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The UnitedHealthcare Community Plan Heritage Health Adult Expansion plan is for Nebraska adults, ages 19-64, who are not eligible for or already in Medicare, and meet income requirements. You can enjoy many benefits and services that we have to offer. We will partner with your doctors to give you the quality of care you deserve.
Heritage Health Adult Expansion Benefits includes two tiers, Basic and Prime.
A comprehensive benefits package that includes ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive, wellness and chronic disease management and other services such as long-term care, non-emergent transportation and durable medical equipment.
Includes Basic Benefits, plus dental and vision services and select over-the-counter medications for eligible Nebraskans who are 19 or 20 years old, pregnant, or Medically Frail.
Medically Frail – Members who Nebraska Medicaid determines to be Medically Frail will be enrolled in the Heritage Health Adult Expansion program’s Prime Coverage.
Health Risk Screening
A tool that has a few questions about your health that will help UnitedHealthcare Community Plan’s clinical care team will work with you to identify areas where you may want to focus on to maintain or improve your health as well assist you with area of social service needs.
This plan is available in all counties.
Do you or a family member have trouble managing asthma or COPD symptoms?
You will get a customized treatment plan and medicine to:
When a member has complex health care needs, a care manager can really help. He or she will:
Eligible members can get health support with mobile phone service at NO COST to you from select Lifeline service providers. We want to help you stay connected! Apply Now! Call Member Services at 1-800-641-1902, TTY 711 for assistance..
Medicaid limits coverage of chiropractic services to: (i) Certain spinal X-rays; (ii) Manual manipulation of the spine; (iii) Certain evaluation and management services; (iv) Traction; (v) Electrical stimulation; (vi) Ultrasound; and (vii) Certain therapeutic procedures, activities, and techniques designed and implemented to improve, develop, or maintain the function of the area treated.
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.
Each member can choose a primary care provider (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.
Your PCP is your main doctor for:
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.
This service is provided by Medicaid and Long-Term Care. MCNA Dental is the Medicaid dental plan for the State of Nebraska. MCNA administers the dental benefits for eligible children and adults. MCNA Member Hotline: 1-844-351-6262, TTY (Hearing Impaired) 1-800-833-7352, or visit www.mcnane.net.
Note: Only Heritage Health Adult Expansion Prime Coverage members have dental benefits.
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:
If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:
Our member’s health and safety at home are important.
Our plan covers medical equipment ordered by the doctor or care manager. This can include supplies like:
We provide the exams you need to help keep your feet in great shape. And if you have diabetes, good foot care can help prevent much more serious problems.
Our podiatry coverage includes:
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:
Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.
After surgery or a serious illness, you may need in-home medical visit(s) to check on how well you are healing.
With approval, our plan covers:
This plan pays for expenses related to a hospital stay, so our members can rest and heal.
Hospitalization coverage includes:
And after leaving hospital, we can provide transitional care services. We make sure you get follow-up care to continue healing at home.
Hospice services are covered when they are ordered by a physician.
Knowing what’s wrong and finding it early can make all the difference. Our plan covers:
We’ll help you get the information needed to improve your health or be at your best.
If you have trouble hearing, you can get help by phone. Call the TTY Service at TTY 711. Ask them to call Member Services at 1-800-641-1902. They will connect you to us.
If you don't speak English, you can get help by phone. Call Member Services at 1-800-641-1902. They can let you speak to someone in your language.
Members can get 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. Just ask.
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:
Inpatient, residential and outpatient services for mental health and substance use disorders are covered by UnitedHealthcare. The type, amount and length of services provided will be based on the level of your needs. Visit www.liveandworkwell.com.
You will not have a copayment for care and services covered by our plan.
This includes in network services:
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:
UnitedHealthcare Community Plan also covers many Over-the-Counter (OTC) Medications that are on the state’s approved list.
A provider must write you a prescription for the OTC medication you need. Then all you have to do is take your prescription and member ID card into any network pharmacy to fill the prescription.
OTCs include: • Pain relievers. • Cough or cold medicine. • First-aid cream. • Contraceptives. • Acne medicine. For a complete list of covered OTCs, go to .myuhc.com/CommunityPlan
Note: Only Heritage Health Adult Expansion Prime Coverage members have Over-the-Counter (OTC) Medication benefit.
Our plan includes prescription drugs and refills, and we make getting your medicine easy. Medicare and other insurance copays may apply. You can fill your prescriptions at:
When you have a prescription filled, be sure to check that:
Prescription Drug Copays
You can receive many available PREFERRED brand name and generic drugs with no copay. Brand NON-PREFERRED prescriptions drugs have a $3 copay.
If the Center of Medicare and Medicaid Services (CMS) shows you’re copay exempt, you will not have to pay the $3 copay. You may be copay exempt if you are:
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:
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. Counseling is covered when you enroll with the Nebraska Tobacco-Free Quit Line. Medication for smoking cessation are available through Nebraska Medicaid. Call 1-800-784-8669.
After a serious illness, surgery or injury, you may need extra nursing and therapy. If needed, our plan covers short stays in a skilled facility where you can heal.
Routine shots help protect members and their family from illness. Our plan covers:
Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.
Our plan provides:
Your coverage for transportation includes rides with ModivCare (formerly Logisticare) for medical visits and other health related appointments. ModivCare (formerly Logisticare) provides dependable rides and excellent personal service. Your health care appointments are important, and they work to meet your unique transportation needs with 24/7 support.
You can also learn more, schedule rides at www.modivcare.com
Covered when ordered by a network physician.
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.
You’ll get the care, eyeglasses and treatment that let you see life more clearly. Coverage includes:
This benefit is offered by MARCH Vision.
Note: Only Heritage Health Adult Expansion Prime Coverage members have the vision care benefit.
We will provide members and families with door and window alarms (up to six per household) to help reduce wandering without caregiver awareness.
These visits can catch health problems early, so they can be treated.
Preventive services :
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