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UnitedHealthcare Community Plan
Our Medicaid family plan is for children, pregnant women, families and adults who meet income and health need requirements. We also cover children and young adults with special health or developmental needs.
This plan is available in the following counties:
Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Bay, Benzie, Berrien, Branch, Calhoun, Cass, Charlevoix, Cheboygan, Clare, Crawford, Emmet, Genesee, Gladwin, Grand Traverse, Gratiot, Hillsdale, Huron, Ionia, Iosco, Isabella, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Lapeer, Leelanau, Lenawee, Livingston, Macomb, Manistee, Mason, Mecosta, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Sanilac, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Washtenaw, Wayne, and Wexford.
Michigan offers several medical assistance programs. Each program covers different groups of people and each program has different eligibility requirements. When you apply for a program, your age, income, financial resources, and other information will be used to determine if you are eligible. You must also meet the financial and non-financial eligibility conditions for that program.
UnitedHealthcare will work with and follow all guidance and protocols provided by the U.S. Centers for Disease Control and Prevention (CDC), and state and local public health departments that are appropriate for our members. Please review the UnitedHealthcare Coronavirus (COVID-19) FAQ. To learn more about COVID-19, go to CDC.gov.
Michigan Department of Health and Human Services (MDHHS) has provided the following links to keep public informed about the COVID-19 vaccine. Please bookmark these pages for the most up to date information.
- General information: https://www.michigan.gov/coronavirus/
- COVID 19 Vaccination : https://www.michigan.gov/COVIDVaccine
- MDHHS Vaccination Prioritization Guidance: https://www.michigan.gov/documents/coronavirus/MI_COVID-19_Vaccination_Prioritization_Guidance_710349_7.pdf
- Vaccine FAQs: https://www.michigan.gov/documents/coronavirus/COVID-19_Vaccine_Public_FAQ_FINAL_710077_7.pdf
- Vaccine Infographic: https://www.michigan.gov/documents/coronavirus/Vaccine_infographic_v2_710069_7.pdf
- Information on mRNA vaccines: https://www.michigan.gov/documents/coronavirus/2020_MDHHS_COVIDVaccine_Infograph_3.0_710373_7.pdf
UnitedHealthcare provides coverage of OTC (Over the Counter) COVID-19 Home Tests without a prescription at our network pharmacies. Please speak to your pharmacist for assistance.
UnitedHealthcare provides coverage of certain COVID-19 monoclonal antibodies authorized by Michigan Department of Health and Human Services (MDHHS) at our network pharmacies. Please speak to your pharmacist for assistance.
UnitedHealthcare will reimburse you if you purchased an over-the-counter COVID-19 test from a pharmacy, store, or online retailer and are charged for your test. You must keep your original sales receipt and fill out the Member Reimbursement Form. We will reimburse you up to $12 per individual test (or the cost of the test, if less than $12). Reimbursement is limited to 8 tests per month.
Any changes in phone number, email, or address should be reported to the Michigan Department of Health and Human Services (MDHHS). You can do this by going to the MIBridges website at www.michigan.gov/mibridges. If you do not have an account, you will need to create an account by selecting “Register”. Once in your account, when reporting changes, please make sure you do so in both the profile section and the Report Changes area. The Report Changes area is what the local office will use to update the address for your case.
The Michigan Department of Health and Human Services (MDHHS) is working to eliminate Hepatitis C Virus (HCV) as a health threat to Michiganders through the We Treat Hep C Initiative
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Benefits & Features
Asthma and COPD Care
Do you have trouble managing asthma, allergies or COPD symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:
- Manage flare-ups.
- Reduce symptoms.
- Help you or your child stay active.
Does your child have asthma or respiratory allergies? A nurse who specializes in breathing issues can really help childhood breathing problems. Your child's nurse will
- Get to know your child
- Learn his or her triggers and activities.
- Develop a customized treatment plan.
Do you or a family member have a serious health problem or a high-risk pregnancy? If so, our care managers are in your corner. They will:
- Explain medical terms in plain language.
- Coordinate your doctor appointments.
- Provide your care team with your medical records.
Your care manager will stay with you on your medical journey. He or she will:
- Think beyond your medical needs.
- Make sure you have support at home.
So you can focus on getting better.
Choice of Doctors
You or your child gets a primary care provider (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.
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.
Choice of Birth Center
Where you have your baby is an important choice. That's why you can pick from nearly 100 hospitals across Michigan.
We encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you’ll be more relaxed when you have your baby.
Understanding your health care options can be confusing. Now you have someone you can call. We can answer your questions simply and completely.
We help you find:
- Hospitals or other health facilities.
- Local resources.
We also have people who speak more than one language. Chances are, we have someone who speaks your language.
If you have diabetes you may need insulin, needles, wipes and glucose strips. We cover all that and more.
Our plan also steps up with services to help you manage your diabetes including:
- Coordinating doctor care.
