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UnitedHealthcare Rhody Health Partners ACA Adult Expansion
The Affordable Care Act (ACA) expanded health coverage to certain adults age 19 or older and under 65. The UnitedHealthcare Rhody Health Partners ACA Adult Expansion plan is for certain Adults aged 19-64 with no dependent children with an income at or below 133 percent Federal Poverty Level - You have to earn less than $15,654 per year or earn less than $1,305 per month and are a United States citizen or a legal permanent resident under 65 meeting income eligibility guidelines.
You are able to enjoy the many benefits and services that we have to offer, call us today to learn about all these benefits. We will work with your doctors to give to you the quality of care you deserve.
Who can join?
UnitedHealthcare offers coverage to beneficiaries of Rhode Island's Rhody Health Partners programs throughout the state. Eligibility for enrollment in Rhody Health Partners is determined by the Department of Human Services (DHS).
The Affordable Care Act has enabled millions of people to apply for health insurance. This means, that if you are a single adult, (adult with no dependent children) you may now qualify for Medicaid.
To be eligible for Rhody Health Partners ACA Adult Expansion, you must:
- Be a Rhode Island resident.
- Be a Citizen of the United States or a legally permanent non-citizen who has been in the United States for 5 years.
- Be between the ages of 19-64.
- Have no dependent children and not pregnant.
- Have annual income at or below 133% Federal Poverty Level or make less then $15,654 per year.
Under federal health care reform, the income eligibility limits for Medicaid are bumped up to include people with income up to 138% of the federal poverty level.
We are committed to making a difference in each member’s life by providing benefits and services to help them take charge of their health. We take great pride in the quality of service we provide our members in the communities we serve. We’d be proud to have you as a member of UnitedHealthcare Community Plan.
EOHHS in collaboration with DHS, RIDOH and the Governor’s office, continue to monitor the COVID-19 outbreak in RI and will work with our government partners and MCOs to ensure all lines of communication remain open and available. The health, safety and welfare of our members is our highest priority. More information about COVID-19 is available in multiple languages at health.ri.gov/covid. People with questions about COVID-19 can call 401-222-8022. This is the COVID-19 Hotline that RIDOH has available to the public. Please call 211 after hours.
View more information from the Centers for Disease Control and Prevention
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Benefits & Features
Annual Notice of Change in Benefits
Listed below is a comprehensive list of professional health care services. Please review these services to find out which ones are covered by this health plan.
- Inpatient Hospital Care
- Outpatient Hospital Services
- Physical Therapy
- Language Therapy
- Speech Therapy
- Hearing Therapy
- Respiratory Therapy
- Physician Services
- Family Planning Services
- Prescription Drugs
- Non-Prescription Drugs
- Laboratory Services
- Radiology Services
- Diagnostic Services
- Mental Health and Substance Abuse Outpatient
- Mental Health and Substance Abuse Inpatient
* For further details, see the Rhody Health Partners Benefits Summary
In addition to the services listed above, all Rhody Health Partners Members will receive the following mental health and substance abuse services Out-of-Plan:
- Psychiatric Rehabilitation Day Programs
- Community Psychiatric Supportive Treatment
- Crisis Intervention for individuals with SMPI enrolled in Community Psychiatric Supportive Services
- Clinician's services delivered at a Community Mental Health Center for individuals with SPMI enrolled in CPST - CSP
- RI-Assertive Community Treatment I and II
- Community-based narcotic treatment
- Community based detoxification
- Residential Treatment
The following services are not covered by the Health Plan or Medicaid Fee for Service
- Experimental Procedures
- Abortion Services except to preserve the life of the women, or in cases of rape or incest
- Private rooms in hospitals (unless medically necessary)
- Cosmetic surgery
- Infertility Treatment Services
- Sexual and erectile dysfunction medications
- Medical Assistance Program Fee Schedule
If you are enrolled in a Medicaid Waiver you may have additional benefits available to you through Medicaid Fee for Service. UnitedHealthcare Care Managers at 1-800-672-2156 or Hard of Hearing 711 can help you access these services.
Other Member Programs
Optum Behavioral Health (OBH)
OptumHealth can help you find solutions that relieve the pressures and demands of everyday life. OptumHealth focuses on prevention and education to guard against problems before they start.
Are you ready for flu season?
Influenza, commonly called the flu, is a serious illness that can spread easily. It can lead to missed days at school or work, and even hospital stays. Here’s the good news: a simple shot can reduce your chances of getting influenza — and it’s available to you at no cost with your UnitedHealthcare Community Plan. Talk to your UnitedHealthcare network doctor about getting the flu shot. If you don’t have one, please contact Member Services at 888-716-8787 and a representative can help you find one.
For a list of places to get a flu shot near you, visit http://www.health.ri.gov/flu
At UnitedHealthcare, we care about your health. Our goal is to improve the health of our members by providing high-quality services. Learn more about the CAHPS Survey below.
Citizenship Documents Required
There are new laws that may require you to show proof of citizenship in order to renew your health coverage. Click on a document below to read about what you will need:
If English is not your primary language, you can ask for an interpreter to help with your call to Member Services. We can also provide interpreter services for your doctor visits.
Call Member Services at (844) 445-7222 (TTY 711) at least 72 hours hours before your scheduled appointment to arrange for an interpreter to meet you at your appointment. Call Member Services 14 in advance for American Sign Language interpreter requests.
Member Advisory Committee
Join our Member Advisory Committee and share your feedback and concerns with us. Members come and learn about your health plan and share your feedback and concerns with us. and transportation is provided. Call Member Services at 844-445-7222 (TTY: 711) if you are interested in joining.
Member Rights & Responsibilities
As a UnitedHealthcare member, you have certain rights and assume certain responsibilities when you become a member. It is important you fully understand both your rights and your responsibilities. For more information, For more information, refer to your Member Handbook.
Notice of Privacy Practices
We have a Notice of Privacy Practices that tells you how health information about you may be used and shared. We are required by law to let you know that the Notice is available, and how you can get a copy of it. You can download a copy of our Notice of Privacy Practices below.
As a RIte Care member, you may qualify for a bus pass for you and your family to use to get to the doctor’s office. You will need to call MTM Transportation at 1-855-330-9131 TTY (866) 288-3133 to request a bus pass at least 7 business days before the appointment. Tell them the date and time of the medical, dental and behavioral health appointments as well as the name of the provider and a bus pass will be mailed to you.
If you cannot take a bus for medical reasons or because your home or your adult managed care appointment is not near a bus line, please call MTM Transportation for help in getting transportation to your appointment. Please use family and friends for transportation needs before calling MTM Transportation.
Preventive Care Guidelines
Preventative care helps you manage your health and health of your family. Maintaining or improving your health is important – and a focus on regular preventive care, along with following the advice of your doctor, can help you stay healthy.
Member Newsletters 2016 - Current
Member Newsletters Prior to 2016
UnitedHealthcare Rhody Health Partners ACA Adult Expansion
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