UnitedHealthcare Community Plan

Medicaid

Our TennCare Medicaid plan offers a range of benefits. Children, pregnant women, adults and people who are elderly or have a disability may qualify based on income. View the benefits below to see all that our Tennessee Medicaid plan offers.

This plan is available wherever you live in Tennessee.

More information on eligibility and enrollment can be found on the TennCare website.

View and manage health benefits online with TennCare Connect. For more information, visit tenncareconnect.tn.gov.

This plan is available in all counties.

We obey federal and state civil rights laws.  We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion, or sex.  Do you think we did not help you or you were treated differently because of your race, color, birth place, language, age, disability, religion, or sex?  You can file a complaint by mail, by email, or by phone. Download and print the information (PDF 30.64 KB) or see below:

UnitedHealthcare Community Plan
Attn: Appeals and Grievances
2035 Lakeside Centre Way, Suite 200
Knoxville, TN 37922
Phone: 800-690-1606 TTY: 711

Health Care Finance and Administration
Office of Civil Rights Compliance
310 Great Circle Road, Floor 4W
Nashville, Tennessee 37243
Email: HCFA.Fairtreatment@tn.gov
Phone: 855-857-1673 (TRS 711)

You can get a complaint form online at:
http://www.tn.gov/hcfa/article/civil-rights-compliance

You can get a complaint form online at:
http://www.hhs.gov/ocr/office/file/index.html

Or you can file a complaint online at:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

U.S. Department of Health & Human Services
Office for Civil Rights

200 Independence Ave SW, Rm 509F, HHH Bldg.
Washington, D.C. 20201
Phone: 800-868-1019 (TDD): 800-537-7697

Benefits & Features

Well and Sick Care

Get the care you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get support to keep you and your baby healthy. Member benefits include:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Lab and X-rays. Lab tests and x-rays are covered.

Nothing is more important than the health and well-being of you and your baby. That’s why our TennCare Medicaid plan benefits include:

  • Choice of Doctor. Find an OB/GYN you trust in our network.
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • Choice of Birth Centers. Pick from hospitals all across Tennessee.

If you have asthma, diabetes or another long-term condition, you can depend on us. Our TennCare Medicaid plan makes sure you get the care and services you need. Benefits include:

  • Mental Health. Counseling and other treatments are available.
  • Care Management. Personal support from an experienced professional.
  • Population Health Services. Help to manage your ongoing health or chronic condition.

Make sure sight, teeth and hearing are at their best. Benefits include:

  • Vision. Eye exams and glasses covered to age 21.
  • Dental. Exams and dental work covered to age 21.
  • Hearing. Tests and hearing aids covered to age 21.

Members who qualify can get the medically necessary equipment and help needed to live safety at home. Benefits include:

  • Equipment and Supplies. In-home medical safety materials are covered.
  • Nurse Visits. Short-term medical care while recovering at home.
  • Care Coordinator. Someone to get you the services to live safely at home.

Sometimes you might need a little extra help using your health plan. For those times, you can rely on:

  • Transportation. We provide rides to and from needed medical visits.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Language Help. Connect to a translator through Member Services.
  • Member Services. Someone to help you understand and use your benefits.
  • Weight Control. Support and treatment to reach a healthy weight.
  • Health Education. Free classes to help improve your health.
  • Quitting Tobacco. Coaches, supplies and medicines to help you quit using tobacco.

TennCare CHOICES is for people who need extra support and care to live safely in their own home. If you qualify for CHOICES, you have access to these extra benefits:

  • Vision. Glasses or contact lenses after cataract surgery.
  • Equipment and Supplies. In-home medical safety materials are covered.
  • Nurse Visits. Short-term medical care while recovering at home.
  • Personal Care. Someone to help with dressing, bathing and eating.
  • Home Meal Delivery. If you can’t safely prepare meals, we’ll bring them to you.
  • Chore Services. Someone to do your errands, cleaning or laundry.
  • Care Coordinator. Someone to get you the services to live safely at home.
  • Respite Care. In-home help to give your caregiver a break.

Employment and Community First CHOICES (ECF CHOICES) is for people with intellectual and/or developmental disabilities. If you qualify for ECF CHOICES, you have access to benefits such as:

  • Job Exploration and Discovery. Find out if you would like to work and what jobs are available.
  • Skills Discovery. Find out the best jobs for your skills and interests.
  • Job Coaching. To help you as you start your job.
  • Career Advancement Services. To help you get a better job and earn more money.
  • Benefits Counseling. Learn about how your salary can affect your benefits.
  • Community Integration Support Services. Helps you do things in the community you want to do.
  • Independent Living Skills Training. Helps you learn to live independently.
  • Community Transportation. Helps you get to work and community activities.
  • Personal Assistance. Helps you with personal care needs or daily living activities.
  • Equipment and Supplies. Medical safety materials are covered for your use in your home or community.
  • Minor Home Modifications. Certain changes to make your home safer and easier for you.
  • Respite. Someone to support you for a short time so your caregiver can have a break.
  • Community Living Supports (CLS). To provide residential supports.
  • Adult Dental Services. Dental exams, cleanings and fillings.