- Dedicated team to help you understand your condition and manage it.
Equipment and Supplies
Your health and safety at home are important.
Our plan covers medical equipment ordered by your doctor. This can include items like:
- Hospital beds.
- Oxygen tanks.
- Walkers or wheelchairs.
Healthy First Steps®
Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up.
We will help you:
- Choose a pregnancy provider and a pediatrician (child’s doctor).
- Schedule visits and exams and arrange rides to your visits.
- Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
- Get supplies, including breast pumps for nursing moms.
- Connect with community resources such as Women, Infants and Children (WIC) services.
Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to determine whether a hearing problem exists.
- Exams, therapy and tests.
- Hearing aids are covered for Members under age 21.
This plan pays for medical expenses related to a hospital stay.
Our plan covers:
- Nursing care.
- Room and board.
- Supplies and equipment.
- Treatment and therapies.
- Diagnostic tests and exams.
And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing.
Lab and X-rays
Knowing what's wrong and finding it early can make all the difference. Our plan covers:
- Labs and testing.
- X-rays, scans and other imaging.
We'll help get the information needed to improve your health or be your best.
We have people at our member services who speak more than one language. Chances are, we have someone who speaks your language.
Our plan includes prescription drugs and refills.
We also cover many medically needed, over-the-counter medicines with a written order from your doctor. There is no copay for these medicines.
And we make getting your medicine easy. You can fill your prescriptions at:
- Network pharmacies.
Mental health is as important as physical health. That's why we cover both.
Short-term required care is covered with no co-pay. This includes:
- Behavioral therapy.
You will not have a copayment for most care and services covered by our plan. That means you will pay nothing for covered services, including:
- Preventive care.
- Annual checkups.
- Routine vision care.
Sometimes you may need continued care after you leave the hospital or urgent care. If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:
- Provide medical care for you.
- Answer your questions and concerns.
Nothing is more important than the health and well-being of you and your baby. That's why our benefits include:
- Prenatal Visit.
- Healthy First Steps®.
- Wellhop for Mom & Baby.
- Dental Services.
Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.
All of your recommended prenatal clinical visits and tests are covered.
At these visits, the clinic will:
- Make sure you and your baby are healthy.
- Explain what to expect at each stage of your pregnancy.
- Answer your questions.
- Get dental coverage as a pregnant member, during and for a full year after delivery.
You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.
Shots and Vaccines
Routine shots help protect against illness. So, our plan covers:
- Recommended shots and vaccines.
- Influenza shots.
Many communities offer additional benefits for children with special care needs. Social Services helps members connect to local programs and services, such as:
- WIC and financial support.
- School services.
- Respite care.
Download more information about social services benefits here.
Speech therapy visits and exercises can help those who have difficulty speaking. At your doctor's request we will cover short-term, medically needed physical, occupational, speech and other therapy visits each year.
Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.
Our plan provides:
- Occupational therapy.
- Physical therapy.
- Speech therapy.
With a doctor's request your coverage includes short term physical, occupational, speech and/or other therapy visits each year.
Our plan provides a ride for you to and from health care locations. That includes rides to:
- Doctor or therapy visits.
- Health departments.
- Vision clinics.
You can also be reimbursed for gas for driving to and from health care visits:
Unlimited Primary Care Provider/PCP Visits
There may be times when your health requires repeated doctor visits. Our plan does not limit the number of times you can see your primary care provider. This way you get the care you need when you need it. And your doctor can see how your health is progressing.
Regular eye exams and glasses, if needed, can help you see more clearly. We also include:
- Prescription lenses.
- Designer-style frames.
Call Member Services at 1-800-903-5253 for vision services and providers.
Well visits with your doctor can help keep you healthy. These visits can catch health problems early, so they can be treated. Preventive services include:
- Checkups for adults and children.
- Routine shots and tests.
- Mammograms and Pap Smears.
- Well-baby care.
- Colorectal Screenings.
There are no copayments for preventive care.
Wellhop for Mom & Baby
Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.
Here’s how it works:
- Join video conversations every other week with women who have similar due dates and a group leader.
- Chat and share experiences with moms from your group on the Wellhop app or website.
- Visit the Wellhop library. You’ll find articles, videos and more.
Certificate of Coverage
Certificate of Coverage
Transition of Care
Transition of Care
Getting Started Guide
We want to be sure you have all the information you need to make this the best health care experience possible. This guide will walk you through the important steps for getting started.
Member Newsletters 2016 - Current
Additional Benefit Information
Additional Benefit Information
UnitedHealthcare Community Plan
This link is being made available so that you may obtain information from a third-party website. This link is provided solely as a convenience and is not an endorsement of the content of the third-party website or any products or services offered on that website. We are not responsible for the products or services offered or the content on any linked website or any link contained in a linked website. We do not make any representations regarding the quality of products or services offered, or the content or accuracy of the materials on such websites.