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UnitedHealthcare Community Plan

Medicaid

我們的 TennCare Medicaid 計劃提供一系列承保福利。兒童、孕婦、成人和老年人或殘疾人士根據收入可能符合資格。View the benefits below to see all that our 田納西 Medicaid plan offers.

無論您居住於田納西何處,都可以使用本計劃。

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.

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: 申訴及投訴
P.O. Box 5220
Kingston, NY 12402-5220
Phone: 800-690-1606 TTY: 711

Health Care Finance and Administration
Office of Civil Rights Compliance
310 Great Circle Road, Floor 3W
Nashville, 田納西 37243
Email: HCFA.Fairtreatment@tn.gov
電話: 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

承保福利和特點

康復與生病照護

獲取使您保持健康的照護 — 或獲取針對您受傷或生病的更好照護。And pregnant moms get support to keep you and your baby healthy. 保戶福利包括:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • Nurse Hotline. 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.

沒有什麽比您和您的孩子的健康更重要。這就是為何我們的 TennCare Medicaid 計劃承保福利包括:

  • 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®. Get extra support and rewards to keep you and your baby healthy.
  • Choice of Birth Centers. Pick from hospitals all across 田納西.
  • Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

如果您有氣喘、糖尿病或其他長期疾病,您可以信賴我們。Our TennCare Medicaid plan makes sure you get the care and services you need. 承保福利範圍包括:

  • 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. 承保福利範圍包括:

視力.

  • For adults age 21 and older- vision services are limited to medical evaluation and management of abnormal conditions and disorders of the eye. The first pair of cataract glasses or contact lens/lenses after cataract surgery are covered.
  • Children under 21 years old- can have their eyes checked and get eyeglass lenses and frames as medically necessary. If the eyeglass lenses or frames are broken or lost, we will replace them as medically necessary.
  • TennCare will pay for other vision care if it is medically necessary. Contacts are covered only if they are medically necessary.
  • Children do not have to see their PCP before seeing their eye doctor, the eye doctor must be in our Provider Directory.

牙科.  

  • Dental care for adults age 21 and older is covered with limits. Dental care includes benefits like checkups, x-rays, oral treatments and more. See your Dental Benefits Manager (DBM) Handbook for limits. Your dental plan for your teeth is called DentaQuest.  They can help you if you have questions about dental care.  To find a DentaQuest dentist, go to http://www.dentaquest.com/state-plans/regions/tennessee/.  Then click Find a Dentist.  Or you can call them at 855-418-1622. It’s a free call.
  • Dental Care for Children (for teeth) You also have a dental plan for your teeth called DentaQuest.  Their phone number is 1-855-418-1622.  You can call DentaQuest to find a dentist.  Or, if you have questions about caring for your child’s teeth, you can call them.  It’s a free call.
  • Children’s teeth need special care.  Children under age 21 should have a checkup and cleaning every six months.  Children need to start seeing a dentist the time the first tooth comes in the mouth, or no later than the first birthday.
  • TennCare will pay for some other dental care if it is medically necessary.  Braces are covered only if they are medically necessary and only for children.
  • You do not need to see your PCP before you go to a dentist.  But, you will need to go to a DentaQuest dentist. 

Members who qualify can get the medically necessary equipment and help needed to live safety at home. 承保福利範圍包括:

  • 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.

有時在使用您的健康計劃時您可能需要少許額外幫助。此時,您可以依靠:

  • Nurse Hotline℠. Speak with a registered nurse 24/7.
  • Language Help. Connect to a translator through Member Services.
  • Member Services. Someone to help you understand how to use your benefits.
  • Quitting Tobacco.  Coaches, supplies and medications to help you quit using tobacco.  
  • Weight Control. Support and treatment to reach a healthy weight.
  • Health Education. Free classes to help improve your health.

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.

在哪裡生孩子是一項重要決定。That’s why you can pick from hospitals all across 田納西.

我們歡迎您參觀我們醫院的生產中心。這樣您可以熟悉它。當您生產時您就會更加放鬆。

設備和用品

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

您在家中的健康和安全很重要。

我們的計劃承保您的醫師或照護經理開立的醫療器材。這些可能包括下列用品:

  • 醫療用床
  • 氧氣罐。
  • 助行器或輪椅。

健康教育

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.

健康首要步驟 (Healthy First Steps®)

加入「Healthy First Steps」計劃,爲您和您的寶寶創造健康的未來,並賺取豐厚獎勵。我們的計劃將幫助您採取正確的步驟來保持您和寶寶的健康。此外,註冊還可以賺取$20獎勵。

我們將幫助您:

  • 選擇懷孕服務提供者和兒科醫師(孩子的醫師)。
  • 預約就診和檢查,並安排就診接送服務。
  • 您在整個懷孕期間和寶寶 15 個月大之前參與就診可獲得獎勵。
  • 獲取用品,包括哺乳媽媽的擠奶器。
  • 與社區資源聯繫,例如女性、嬰兒和兒童 (Women, Infants and Children, WIC) 服務。

住院

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

這些包括:

  • 照護。
  • 病房與餐宿。
  • 用品與設備。
  • 治療。
  • 診斷檢驗和檢查。

在您離開醫院後仍可獲得關懷。我們保證您可獲得後續照護幫助您在家治癒。

Internet

Do you know about the Affordable Connectivity Program? It’s a new program that helps pay for high-speed internet.  You can use the internet for work, school, healthcare, and more. What do you get with this program?  You may get up to $30 per month off your internet bills.  There is also a one-time $100 discount off a laptop, tablet, or computer. Who can get this program?  Any household that has at least one person enrolled in Medicaid.  How do you get this program?  You must enroll to get it.  Go online to getinternet.gov and enroll today.

