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The New York State Medicaid Managed Care Plan is offered through UnitedHealthcare Community Plan. It’s for New York State residents who meet the income or disability 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.
More information on eligibility and enrollment can be found on the New York State of Health website.
For more information about Child Health Plus or Medicaid, call New York Health Options at 1-800-541-2831.
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, 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, please contact your provider.
Companionship is important. Adult day care provides care and companionship for seniors who need extra help during the day.
Caregivers also benefit, knowing their loved one is well cared for and safe during the day.
Adult day care can provide:
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:
Do you or your child have a serious health problem or a high-risk pregnancy? If so, and you or your child qualifies, we offer case managers that can:
Your case manager will stay with you or your child throughout the medical journey. He or she will:
So you or your child can focus on getting better.
Where you have your baby is an important choice. That's why you can pick from hundreds of hospitals across New York.
We encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you have your baby.
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 and emergency care 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.
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:
If you are at risk for a fall or sudden illness, an emergency call system can really help. It sends an urgent request for someone to check on you and help you.
A loss can take many different forms. And you may get lots of suggestions on what to do. Grieving is part of the healing process.
If a recent loss has made you sad or unhappy, help is available. Our plan offers counseling and support during the grieving process. Our team will work with you to find a counselor or program to help you adjust to your loss.
The Healthy First Steps team is here for you. Our program will help you take the right steps to keep you and your baby healthy.
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.
Our plan covers:
Taking care of the basics, like cooking, can be hard to do yourself after an illness or sickness.
If you are receiving personal care services, you may need extra help to get through the tough times. We'll step in to bring nutritious meals to you. You can get up to 10 meals delivered each year.
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:
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 of $0.50 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:
Addiction can happen to anyone, any family, at any time according to the New York State Office of Alcoholism and Substance Abuse Services (OASAS).
UnitedHealthcare is here to assist you in all your healthcare needs. We have trained professionals who are experienced in understanding Substance Use Disorder and able to help you get treatment or give you information that will help you make decisions about your healthcare. You or your provider can call Optum Behavioral Health anytime for help at 1-844-206-1399.
Covered services include:
You will not have a copayment for care and services covered by our plan, other than for prescription drugs.
That means you will pay nothing for covered services, including:
You pay nothing for your child's care and services covered by our plan.
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:
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:
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.
Our plan offers the following palliative care services:
Sometimes the basics are hard to do yourself after an illness or injury.
If needed, we provide someone to help with:
A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.
All of your recommended prenatal clinical visits and tests are covered.
At these visits, the clinic will:
You know the bad health effects of smoking.
You know you need to quit. We support you while you quit with the help of coaches and supplies. The only thing you won't get from us is a lecture.
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:
See life more clearly with routine eye exams and glasses, if needed.
We also include:
This benefit is offered by March Vision Care.
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:
There are no copayments for preventive care.
UnitedHealthcare Community Plan
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