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Families and Children Medical Assistance

Medicaid

UnitedHealthcare Community Plan of Minnesota is offering coverage for Families and Children Medical Assistance - also known as the Prepaid Medicaid Assistance Program (PMAP). This is a program that serves pregnant women and children, adults without children, low-income individuals, and families.

Benefits & Features

Well and Sick Care

Get the assistance you and your family needs to stay healthy, to get better if you are injured or sick or — simply achieve your potential. That includes:

  • Hospitalization. You pay nothing for care in a hospital
  • Therapy Services. Therapy visits to help you recover or achieve your potential.
  • NurseLine. Speak with a registered nurse 24/7.
  • Well Visits. Annual checkups to help keep you and your family healthy.
  • Health Screenings and Vaccinations. Routine tests and shots to help protect against illness
  • Virtual Visits. Connect to a live doctor through a smart phone or computer for non-emergent visits..

Behavioral health is about how you feel and act. It is also called mental health. Your mental health is very important. All UnitedHealthcare Community Plan of Minnesota for Families and Children packages include mental health and addiction services. You may see any in-network doctor without a referral for outpatient treatment.

You are able to get behavioral health services without a referral from your Primary Care Provider or PCP. Sometimes it makes sense to talk to your PCP about any behavioral health problems you have. That way, your PCP can help to refer you to a behavioral health provider with Community Plan. If you want to find a behavioral health provider on your own, you can search for one at any time and make an appointment. You can also call a Member Services Advocate at 1-888-269-5410 TYY 711, for help.

We cover:

Behavioral Health Services

  • Individual, group and family therapy
  • Outpatient behavioral health services
  • Inpatient behavioral health services
  • Specialized behavioral health services for children with autism

Substance Use Disorder Services

  • Outpatient opioid treatment
  • Residential treatment
  • Targeted case management

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

If you believe you need access to behavioral health services, talk with your PCP or call a Member Services Advocate.

Search for a behavioral health specialist

What if I have a behavioral health crisis?
You are always covered for a behavioral health, mental health, drug, or alcohol use emergency. An emergency means a behavioral health condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated.

Emergency services are covered anywhere in the United States. If you think you have a life-threatening emergency, call 911 or go to the nearest hospital location where emergency providers can help you.

As soon as possible, call us to arrange for follow-up behavioral health care after an emergency.

A behavioral health crisis is a moment when someone's behavior can put themselves or others in danger, especially if they do not get help, such as:

  • Threatens to or talks about hurting or killing themselves
  • Feels hopeless
  • Feels rage or uncontrolled anger
  • Feels trapped, like there is no way out
  • Engages in reckless behavior
  • Feels anxious, agitated, or unable to sleep
  • Increases alcohol or drug use
  • Withdraws from friends and family
  • Encounters dramatic mood changes
  • Sees no reason for living

Crisis Services:

If you think you have an emergency, no matter where you are, call 911 or go to the nearest hospital location where emergency providers can help you. As soon as possible, call your doctor or behavioral health provider to arrange for follow-up care after the emergency is over.

If you need to talk to someone, we are here for you. If you do not feel like it is time to call 911 but need help right away, you can call our Behavioral Health Crisis line 24/7 at 1-888-269-5410.

Here are additional Behavioral Health Services and Crisis Intervention Contacts:

Teen Link: 1-866-833-6546
Online: http://www.866teenlink.org

Suicide Prevention: 1-800-273-8255
TTY Users: 1-800-799-4TTY (4889)
Online: http://www.suicidepreventionlifeline.org

Additional health resources can be found here. Find the balance, support, and care you need to live the healthiest life possible.

Nothing is more important than the health and well-being of you and your baby. That's why our plan benefits include:

 

  • Prenatal Visits. Care for you before your baby is born.
  • Choice of Doctor. Find a doctor or OB/GYN you trust in our network.
  • Healthy First Steps®. Extra support to help you and your baby stay healthy with additional gift opportunities
  • Care Management Services. For high risk pregnancies during pregnancy and for two months after delivery
  • Postpartum Visits. Care for you after your baby is born
 

 

Our care coordination services will help you and your doctors address your health care needs. Our goal is to help you get the right care at the right time and in the right place. We do this by working together with you and your doctors on your individual care plan. We coordinate all your needs including physical, behavioral health and social needs. Care coordination includes:

