UnitedHealthcare Community Plan - MO HealthNet Managed Care

Asthma Care

Do you or a family member have trouble managing asthma symptoms?
You will get a customized treatment plan and medicine to:

• Manage flare-ups.
• Reduce symptoms.
• Help you stay active.

Behavioral Health and Substance Use Services

Inpatient, residential and outpatient services for behavioral health and substance use are covered. The type, amount and length of services provided will be based on the level of your needs. These services are part of your MO HealthNet Managed Care benefits.

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Care Management

When a member has complex health care needs, a care manager can really help. He or she will:

• Work with you and family members and friends on a plan of care.
• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records. 
• Make a referral to community social service programs.

Choice of Birth Center

Where you have your baby is an important choice. That's why you can pick from our large network of hospitals or Birthing Center.

We also encourage you to tour the hospital's birthing center. This way you will be familiar with it and be better informed when you have your baby.

Choice of Doctor

Each member can choose a primary care provider (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.

The PCP is the main doctor for:

• Preventive care.
• Treatment if you are sick or injured.
• Care coordination with specialists.

For members who don’t have a doctor or whose doctor is not in our network, member services can help find a new one close by.

Disease Management

If you have chronic or high-risk illnesses, our disease management services are designed to support you.

Equipment and Supplies

Our member's health and safety at home are important.

MO HealthNet Managed Care covers medical equipment ordered by the doctor or care manager. This can include supplies like:

• Oxygen tanks.
• Hospital beds.
• Wheelchairs or walkers.

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 $10 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.

Home Care

After surgery or a serious illness, you may need  in-home medical visit(s) to check on how well you are healing.

MO HealthNet Managed Care covers:

• In-home medical visit(s).
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.

Hospitalization

MO HealthNet Managed Care covers expenses related to a hospital stay, so our members can rest and heal.

Hospitalization coverage includes:

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

And after leaving hospital, we can provide transitional care services. MO HealthNet Managed Care makes sure you get follow-up care to continue healing at home.

Interpreters

You and your doctor need to understand each other. We have interpreters for you if your provider does not speak your language. We also have qualified American Sign Language interpreters available. This is provided at no cost to you when you speak to us, your provider, or NurseLine.^SM

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Lab and X-rays

Knowing what's wrong and finding it early can make all the difference. MO HealthNet Managed Care 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

Members can get printed information in their preferred language. You will get member materials in English and Spanish. We can give you member materials in a language or format that is easier for you to understand. We also have qualified American sign language interpreters available. Just ask.

We provide aids and services to people with disabilities at no cost to you to help you communicate with us. Such as, letters in other languages or large print, audio, accessible electronic formats, other formats. Or, you can ask for an interpreter if English is not your primary language. Qualified American sign language interpreters are also available at no cost. To ask for help, please call the toll-free member phone number listed on your health 1-866-292-0359, TTY 711, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Member Services

Sometimes you might need a little help understanding your health care options. Call us. We'll answer your questions simply and completely.

We help you find:

• Doctors.
• Pharmacies.
• Hospitals or other health facilities.
• Local resources.

No Copays

You will not have a copayment for care and services covered by MO HealthNet Managed Care.

This includes in network services:

• Visits to doctors
• Treatments at hospitals and clinics.
• Behavioral Health and Substance Use.
• Home medical equipment and supplies to help you be at your best.

NurseLine

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:

• 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.

Pharmacy

All pharmacy benefits are covered by MO HealthNet Fee-for-Service. For more information:

Please contact 1-800-392-2161 or visit the MO HealthNet website at www.dss.mo.gov.

Prenatal Visits

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

• Make sure both you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. That's why we encourage members to talk to their doctor about getting smoking cessation support. UnitedHealthcare Community Plan covers counseling when you enroll with Quit for Life. Medication for smoking cessation is available. Call 1-800-784-8669.

Shots and Vaccines

Routine shots help protect members and their family from illness. MO HealthNet Managed Care covers:

• Pneumonia, influenza and shingles shots.
• Vaccines and Immunizations. Routine shots to help keep your child healthy.
• Other recommended shots and vaccines.

Therapy Services

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

For children under age 21 and for pregnant women, MO HealthNet Managed Care provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.

Transplant Services

Covered when ordered by a network physician.

Unlimited Primary Care Provider Visits

There may be times when a member's health requires repeated doctor visits. Our plan does not limit the number the number of visits to a primary care provider (PCP). This way the members get the care they need. And the doctor can see how their health is progressing.

Vision Care

You'll get the care, eyeglasses and treatment that help you see better. Coverage includes:

• One eye exam every 24 months for members 21 and over.
• One eye exam every 12 months for children under 21 and pregnant women.
• One pair of frames and lenses ever 24 months.

This benefit is offered by MARCH Vision Care.

Well Visits

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.

There are no copayments for preventive care.