UnitedHealthcare Connected® for MyCare Ohio H2531-001

Medicaid

H2531-001

This plan is for adults who need extra support and care. You may qualify based on income and health needs. The plan offers members a customized care plan and a single point of contact for all Medicare and Medicaid services. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. You get many services to help with daily activities that other MyCare Ohio plans don’t offer. View the benefits below to see all that it offers.

More information on eligibility and enrollment can be found on www.ohiomh.com, or by calling the Medicaid Hotline at 1-800-324-8680, TTY users should call Ohio Relay at 7-1-1. The Hotline operates from 7 a.m. to 8 p.m. ET Monday through Friday and 8 a.m. to 5 p.m. ET on Saturday.

 

 

Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Stark, Summit, Trumbull, and Wayne.

Benefits & Features

Well and Sick Care

If you just need a checkup or if you are injured or sick, you will have access to the care you may need. That includes:

  • Unlimited PCP Visits. See your doctor as often as needed.
  • NurseLineSM. Speak with a registered nurse 24/7. Call 1-800-542-8630.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Therapy Services. Physical and other needed therapies are covered.
  • Urgent Care. Convenient care for a sudden illness or injury.

A healthy mom is more likely to have a healthy baby. Pregnancy is an important time for women to take good care of themselves and their unborn baby. We have a special program for pregnant members. Our Healthy First Steps program gives pregnant women information, education and support during pregnancy. Pregnant members can enroll in Healthy First Steps by calling 1-800-599-5985.

If you have asthma, diabetes or another chronic condition, you can depend on us. Our plan helps you get the care, support and services you may need. Benefits include:

  • Mental Health and Substance Abuse Services. Counseling and other treatments are covered.
  • Care Management. Personal support from an experienced professional.
  • Asthma and COPD Care. Exams, testing and supplies are covered for asthma and other lung diseases.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.

We help members keep their vision, smile and hearing in the best shape possible. Benefits include:

  • Vision. Eye exams are covered every year for members age 21-59.
  • Dental. We pay for an exam every six months for members over the age of 21.
  • Hearing. Tests, checkups and hearing aids, if needed, are provided.

You get the medical care and equipment you may need to live safely at home. Benefits include:

  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Care Coordinator.. Someone to get you the services after surgery or illness.
  • Home Health Care. Medical and personal care in your home, if needed.

Sometimes members need a little extra help using their health plan. For those times, they can rely on:

  • Transportation. Transportation to a doctor's office is only covered in certain circumstances.
  • Members Matter. Someone to help you get the most from your plan.
  • Language Help. Connect to a translator through Member Services.
  • My Advocate. We help members connect to community services.

Adult Day Care

Companionship is important. Adult day care provides care and companionship for seniors who who qualify for extra help during the day.

Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

If your need for long‑term care has been determined by Ohio Medicaid, Adult day care can provide:

  • Social connections and friendship.
  • Bathing and personal care.
  • Meals.

Asthma and COPD Care

Individual care to help control asthma and other lung diseases.

Some members may have trouble managing asthma or COPD symptoms. For them, a nurse who specializes in breathing issues can really help. They get a customized treatment plan and medicine to help you:

  • Manage flare-ups.
  • Reduce symptoms.
  • Help you stay active.

Care Management

Members get a get a Personal Care Manager. The care manager is there for you throughout your medical journey. He or she will:

  • Work with you to develop a plan of care that meets your individual needs.
  • Coordinate with family members, caregivers and health care providers.
  • Help get additional services or support you may need.

Chiropractor Services

Our plan includes visits for chiropractic care. Whether chiropractor services are your primary or alternative treatment method, you're covered.

Members of all ages can get up to 15 visits per year. Members under 21 may get additional visits with prior authorization.

Choice of Doctor

From regular checkups to preventive health screenings, we want to make sure you get access to the right care at the right time.

You get a primary care physician (PCP), who is your main doctor. 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:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

Dental Care

Regular exams help keep teeth and gums strong and healthy. Beginning April 30, 2015, oral exams are covered once per year for members over age 21.

Equipment and Supplies

Our plan covers some medical equipment ordered by a member's doctor or case manager. This can include supplies like:

  • Walkers
  • Wheelchairs
  • Hospital beds

Foot Care

We provide the exams and treatments needed to help keep your feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

  • Routine foot exams.
  • Tips about foot care and choosing the right shoes.
  • Therapeutic shoes and inserts for members with diabetes.

Hearing Care

Trouble hearing can affect a person's 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, batteries, and accessories.

Healthify

Sometimes a person's health and safety needs require the assistance from community support programs.

Here's where UnitedHealthcare's Healthify program can easily help. By calling 1-877-542-9236 our members can learn about and sign up for money-saving programs like: food, legal assistance, housing, utility discounts, free cell phone service; adult and child day care; and other social service programs.

Healthy First Steps

When you're pregnant, you receive help and advice from your family and friends. Yet every pregnancy is different. This program will support you through your pregnancy.

We help you:

  • Find a doctor for both mother and baby.
  • Learn about nutrition, fitness and safety.
  • Get supplies, including breast pumps for nursing moms.

Home Health Care

If you are living with a long-term health condition, disability or leaving the hospital after surgery or a serious illness, you may need extra support. This can include 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 may cover:

  • An in-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • A home health aide, nursing services or a private nurse.
  • Physical, occupational, and speech therapy.
  • Help with personal care or housekeeping.
  • Home infusion therapy.

Hospitalization

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

Our plan covers these services and more:

  • 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.

Language and Interpretation

You and your doctor need to understand each other. We can explain information in English or in your primary language. If you are visually or hearing impaired, special help can be provided.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working regular treatments, called renal dialysis, or an organ transplant are needed to live. Dialysis uses a machine to clean the blood just like healthy kidneys do.

Our services may include:

  • Dialysis.
  • Needed equipment and supplies.
  • Home support services.
  • Health education and training.

Medicines

Our plan includes prescription drugs and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.

You pay a co-pay amount, if needed, and you can get your prescription drugs at any in-network pharmacy.

Member Matters Representative

Every member of the health plan gets a personal Members Matter representative. This person can help you get the most of your benefits. They can:

  • Welcome you to the plan and help you understand your benefits.
  • Arrange for extra support services.
  • Complete a health risk assessment.
  • Help you access community services.

Mental Health and Substance Use Disorder Treatment Services

Get help with personal problems that may affect your mental or physical health. These may include stress, depression, anxiety or drugs and alcohol abuse. Our services also include:

  • Therapy
  • Counseling
  • Medications

Nurse Advice

Medical questions and situations 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.

Obesity Care

Obesity is common and serious. It can also lead to other health problems. To help our members be their best, our plan include weight counseling. The counseling takes place in your primary care setting, so that it can be managed along with your other needs.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members with coaching while they quit.

Therapy Services

Therapy can help you recover from a serious injury or illness, or simply reach your full potential. Members receive needed:

  • Occupational therapy.
  • Physical therapy.
  • Respiratory therapy.
  • Speech therapy.

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.
  • Federally qualified health centers.
  • Other walk-in clinics.

Vision Care

Eye exams are covered once every two years.

Beginning April 30, 2015, eye exams are covered once every two years for members age 21-59. No extra allowance for contact lenses. Contact lenses are covered only if medically necessary.

UnitedHealthcare Connected® for MyCare Ohio

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UnitedHealthcare Connected® for MyCare Ohio H2531-001