  • Complex care management
  • Care management
  • Disease management

If you have asthma, diabetes, or another health condition, you can depend on us. Care Managers want to learn more about you. Then they can help you learn self-care and how to get help from others. Care Managers may meet with your PCP and other health resources to make sure they are working together. Care Managers work to make sure you have all the services you need, including non-medical services like food and housing. Programs include:

  • Asthma and COPD care. Exams, testing and supplies, education, and support.
  • Diabetes support. Medicine, needles, education, and support for managing diabetes. 
  • Kidney disease care. Dialysis, medicine, treatments, education, and personalized support.
  • Other conditions. Testing, medication, treatments, education, and support are also covered for many other conditions like behavioral health, ADHD, autism and disorders like it, heart disease, high blood pressure, sickle cell disease, HIV, or hepatitis.

Regular eye exams are important. Members are eligible for routine eye exams and prescription eyeglasses. Call your doctor to schedule a routine eye exam. You can schedule an appointment with any participating vision care provider.

The following vision services are covered for members under age 21: 

  • Coming Soon

The following vision services are covered for members age 21 and over: 

  • Coming Soon

Getting a yearly dental check-up is important to your health. Your coverage includes:

  • Exams and cleanings
  • Minor restorations such as filling
  • Deep cleanings and surgical treatment for gum disease
  • Partial or full dentures, and repairs to partials or full dentures
  • Sedation and nitrous oxide (known as laughing gas) if medically necessary
  • Complete set of x-rays: Panoramic film– 1 every 5 years, Full mouth set of films
  • Crowns: 1 every 5 years
  • Root canals: 1 per tooth per lifetime

Managing your health care alone can be hard, especially if you are dealing with many health problems at the same time. If you need extra support to get and stay healthy, we can help. All of our UnitedHealthcare Community Plan of Minnesota members have access to a Member Services Advocate.

A Member Services Advocate can help you: 

  • Understand the UnitedHealthcare Community Plan of Minnesota program
  • Find a doctor, dentist, or eye doctor
  • Explain your benefits and coverage
  • Talk to you about special programs that are available to you
  • Connect you with a Care Manager if needed
  • Find resources located near you to help you with other problems like food, housing, transportation, employment, feeling safe or education
  • Make sure you are aware of other State programs and services available to you, such as SNAP (Supplemental Nutrition Assistance Program) or WIC (Women, Infants and Children) program benefits
  • Help you update your personal contact information like address, phone number or email
  • Make sure we know how you would like to be contacted (email, phone, or mail)
  • Resolve issues with providers, including specialty care and behavioral health
  • Assist with challenges due to prior approval, payment for services, care delivery and family welfare

Get extra benefits and support. You can rely on:

  • Health Education. Free coaching to help improve your health.
  • Language Help. Connect to a translator through Member Services.
  • Mom's Meals. Your care manager can coordinate delivery of healthy meals after you are discharged from a hospital stay. 

Contact a Member Services Advocate to learn more. We are available Monday through Friday, 8 am to 6 pm Local Time, by calling 1-888-269-5410, TYY 711.

If you need a ride, your benefits include non-emergency transportation. We cover trips to:

  • Medical, dental, vision and mental health appointments
  • Pharmacy
  • Durable medical equipment

We may cover trips to:

  • Medicaid eligibility appointments
  • WIC appointments
  • Social services such as food pantries

Following these simple rules will help you get a ride:

  • Call at least two (2) business days (Monday - Friday) ahead of time for non-urgent trips
  • Call 1-888-444-1519, TTY 711 to set up your ride, 24 hours a day. 7 days a week
  • To cancel your ride, call 1-888-444-1519 
  • Have your Minnesota Health Care Program MHCP member identification (ID) card and UHC member ID card available
  • Rides are only for approved reasons
  • You can call to see if same or next day rides are available, but shuld call at least two (2) business days in advance 
    • Calls for same day or next day trips are not guaranteed
  • Bus passes (including monthly) may be offered for trips
    • If bus pass is required, bus pass will be mailed to you in 5-7 days
  • If trip is needed in 2 business days, replacement bus pass may be mailed or, if appropriate, other mode of transportation provided
  • Know the address of your health care provider and the date and time of your appointment
  • Be specific about where you need a ride to
  • Be ready for your ride up to one (1) hour before scheduled pick up
  • After your visit, call Bus passes (including monthly) may be offered for trips
  • If bus pass required, bus pass will be mailed to you in 5-7 days
    • If trip is needed in 2 business days, replacement bus pass may be mailed or, if appropriate, other mode of transportation provided for a ride home
  • Let us know if you have special needs like a wheelchair
  • Members under the age of 18 must have a parent or guardian with them
  • Transportation may be limited to a provider near you. including 30 miles from your home for a primary care physician (PCP) and 60 miles from home for a specialist

Give a Member Services Advocate a call to schedule a ride or ask questions about getting transportation services.

