UnitedHealthcare Community Plan Medicaid

Medicaid

UnitedHealthcare Community Plan of North Carolina Medicaid offers a range of benefits along with extras that other plans don’t cover. Children, families, pregnant women and single adults may qualify based on income. You can choose your own doctor, and get many extras that other plans don’t offer. View the benefits below to see all that it offers.

This plan is available in all counties.

Benefits & Features

Extra Benefits

  • Education. 
    • Life skills training and 3 round trip employment rides.
    • Members 18 and older can get free GED Exam Voucher and materials (up to $160).
  • Prenatal.
    •  Free breast pump.
    • Up to $100 in rewards for baby products.
  • Wellness. 
    • Up to $75 yearly in rewards.
    • 13-week voucher for Weight Watchers.
  • Youth. 
    • $75 yearly for youth club membership.
  • Other. 
    • $100 yearly value in alternative healing, massage therapy, acupuncture.
    • Up to $150 for hypoallergenic mattress cover and pillowcase for asthma.
    • Free cell phone with 350 minutes per month, free texts.
    • Free home meal delivery up to 14 days.
    • $250 twice a year for inpatient Traditional Native American Healing Benefit and up to $200/once per year outpatient.
    • Online member portal. Manage health, access health history, track doctor visits, and live “Nurse Chat” option.
    • Free mobile app that connects Supplemental Nutrition Assistance Program (SNAP) accounts. Providing balances, find stores that accept SNAP, find grocery store deals and get healthy meal ideas and how to prepare them.
    • Peer support program. Connecting members to health and unmet health related resources.
    • Substance Use Disorder (SUD) Recovery Coaching and support .
    • Coping skills therapy courses to help individuals with a history of trauma attain safety from their trauma and/or substance use.

Get the care you need to stay healthy — or to get better if you are injured or sick. Member benefits include:

  • Care Coordinator. Someone to coordinate the services and care you need for your health.
  • Choice of Doctor. Find a doctor you trust in our network.
  • Hospitalization. You pay nothing for care in a hospital.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Medicines. Fill prescriptions at local pharmacies.
  • NurseLineSM. Speak with a registered nurse 24/7.
  • Pregnancy Care. Extra care and support for both you and your baby.
  • Shots and Vaccines. Routine shots to help protect against illness.
  • Therapy Services. Physical or other therapy to help you be your best.
  • Well Visits. Annual physical exams, checkups, shots and lab tests.
  • Unlimited Doctor Visits. See your doctor as often as needed.
  • Urgent Care. Convenient care for a sudden illness or injury.  

Nothing is more important than the health and well-being of a mother and her baby. That’s why member benefits include:

  • Choice of Doctors. Find a doctor or OB/GYN you trust in our network.
  • Healthy First Steps. Earn rewards for taking steps to keep you and your baby healthy.
  • Prenatal Visits. Care for you before your baby is born.
  • Text4baby. Receive text messages with helpful tips and reminders.

If you have asthma, diabetes or another long-term condition, you can depend on us. Our plan makes sure you get the care and services you need. Benefits include:

  • Asthma and Allergies Care. Exams, testing and supplies are covered.
  • Care Management. If you qualify, get personal help managing health conditions.
  • Diabetic Support. Medicine, needles, wipes and other supplies for managing diabetes.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Behavioral/Mental Health Disorders. Counseling and other treatments are covered.
  • Obesity Care. We cover screenings and counseling for obesity
  • Special Needs Unit. Services for members with special health care needs.  

Make sure your sight and hearing are at their best. Benefits include:

  • Hearing. Tests, checkups and hearing aids, if needed, are provided.
  • Vision. Covers eye exams and glasses if needed. 

Rides and Other Help

Sometimes you might need a little extra help using your health plan. For those times, you can rely on:

  • Healthy First Steps. Earn rewards for keeping you and your baby healthy.
  • Language Help. Connect to a translator through Member Services.
  • Member Advocate. Someone to get you information, services and care.
  • NurseLineSM. Speak with a registered nurse 24/7.
  • Quitting Tobacco. Coaches and supplies to help you quit using tobacco.
  • Social Services. We’ll help you find community services.
  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • Weight Control. Support and treatment to reach a healthy weight.

Behavioral Health

Get help to deal with stress or anxiety.

Call the Behavioral Health Crisis Line at 1-877-334-1141, at any time, 24 hours a day, 7 days a week. If you are in danger or need immediate medical attention call 911.

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.
  • Referrals to specialists for certain conditions.

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

Copays

Your Copays if You Have Medicaid

CHIP (Health Choice)

Your Copays if Your Child has NC Health Choice

 

 

Diabetic 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. 