深入瞭解

翻譯人員

醫師和您需要相互瞭解,無法說流暢的英文會造成困難。在您就診時,我們可安排醫療翻譯人員在場。

我們也有保戶服務人員會說不只一種語言。我們可請到能夠說您的語言的人員,

檢驗室檢驗和 X 光檢查

知道健康出了什麼問題,並及早找出問題所在,可能是成功治療的關鍵。我們的計劃承保:

  • 檢驗室檢驗。
  • X 光、掃描和其他影像技術。

我們會協助您取得所需資訊,幫助改善您的健康或達到最佳狀態。

語言幫助

You can receive information in your preferred language. 你只需提出來。We also have people at our member service centers who speak more than one language. 我們可請到能夠說您的語言的人員,

保戶服務

Understanding your health care options can be confusing. 我們會簡潔而完整地回答您的問題。

We help you find:

  • 醫師。
  • 藥房。
  • 醫院或其他保健設施。
  • 當地資源。

精神健康

心理健康與身體健康一樣重要。That’s why we have the same coverage for both.

所需照護為 100% 承保,無共付額。這些包括:

  • Mental health therapy.
  • 物質濫用治療。
  • 藥物。

No Copays

Members have no copayments for:

  • 預防照護。
  • 年度檢查。

護士看診

在離開醫院或緊急照護機構後,有時候會需要持續照護。例如,在重病、手術或受傷後。在這些情況下,護士將會進行居家訪視,以便:

  • Provide medical care for you.
  • Answer your questions and concerns.
  • Home health. Home nursing care limited to 125 visits per calendar year.

護士熱線

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 Nurse Hotline nurses will: 

  • 聽取您的症狀。
  • 引導您進行自助照護。
  • 建議您看醫生或到緊急護理中心看診。
  • 幫助您了解什麽時間應該掛急診。

產前看診

A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

承保推薦的所有產前看診和檢驗。

在看診時,診所將:

  • 確保您和您的孩子都健康。
  • 說明您在懷孕期各個階段可能會有的症狀。
  • 回答您的問題。

主要照護提供者

You can have one main person for your health care. He or she can be a doctor, a nurse practitioner, or a physician’s assistant. This person is called your Primary Care Provider (PCP). 

您的主要照護醫師 (PCP) 就是為您提供下列服務的主治醫師:

  • 預防照護。
  • 在您生病或受傷時為您治療。
  • 針對您的特殊健康問題,將您轉診給專科醫生。

To change your PCP:

  1. Find a new PCP in the UnitedHealthcare Community Plan network. To find a new PCP you can look in our Provider Directory, you can go online at
    myuhc.com/CommunityPlan, or call 1-800-690-1606.
  2. Then call the new PCP to make sure that he or she is in the UnitedHealthcare Community Plan provider network. Be sure to ask if he or she is taking new patients.
  3. If the new PCP is in our network and taking new patients, fill out the PCP Change Request in Part 8 of your Member Handbook and mail it back to us. Or you can call us at
    1-800-690-1606 to tell us the name of your new PCP.

戒煙

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.

預防針和疫苗

Routine shots help keep you healthy. 因此,我們的計劃承保:

  • 建議施打的預防針和疫苗。
  • 流感預防針。

載送

In case of emergency call 911

Important tips for setting up a ride- Please review 田納西 Carriers website- Rider Information Riders | 田納西 Carriers (tenncarriers.com)

  • 請致電 1-866-405-0238,聽障專線 (TTY) 711 來安排您的接送服務 
  • Call at least seventy-two (72) hours in advance of your appointment whenever possible
  • If the time for your return trip home was not already scheduled, you are responsible for calling to tell the transporter that you are ready to be picked up for your trip home
  • If you cancel your appointment/visit, call 1-866-405-0238 to cancel your ride 
  • 準備好您的 Medicaid ID 卡 
  • If you have more than one appointment on the same day, you can get a ride to all covered services. Please give 田納西 Carriers information for each appointment
  • 瞭解您的健康照護服務提供者的地址以及約診的日期和時間 
  • 具體說明您需要搭乘前往的目的地 
  • 如果您的醫師給您處方,您可以到藥房領取處方 
  • 如果您有輪椅等特殊需求,請告知我們 
  • Any minor requesting transportation without an accompanying adult will be handled on a case-by-case basis 
  • If you wish to bring someone with you to your appointment, you can have someone ride with you. This is sometimes called an escort. An escort is someone over the age of 12. Please let 田納西 Carriers know you’ll have an escort riding with you
  • If you’re going to an appointment and need to take your child with you, he or she won’t count as your escort

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.

康復看診

康復看診可以幫助您保持健康。These visits can help catch health problems early so they can be treated. 預防保健服務包括:

  • 成人和兒童的健康檢查。
  • 健康寶寶照護。
  • 孕婦照護。
  • 施打例行預防針和檢測。
  • 乳房攝影檢查。

You will not have a copayment for preventive care.

Wellhop for Mom & Baby

Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.
Here’s how it works:

  • Join video conversations every other week with women who have similar due dates and a group leader.
  • Chat and share experiences with moms from your group on the Wellhop app or website.
  • Visit the Wellhop library. You’ll find articles, videos and more.

保戶資源

Healthier 田納西 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

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