This service is for rides planned in advance. If you have a life-threatening emergency, call 911.. 

Information you need to schedule your trip:

  • Minnesota Health Care Program MHCP member identification (ID) card
  • UHC member ID card
  • Name, home address, date of birth
  • Phone number
  • Date, time, name, phone number, and address for ride

Asthma and COPD Support

We can help you control your asthma or COPD.

If you need help getting the services or supplies you need, contact a Member Services Advocate. We can assist with the process of getting supplies or medications, make an appointment with your doctor, or connect you with a care manager for personal support.

Choice of Doctor

You will have a primary care provider (PCP) who will be your main doctor. Your PCP is the person you see for most of your care. This includes checkups, treatments, vaccinations, minor injuries, and health concerns. Talk to your PCP about any other concerns you may have. Your PCP can help you decide the right options for you.

Your PCP is your main doctor for:

  • Preventive care like check-ups, cancer screenings and vaccinations
  • Treatment if you are sick or injured
  • Referrals to specialists for certain conditions

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. You can change your PCP at any time.

Customer Engagement Center

All UnitedHealthcare Community Plan members have access to a Member Services Advocate (MSA) to help you throughout your health care journey. A MSA can help:

  • Understand the UnitedHealthcare Community Plan of Minnesota program
  • Find a doctor, dentist, or eye doctor
  • Explain your benefits and coverage
  • Talk to you about special programs that are available to you
  • Connect you with a Care Manager if needed
  • Find resources located near you to help you with other problems like food, housing, transportation, employment, feeling safe or education
  • Help you update your personal contact information like address, phone number or email
  • Make sure we know how you would like to be contacted (email, phone, or mail)
  • Resolve issues with providers, including specialty care and behavioral health
  • Assist with challenges due to prior approval, payment for services, care delivery and family welfare

Diabetes Support

If you have diabetes, we'll help make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best. You are also rewarded with gift cards for taking simple steps to manage your diabetes.

Equipment and Supplies

Your health and safety at home are important.

Our plan covers medical equipment ordered by your doctor. This can include supplies like:

  • Hospital beds
  • Oxygen tanks
  • Walkers or wheelchairs

Foot Care

Our podiatry coverage includes routine foot care.

If you have diabetes or a circulatory condition, good foot care can help prevent much more serious problems. We provide the needed exams to help keep your feet in great shape.

Foster Care Support

Foster care is a temporary service provided for children who can no longer remain in their own homes due to safety issues. We have programs to help support guardians and children in foster care.

UnitedHealthcare’s On My Way (OMW) is a tool designed to help young adults transition from foster care to adulthood and independence. This tool can be found in the member secure portal.

The OMW tool can connect transition-aged foster care youth with peer support staff and has modules that teach the following skills: 

  • Money management 
  • Securing housing 
  • Creating a resume 
  • Finding a job 
  • Applying for college
  • Personal goal setting 
  • The platform also provides a vault for youth to store secure documents such as birth certificates and driver’s license information for their convenient access after transitioning from foster care to adulthood

Call Member Services to learn more about these and other foster care support programs.

Healthy First Steps®

Our Healthy First Steps program can help both you and your baby get the care you need and deserve. With Healthy First Steps, you’ll earn great rewards for completing checkups on time during and after your pregnancy. Join at UHCHealthyFirstSteps.com or contact Member Services to get started.

We can help you:

  • Find a doctor for both mother and baby.
  • Learn about nutrition, fitness, and safety.
  • Find out what extra gifts you could be eligible for.

High School Equivalency (HSE)

It’s not too late to finish high school. UnitedHealthcare Community Plan can help you get your High School Equivalency (HSE). Any member age 16 or older can be part of this program.

Please contact a Member Services Advocate for more information.

Home-based Services

After surgery or a serious illness—or if you have a disability—you may need extra help with day-to-day tasks. With approval, and ordered by your doctor, our plan covers:

  • Time-limited skilled nursing services 
  • Specialized therapies, including physical therapy, speech-language pathology, and occupational therapy 
  • Medical supplies

Hospitalization

This plan pays for all hospital expenses related to a hospital stay.

