UnitedHealthcare Community Plan

Children's Special Health Care Services

The Children Special Health Care Services program is for children and young adults with special health or developmental challenges. Our plan provides extra services and support to help manage your child's care needs. If you are enrolled in Medicaid, you may qualify for this additional coverage.

Download more information about the CSHCS program here: Children's Special Health Care Services (CSHCS) Program.

Asthma and COPD Care

Do you 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:

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

Asthma Care

Does your child have asthma or respiratory allergies? A nurse who specializes in breathing issues can really help childhood breathing problems. Your child's nurse will

• Get to know your child
• Learn his or her triggers and activities.
• Develop a customized treatment plan.

照護管理

Do you or a family member have a serious health problem or a high-risk pregnancy? If so, our care managers are in your corner. They will:

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

Your care manager will stay with you on your medical journey. He or she will:

• Think beyond your medical needs.
• Make sure you have support at home.

So you can focus on getting better.

Choice of Doctors

You or your child gets a primary care provider (PCP) who is your main doctor. 使用醫師查詢來查看您的醫師是否在我們的網路內。

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.

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。

選擇生產中心

在哪裡生孩子是一項重要決定。That's why you can pick from nearly 100 hospitals across 密西根.

We encourage you to tour the hospital's birthing center. 這樣您可以熟悉它。當您生產時您就會更加放鬆。

Customer Services

Understanding your health care options can be confusing. Now you have someone you can call. 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。

We also have people who speak more than one language. 我們可請到能夠說您的語言的人員，

糖尿病患者支持

If you have diabetes you may need insulin, needles, wipes and glucose strips. 我們包含所有這一切，甚至更多。

Our plan also steps up with services to help you manage your diabetes including:

• 協調醫師照護。
• Dedicated team to help you understand your condition and manage it.

設備和用品

您在家中的健康和安全很重要。

我們的計劃承保您的醫師開立的醫療器材。This can include items like:

• 醫療用床
• 氧氣罐。
• 助行器或輪椅。

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。

Hearing Services

聽力障礙會在很多方面對您的日常生活產生影響。Our plan includes services and support to determine whether a hearing problem exists.

我們承保：

• 檢查、治療和檢測。
• Hearing aids are covered for Members under age 21.

住院

This plan pays for medical expenses related to a hospital stay.

我們的計劃承保：

• 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。We make sure you get follow-up care to continue healing.

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。

We'll help get the information needed to improve your health or be your best.

語言幫助

We have people at our member services who speak more than one language. 我們可請到能夠說您的語言的人員，

藥物

Our plan includes prescription drugs and refills.

We also cover many medically needed, over-the-counter medicines with a written order from your doctor. There is no copay for these medicines.

And we make getting your medicine easy. You can fill your prescriptions at:

• Network pharmacies.

精神健康

心理健康與身體健康一樣重要。That's why we cover both.

Short-term required care is covered with no co-pay. 這些包括：

• 行為治療。
• 藥物。

No Copays

You will not have a copayment for most care and services covered by our plan. 這意味著對於承保服務您無需支付任何費用，包括：

• 預防照護。
• 年度檢查。
• 常規視力照護。

護士看診

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:

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

懷孕照護

沒有什麽比您和您的孩子的健康更重要。That's why our benefits include:

• Prenatal Visit.
• 健康首要步驟 (Healthy First Steps®)。
• 載送。
• Wellhop for Mom & Baby. 
• Dental Services.

產前看診

Your 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。
• Get dental coverage as a pregnant member, during and for a full year after delivery. 

戒煙

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

預防針和疫苗

Routine shots help protect against illness. 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。

社會服務

Many communities offer additional benefits for children with special care needs. Social Services helps members connect to local programs and services, such as:

• WIC 和財務協助。
• 學校服務。
• 喘息照護。

Download more information about social services benefits here.

語言治療

語言治療就診和練習有助於有言語困難者。At your doctor's request we will cover short-term, medically needed physical, occupational, speech and other therapy visits each year.

治療服務

物理、職能和語言治療可協助您自嚴重傷害或疾病中恢復，或只是發揮您的全部潛力復原。

我們的計劃提供：

• 職業治療。
• 物理治療。
• 語言治療。

With a doctor's request your coverage includes short term physical, occupational, speech and/or other therapy visits each year.

載送

Our plan provides a ride for you to and from health care locations. 這包括前往以下地點的接送服務：

• Doctor or therapy visits.
• Health departments.
• Vision clinics.

You can also be reimbursed for gas for driving to and from health care visits:

ModivCare Member Gas Reimbursement Instructions
ModivCare Mileage Reimbursement App
ModivCare Member Gas Reimbursement Form
ModivCare Standing Order Form

To learn more visit https://www.mymodivcare.com

Unlimited Primary Care Provider/PCP Visits

There may be times when your health requires repeated doctor visits. Our plan does not limit the number of times you can see your primary care provider. This way you get the care you need when you need it. 且您的醫師可瞭解您健康上的進展。

視力照護

Regular eye exams and glasses, if needed, can help you see more clearly. We also include:

• 處方鏡片。
• Designer-style frames.

Call Member Services at 1-800-903-5253 for vision services and providers.

康復看診

康復看診可以幫助您保持健康。這些檢查可以及早發現健康問題並進行治療。預防保健服務包括：

• 成人和兒童的健康檢查。
• 施打例行預防針和檢測。
• Mammograms and Pap Smears.
• 健康寶寶照護。
• Colorectal Screenings.

預防性護理無需支付共付額。

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.