UnitedHealthcare Community Plan - MO HealthNet Managed Care Glossary

A

  • Advance Directive

    A decision about your health care that you make ahead of time in case you are ever unable to speak for yourself. This will let your family and your doctors know what decisions you would make if you were able to.

  • ASC/SPU

    Ambulatory surgical center/short procedure unit.

B

  • Benefits

    Services, procedures and medications that UnitedHealthcare Community Plan will cover for you.

C

  • Clinical Care Management

    One-on-one help by a nurse providing education and coordination of UnitedHealthcare Community Plan benefits, tailored to your needs.

D

  • Disenrollment

    To stop your membership in UnitedHealthcare Community Plan.

E

  • Emergency

    A situation where your health, or the health of an unborn baby, could be threatened. Medical help is needed right away.

F

  • Federal Poverty Level (FPL)

    Poverty income thresholds by family size that are annually updated by the Census Bureau for inflation.

  • Fraud

    An untruthful act – an example is someone other than you using your UnitedHealthcare Community Plan member ID card and pretending to be you.

H

  • Home Health Agency

    A company hired by UnitedHealthcare Community Plan to provide care for you in your home.

I

  • ID Card

    An identifcation card that says you are a UnitedHealthcare Community Plan member. You should have this card with you at all times.

  • Informed Consent

    That all medical treatments have been explained to you; you understand and agree to them.

  • Inpatient

    When you are admitted into a hospital for a length of time.

M

  • Medical Necessity

    Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.

  • Member

    A person who is eligible for UnitedHealthcare Community Plan.

P

  • Primary Care Physician (PCP)

    A doctor you choose to be your family physician. They have their own private practices.

  • Prior Authorization

    Your MO HealthNet Managed Care health plan’s method of pre-approving certain services.

  • Provider

    Any medical professional that UnitedHealthcare Community Plan has contracted with to take care of you.

  • Provider Directory

    A list of providers who participate with UnitedHealthcare Community Plan to help take care of your healthcare needs.

S

  • Special Needs Unit (SNU)

    A voluntary service offered by UnitedHealthcare Community Plan that can give you extra help in understanding and using your benefits if you have a disability or other special need.

  • Specialist

    Any doctor who has special training for a specific condition or illness.

U

  • Urgent Care

    Urgent care appointments for physical or behavioral illness injuries which require care immediately but are not emergencies such as high temperature, persistent vomiting or diarrhea, symptoms which are of sudden or severe onset but which do not require emergency room services, you must been seen within twenty-four (24) hours.

W

  • WIC

    Women, Infants and Children program, a supplemental nutrition program that provides nutritious food, education support and health care referrals for women, infants and children.

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