This plan pays for all expenses related to a hospital stay, so you can focus on resting and healing.

Our plan covers:

  • Inpatient care
  • Outpatient care
  • Labs, X-rays and other tests

And after you leave the hospital, you are not alone. We are here to help you get any needed follow-up care to continue healing at home.

 

Individuals with Special Needs

We have many services that support individuals with special needs. We are here to make sure you have: 

  • A Member Services Advocate to be your personal guide and help you navigate the health care system 
  • Help to get all your needed services 
  • Support with social needs, such as housing, job opportunities and healthy food 
  • Help getting a ride to and from health care appointments 
  • Materials available in the formats you need

We also offer specialized dental care for our members with sensory issues. Please contact a Member Services Advocate to learn more.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments, called renal dialysis or an organ transplant are needed to live. Dialysis uses a machine to clean the blood just like healthy kidneys do.

Our plan includes:

  • Dialysis.
  • Medications.
  • Health education and support.
  • Organ transplant if needed.

Lab & 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 you get the information needed to improve your health or be at your best.

Language Help

You and your doctor 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 Member Services Advocates who speak more than one language. Chances are, we have someone who speaks your language, or they can connect you with our interpreter service which covers more than 170 languages.

Lead Screening in Children

Lead poisoning is dangerous. If it is not treated in small children, it can cause long term problems. Lead can be found in: 

  • Paint 
  • Soil 
  • Dust 
  • Air 
  • Pottery

A special blood test is ordered by your doctor to check for lead poisoning. The test is usually given between the ages of 6 months and 2 years. If your child has not been tested, your doctor might want to test up to the age of 6 years. More testing may also be necessary if your child has tested positive for lead. For more information, contact a Member Services Advocate. You can also talk to your child’s doctor at their next well visit.

Medicines

Getting prescription medications is an important part of your health care. If your doctor prescribes a medicine that is listed on your plan’s List of Covered Drugs (LOCD), it is covered. If your drug is not listed on the LOCD, your care provider may request an alternative drug for you that is listed on the LOCD. UnitedHealthcare Community Plan covers medicines on this list, including certain over the counter medications, smoking cessation drugs, and diabetes supplies. The plan may pay for other medicines with prior approval

You can get your prescriptions filled at any pharmacy in our network. Many are available 24 hours a day, 7 days a week. For a list of pharmacies, use your provider directory or go to myuhc.com/CommunityPlan/MN.

If you have a problem getting your prescription during normal business hours, call Member Services. If you have a problem getting your prescriptions after normal business hours, on weekends, or holidays, have your pharmacist call the pharmacy help desk.

90-day supply benefit
Members can fill a 90-day supply of select maintenance medication at the retail pharmacy. Maintenance medications are typically those medications you take on a regular basis for a chronic or long-term condition. 

With a 90-day supply, you won’t need to get a refill every month. To find out more details, talk to your doctor or pharmacist. For a complete list of medications included in this benefit, call Member Services at 1-888-269-5410 TTY 711.

List of 90-day supply medications.

NurseLine

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-800-718-9066, TTY 711.

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.

Phone Services

Do you need a mobile phone? You may qualify for free monthly wireless service. SafeLink is a program provided by TracFone Wireless. Visit www.safelinkwireless.com for more information.

A Member Services Advocate can also help you with the application.

Quit using Tobacco or Vaping Products

Quitting is hard, but we can help. Did you know that 20 minutes after you quit, your heart rate drops to a normal level? And within 24 hours after quitting the carbon monoxide level in your blood drops to normal.

Talk to your doctor about quitting. Or call 1-800-QUIT-NOW (1-800-784-8669) to get free coaching, counseling and supplies to help you quit.  Quitting - Tobacco Prevention and Control - Minnesota Department of Health (state.mn.us)

Shots and Vaccines

Routine shots help protect you from illness.

Our plan covers:

  • Shots and vaccines recommended by your PCP
  • Flu shots

Therapy Services

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

Your doctor can order therapy for you if it is needed. This includes:

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

Well Visits

Well visits with your doctor can help you stay healthy. These visits can catch health problems early, so they can be treated. You should see your PCP every year for a well check, even if you aren’t sick or your symptoms are under control. Preventive services include:

  • Checkups for adults and children.
  • Well-baby care.
  • Care for women expecting a baby.
  • Routine shots and tests.
  • Mammograms.

There is no copayment for preventive care.

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