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Verify your mailing address today!
It is important to keep your mailing address up to date to make sure you get important messages about your health care coverage. To update your mailing address:
- Call the New York State of Health Exchange at 1-855-355-5777
- Log on to your New York State of Health account at nystateofhealth.ny.gov/apply
New York Pharmacy Program Changes Effective 04/01
UnitedHealthcare Wellness4Me
Medicaid
The Wellness4me Plan is offered through UnitedHealthcare Community Plan, a Health and Recovery Plan, or HARP, approved by New York State. HARPs are a new kind of plan that provide Medicaid members with their health care, plus care for behavioral health, including Serious Mental Illness and Substance Use Disorders.
This plan is for New York residents age 21 and who qualify for Medicaid coverage.
UnitedHealthcare Community Plan is a special health care plan with providers who have a lot of experience treating people who may need mental health and/or substance use care to stay healthy. We also provide care management services to help you and your health care team to work together to keep you as healthy as possible.
本計劃在以下的郡提供：
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Schenectady, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, Westchester, Wyoming, and Yates.
- UnitedHealthcare Wellness4Me
搜尋本計劃的服務提供者和承保資料。
查找醫師、醫院和專科醫師。
查找此計畫承保的藥物。
查找鄰近的藥房。
查找鄰近的牙醫師。
承保福利和特點
Adult Day Care
Companionship is important. If your Primary Care Provider (PCP) recommends it, you may be able to participate in adult day health care. Adult day health care provides care and companionship for seniors who need extra help during the day.
Caregivers also benefit, knowing their loved one is safe when they can’t provide care.
Adult day care can provide:
- Social connections and friendship.
- Bathing and personal care.
- Meals.
Asthma and COPD Care
Do you need help trouble managing asthma, allergies or COPD symptoms? You’ll get a customized treatment plan and medicine to help:
- Manage flare-ups.
- Reduce symptoms.
- Live an active life.
行為保健
行為健康與身體健康一樣重要。Our behavioral health care includes mental health and substance use treatment services.
所需照護為 100% 承保，無共付額。這些包括：
- Intensive psychiatric rehab treatment (IPRT).
- Inpatient mental health treatment.
- Continuing day treatment.
- Personalized Recovery Oriented Services (PROS).
- Assertive Community Treatment Services (ACT).
- Individual and group counseling.
- Crisis intervention services.
You can also get help with alcohol or other substance use issues.
照護管理
A serious health problem requires extra care and support. We use Health Homes to coordinate services for our members.
Health Home 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 close by throughout the medical journey. He or she will:
- Think beyond immediate medical needs.
- Help manage ongoing medical issues like diabetes, asthma and high blood pressure
- Make sure you have support at home.
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 142 hospitals across New York.
We also encourage you to tour the hospital's birthing center. 這樣您可以熟悉它。And you'll be more relaxed when you have your baby.
醫師選擇
When you join UnitedHealthcare Community Plan, one of our providers will take care of you. Most of the time that person will be your Primary Care Provider (PCP). You may want to choose a PCP from your mental health or substance use clinic. If you need to have a test, see another specialist, or go into the hospital, your Primary Care Provider will arrange it.
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。
牙齒保健
Dental checkups and cleanings can help keep teeth and gums healthy. Covered services include:
- Regular checkups.
- Cleanings.
- X-rays.
- Treatments, including fillings and other services.
You do not need a referral from your PCP to see a dentist.
Diabetic Supplies
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。
我們的計劃還推出可幫助您管理糖尿病的服務，包括：
- Diabetes counseling and self-management training.
耐用醫療設備
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：
- 助聽器。
- Prosthetics.
- Orthotics.
聽力照護
聽力障礙會在很多方面對您的日常生活產生影響。我們的計劃包括幫助您保護聽力的服務和支援。
我們的計劃承保：
- Exams and tests.
- 助聽器及電池。
家庭醫療護理
Sometimes our members are living with a long-term health condition or disability. Others are coming out of the hospital after surgery or a serious illness. These members can receive extra support from our plan.
在核准後，我們的計劃會承保：
- 居家醫療訪視。
- 醫療設備，如病床、助行器或輪椅。
- In-home medical visit
- Help with day-to-day tasks like cleaning, cooking or dressing.
- 一次性醫療用品。
住院
本計劃支付所有住院的相關費用，讓您安心靜養。
住院承保包括：
- Inpatient care.
- Outpatient care.
- Lab, X-ray, other tests.
Your Health Home Care Manager can:
- Help you safely return home after a hospital stay.
藥物
Our plan covers prescription drugs and refills with a small copayment. Your copay is:
| Prescription Item | Wellness4me Plan | |
|---|---|---|
| Co-Payment Amount | Co-Payment Details | |
| Brand name prescription drugs | $3.00/$1.00 | 1 co-pay charge for each new prescription and each refill |
| Generic prescription drugs | $1.00 | Refer to the Preferred Drug List |
| Over-the-counter drugs, such as for smoking cessation and diabetes | $0.50 | Refer to the Preferred Drug List |
Over-the-counter medicines with a written order from your doctor are available for a copayment of $0.50 for each medicine.And we make getting your medicine easy. You can fill your prescriptions at:
- Local pharmacies.
- Services that deliver right to your door.
保戶服務
You can call Member Services to get help any time you have a question.
You may call us to choose or change your Primary Care Provider (PCP for short), to ask about benefits and services, to get help with referrals, to replace a lost ID card, to report that you are pregnant, the birth of a new baby or ask about any change that might affect your benefits.
Residential Care
After a serious illness, surgery or injury, you may need extra nursing and therapy.
若有需要，我們的計劃承保在復健中心的短期住院，讓您可在此復原。包括：
- 療養院服務。
- 24 小時護理照護。
- 協助日常活動。
- 物理、職能及語言治療。
If you are in need of long-term placement in a nursing home, your local department of social services must determine if you meet certain Medicaid income requirements.
留看護理
您家中有照護您的家人或朋友嗎？
如果是這樣，我們也希望能支援他們的辛苦工作。所以我們提供喘息照護，讓您的照顧者休息一下。留看護理為照護人員提供了時間，讓他們可以離開他們關愛的或需要特殊照護的家人。
- Short-Term Respite — gives you a safe place to go when you need to leave a stressful situation.
- Intensive Respite — helps you stay out of the hospital when you are having a crisis by providing a safe place to stay that can offer you treatment.
預防針和疫苗
例行預防針有助於不生病。
因此，我們的計劃承保：
- Pneumonia, influenza and shingles shots.
- Other recommended shots and vaccines.
視力照護
You'll get the care, eyeglasses and treatment that help you see better.
承保範圍包括：
- Eye exams every two years, or as medically needed.
- Prescription lenses, including contact lenses.
- Glasses and frames.
- Specialist care when needed.
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。
- 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。
預防性護理無需支付共付額。
UnitedHealth Group is 100% owner of UnitedHealthcare of New York, Inc