Care Management

Do you or your child have a serious health problem? Then our care managers are in your corner. They will:

  • Explain medical terms in plain language.
  • Coordinate doctor appointments.
  • Provide the care team with medical records.

Your care manager will stay with you or your child throughout the medical journey. He or she will:

  • Think beyond immediate medical needs.
  • Make sure there is support at home.

Care Coordinator

Our members' safety at home is our priority. That is why we conduct home visits for those needing extra help to stay at home.

During this visit, we:

  • Understand your personal needs.
  • See if your home needs minor modifications, such as ramps and bathroom safety devices.
  • Set up emergency monitoring.
  • Arrange for personal care attendants.

Choice of Birth Center

Where you have your baby is an important choice. That’s why you can pick from hospitals all across Tennessee.

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.

Chore Services

If you are having difficulty performing day-to-day household activities, chore services can step in. They can take on the routine tasks that may be hard for you to do on your own.

Services will vary by the member's coverage type and may include:

  • Running errands.
  • Cleaning the house.
  • Doing laundry.
  • Preparing meals.

Dental Care

Cleanings, checkups and dental work are covered up to age 21.

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, we’ll fix it as well. 

Equipment and Supplies

The health and safety of our members at home are important.

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:

  • Hospital beds.
  • Oxygen tanks.
  • Walkers or wheelchairs.

Health Education

Free classes to help improve your health or address a condition.

Our plan includes classes on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

Hearing Care

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect the hearing of members to age 21.

We cover:

  • Exams, therapy and tests.
  • Hearing aids.

Healthy First Steps®

You may receive help and advice from your mom, aunts, sisters and girlfriends. Yet every pregnancy is different. This program will support you through your pregnancy.

We help you:

  • Find a doctor for you and your baby.
  • Learn resources for nutrition, fitness and safety.
  • Get supplies, including breast pumps for nursing moms.

Home Meal Delivery

Good nutrition is essential to good health. Yet you may not be able to safely fix meals for yourself at home. So we’ll arrange for home meal delivery if you qualify.

Hospitalization

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

This includes:

  • 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.

In-Home Care

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:

  • In-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies
  • Help with personal care or housekeeping.

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Lab and X-rays

Knowing what's wrong and finding it early can make all the difference. Our plan covers:

  • Labs and testing.
  • X-rays, scans and other imaging.

We’ll help you get the information needed to improve your health or be at your best.

Language Help

You can receive information in your preferred language. Just ask. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language.

Member Services

Understanding your health care options can be confusing. We can answer your questions simply and completely.

We help you find:

  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

Mental Health

Mental health is as important as physical health. That’s why we have the same coverage for both.

Required care is 100% covered with no copay. This includes:

  • Mental health therapy.
  • Substance abuse treatment.
  • Medications.

No Copays

Members have no copayments for:

  • Preventive care.
  • Annual checkups.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care for you.
  • Answer your questions and concerns.

NurseLine℠

Medical questions and situations can sometimes come at inconvenient times. When you have questions about your health or your child’s health, you can call a trained nurse 24/7.

Our NurseLine nurses will: 

  • Listen to the symptoms.
  • Guide you on 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.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help for:

  • Dressing.
  • Bathing.
  • Eating. 

Prenatal Visits

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:

  • Make sure you and your baby are healthy.
  • Explain what to expect at each stage of your pregnancy.
  • Answer your questions.

Primary Care Provider

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.

Your PCP is your main doctor for:

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

Quitting Tobacco

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.

Respite Care

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.

Shots and Vaccines

Routine shots help keep you healthy. So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots.

Transportation

Our plan provides round trip rides to and from health care locations when necessary.

Vision Care

Regular eye exams and glasses, if needed, can help you see more clearly.

Members up to age 21 receive:

  • Regular exams.
  • Frames.
  • Prescription lenses. 

TennCare CHOICES members get glasses or contacts after cataracts surgery.

This benefit is offered by Vision Service Plan.

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

  • Screening for obesity.
  • Support for healthy diet and exercise choices.
  • Health coaching

Well Visits

Well visits with your doctor can help keep you healthy. These visits can help catch health problems early so they can be treated. Preventive services include:

  • Checkups for adults and children.
  • Well-baby care.
  • Care for women expecting a baby.
  • Routine shots and tests.
  • Mammograms.

You will not have a copayment for preventive care.

Member Resources

Healthier Tennessee is a priority of the Governor’s Foundation for Health & Wellness, involving action promoting healthier behaviors in schools, workplaces and in places of worship. More information is available at www.healthiertn.com

View Available Resources