drugs and alcohol abuse. Our services also include: 

  • Therapy
  • Counseling
  • Medications

Online mental health resources: Access to LiveandWorkWell.com, which provides access to article resources, and provider searches.

No Copays

While you pay nothing for covered services, you get:  

  • Treatments at hospitals and clinics
  • Prescription drugs and over-the-counter medicines

Nurse Line

Medical questions and situations 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: 

  • Listen to symptoms
  • Help with self-care
  • Advise you about getting care at a doctor visit or an urgent care center
  • Help you know when to go to the emergency room

Quitting Tobacco

You know the bad health effects of smoking. You know you need to quit. We will support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Respite Care

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.

Long-term Supports (LTS) Coordinator

Long-term Supports Coordinator (LTS Coordinator) is a person who works with you and your Care Team to make sure you get the services and supports you need for independent living.

If you use or need long-term services and support in the community (such as day rehabilitation, adult foster care, or personal care assistance), you can choose a Long-Term Supports (LTS) Coordinator to meet with you and help evaluate your health and wellness needs. The LTS Coordinator will be part of your Care Team and will tell you about the different kinds of services available and help find the best long-term services and programs for you.

Therapy Services

Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.

Our plan covers visits for:

  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • In-home therapy

Transportation

Whether you live in the city or in the country, rides are available. Medical transportation is covered along with limited non-medical transportation.

Our plan provides round trips to and from plan locations. This includes trips to and from the pharmacy to fill your prescriptions.

 

Vision Care

You'll get the care, eyeglasses and treatment that let you see life more clearly. Coverage includes:

  • You are covered for one pair of contact lenses or eyeglasses (lenses and frames) every 2 years.
  • You have zero ($0) copays and deductibles for vision coverage which covers routine eye exams, prescribed corrective lenses, or 1 pair of prescribed frames up to $125 every year.

This benefit is offered by certain stores and retailers.

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