Our diabetes program also includes self-care training and classes focused on:

  • Planning healthy meals.
  • Managing stress.
  • Living a healthy lifestyle. 

Disease Management

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

We have special programs for:

  • Congestive heart failure.
  • Asthma.
  • HIV.
  • Chronic obstructive pulmonary disease (COPD).
  • Coronary artery disease.

Durable Medical Equipment

Some members may need extra support to live safely at home.

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

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

Health Education

Take free classes to help improve your health or to address a condition.

Our plan includes classes on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you. 

Healthy First Steps

Build a healthy future for you and your baby — and earn great rewards — through Healthy First Steps. This program helps keep you and your baby healthy during your pregnancy and your baby’s first 15 months of life.

Healthy First Steps includes:

  • Email appointment reminders.
  • Fun program to keep track of appointments.
  • Reward cards for clothing and more.

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

You can earn great gifts for your child by doing things like:

  • Completing well-child exams.
  • Getting lab tests.
  • Recording your family’s health activities. 

Hearing Care

Trouble hearing can affect your everyday life in many ways.  Our plan includes services and support to help protect your hearing.

Our plan covers:

  • Exams, therapy and tests.
  • Hearing aids and batteries.

Hospitalization

This plan pays for all expenses related to a hospital stay, so you can rest and heal. 

Hospitalization coverage includes:

  • 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 at home.

In-Home Care

After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

  • An in-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.
  • Help with personal care or housekeeping.

Lab and X-ray Services

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 can get information in another language. Just ask. Then anything we write to you will only be in that language. This is provided at no cost to you.  

Medicines

And we make getting your child's medicine easy. We'll provide a list of covered drugs if you have questions about what prescriptions are covered.

You can fill the prescriptions at local pharmacies in the UnitedHealthcare Community Plan network.

Member Services

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

We can also help you find:

  • Home care providers.
  • Specialists.
  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

Mental Health

Mental health is as important as physical health. That’s why we have coverage for both.

Required care is 100% covered with no copay. This includes:

  • Behavioral therapy.
  • Substance abuse treatment.
  • Medications.

Nurse Visit

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care.
  • Answer any questions and concerns.

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.

Nutrition Coaching

Healthy eating goes a long way to helping you stay at your best. A nutritionist can meet with you to review your eating habits and food choices. 

You’ll come away with new ideas for:

  • Making good choices for quick meals and snacks.
  • Preparing healthy meals on a budget.

Obesity Care

Obesity is common and serious.  It can also lead to other health problems. To help our members be their best, our plan includes:

  • Screening for obesity.
  • Counseling for obesity.

Outpatient Services

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. 

Personal 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. 

Prenatal Visits

A pregnancy is a journey that’s better with the help of friends, family and a pregnancy doctor, or OB/GYN.

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

At these visits, the clinic will:

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

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture.

Rehabilitation Care

After a serious illness, surgery or injury you may need extra nursing and therapy.  If needed, our plan covers short stays in a rehabilitation center where you can heal.  Included are:

  • Nursing home services.
  • 24-hour nursing care.
  • Help with activities of daily living.

Physical, occupational and speech therapy.

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.

Shots and Vaccines

Routine shots help protect you from illness. So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots. 

Social Services

Many communities offer additional benefits for children in this plan. Social Services helps members connect to these local programs and services, such as:

  • WIC and financial support.
  • School services.
  • Respite care.
  • Training and family phone line.

Speech Therapy

Speech therapy visits and exercises can help those who have difficulty speaking. At your doctor’s requests, we will cover up to 60 combined physical, occupational, speech and other therapy visits each year

Text4baby

Text4baby can help new and expecting mothers keep themselves and their babies healthy.

You’ll get text messages throughout your pregnancy and your baby’s first year. Each text contains health and safety tips for topics like:

  • Prenatal care.
  • Labor and delivery.
  • Breastfeeding.
  • Safe sleep.
  • Nutrition.
  • Car seat safety.

So you and your baby can make a great start on life.

Therapy Services

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.

Unlimited Doctor Visits

There may be times when your or a family member’s health requires repeated visits to a primary care provider (PCP). Our plan does not limit the number the number of times you can see your PCP.  This way you get care need when you need it. And your doctor can see how your health is progressing.   

Urgent Care

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

  • Urgent care centers.
  • Medical aid units.
  • Other walk-in clinics.

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

  • Screening for obesity.
  • Support for healthy diet and exercise choices.

Well Visits

Well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated. Preventive services include:

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

There are no copayments for preventive care.

Member Resources

View Available Resources

Learn More

UnitedHealthcare Community Plan