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The Essential Plan is offered through UnitedHealthcare Community Plan. It's for lower income individuals in New York who meet the income or citizenship status requirements.
To find out if UnitedHealthcare Community Plan is offered in your county, please call 1-888-617-8979. A representative will contact you to schedule an appointment to help you apply.
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, Westchester, Wyoming, and Yates.
UnitedHealthcare continues to partner with state and local public health departments, following guidance and protocols appropriate to our members that are provided by the U.S. Centers for Disease Control and Prevention (CDC), and state and local public health departments that are appropriate for our members. Please review the UnitedHealthcare Coronavirus (COVID-19) Information. To learn more, go to CDC.gov.
COVID-19 NY State PPE Fee Guidance
The New York State Department of Financial Services (DFS) recently issued guidance stating that care providers should not charge members additional fees for items such as personal protective equipment (PPE). DFS expects New York care providers to refund any of these charges paid by the member that were more than the member’s financial responsibility on a claim. If you have questions, you may contact your provider or call the number on the back of your card for assistance with filing a complaint.
Individual care to help control asthma, allergies or COPD symptoms.
Do you or your child have trouble managing asthma, allergies or COPD symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:
You get a primary care physician (PCP), who is your main doctor. 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.
Your PCP is your main doctor for:
Checkups are covered. Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well.
See life more clearly with routine eye exams and glasses, if needed. We also include:
This benefit is offered by March Vision care.
*Vision and dental benefits are available through purchase of Essential Plus plans or as a standard benefit in Essential Plan 3 and 4 plans; these benefits are not available for Essential Plan 1 and 2 Standard Plans.
If you have diabetes, you may need insulin, needles, wipes and glucose strips. We cover all that and more.
Our plan also steps up with services to help you manage your diabetes, including:
Your health and safety at home are important.
Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:
Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.
Our plan covers:
This plan pays for all expenses related to a hospital stay, so you can rest and heal.
Hospitalization coverage includes:
And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.
Our plan covers prescription drugs and refills with a small copayment. Your copay is:
Over-the-counter medicines with a written order from your doctor are available for a copayment for each medicine. And we make getting your medicine easy. You can fill your prescriptions at:
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We'll answer your questions simply and completely.
We can also help you find:
Mental health is as important as physical health. That's why we have coverage for both.
Required care is 100% covered. This includes:
* Copays will apply for Essential Plan 1.
Sometimes you may need continued care after you leave the hospital or urgent care.
If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:
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 help improve your health or be your best.
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:
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.
Routine shots help keep you healthy.
So, our plan covers:
Well visits with your doctor can help you stay healthy. These visits can catch health problems early, so they can be treated.
Preventive services include:
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