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UnitedHealthcare Connected® for MyCare Ohio（Medicare-Medicaid 計劃）
Medicare
H2531-001
This plan is for adults who need extra support and care. You may qualify based on income and health needs. The plan offers members a customized care plan and a single point of contact for all Medicare and Medicaid services. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. You get many services to help with daily activities that other MyCare Ohio plans don’t offer. View the benefits below to see all that it offers.
More information on eligibility and enrollment can be found on www.ohiomh.com, or by calling the Medicaid Hotline at 1-800-324-8680, TTY 1-800-292-3572. The Hotline operates from 07:00 to 20:00m local time, Monday through Friday and 08:00 to 17:00, local time, on Saturday.
- UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)
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檢查資格
You are eligible for membership in our MyCare Ohio plan as long as you:
- live in our service area; and
- have Medicare Parts A, B and D; and
- have full Medicaid coverage; and
- are 18 years of age or older at time of enrollment.
You are not eligible to enroll in a MyCare Ohio plan if you:
- have other third party creditable health care coverage except for Medicare.
- have intellectual or other developmental disabilities and receive services through a waiver or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICFIID).
- are enrolled in PACE (Program for All-Inclusive Care for the Elderly).
Additionally, you have the option not to be a member of a MyCare Ohio plan if you:
- are a member of a federally recognized Indian tribe
If you believe that you meet any of the above criteria and should not be enrolled, please contact Member Services at 1-877-542-9236 (TTY 711), or you can also contact the Medicaid Hotline at 1-800-324-8680, TTY users should call Ohio Relay at 7-1-1, or on the managed care enrollment center (MCEC) website at www.ohiomh.com.
Applicants can ask an authorized representative to apply on their behalf using the forms below:
To file an Appeal or Grievance, please visit or FAQ section.
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。
查找鄰近的牙醫師。
查找此計畫承保的藥物。
查找鄰近的藥房。
承保福利和特點
Adult Day Care
Companionship is important. Adult day care provides care and companionship for seniors who who qualify for extra help during the day.
Caregivers also benefit, knowing their loved one is well cared for and safe during the day.
If your need for long‑term care has been determined by Ohio Medicaid, Adult day care can provide:
- Social connections and friendship.
- Meals.
Asthma and COPD Care
Individual care to help control asthma and other lung diseases.
Some members may have trouble managing asthma or COPD symptoms. For them, a nurse who specializes in breathing issues can really help. They get a customized treatment plan and medicine to help you:
- Manage flare-ups.
- Reduce symptoms.
- Help you stay active.
照護管理
Members get a get a Personal Care Manager. The care manager is there for you throughout your medical journey. He or she will:
- Work with you to develop a plan of care that meets your individual needs.
- Coordinate with family members, caregivers and health care providers.
- Help get additional services or support you may need.
Chiropractor Services
Our plan includes visits for chiropractic care. Whether chiropractor services are your primary or alternative treatment method, you're covered.
Members of all ages can get up to 15 visits per year. Members under 21 may get additional visits with prior authorization.
醫師選擇
From regular checkups to preventive health screenings, we want to make sure you get access to the right care at the right time.
You get a primary care physician (PCP), who is your main doctor. 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。
牙齒保健
Regular exams help keep teeth and gums strong and healthy. Oral exams are covered once per year for members over age 21.
設備和用品
Our plan covers some medical equipment ordered by a member's doctor or case manager. 這些可能包括下列用品：
- Walkers
- Wheelchairs
- 醫療用床
足部照護承保
We provide the exams and treatments needed to help keep your feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.
我們的足科承保包含：
- Routine foot exams.
- 提供足部照護以及如何選擇合適鞋類的有用秘訣。
- Therapeutic shoes and inserts for members with diabetes.
聽力照護
Trouble hearing can affect a person's everyday life in many ways. 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：
- 檢查、治療和檢測。
- Hearing aids, batteries, and accessories.
家庭醫療護理
If you are living with a long-term health condition, disability or leaving the hospital after surgery or a serious illness, you may need extra support. This can include help with day-to-day tasks like cleaning, cooking or dressing. 您甚至可能需要居家醫療訪視，以檢查您的復原情況。
With approval, our plan may cover:
- 居家醫療訪視。
- 醫療設備，如病床、助行器或輪椅。
- A home health aide, nursing services or a private nurse.
- Physical, occupational, and speech therapy.
- 個人照護或家務方面的協助。
- Home infusion therapy.
住院
This plan pays for most expenses related to a hospital stay, so you can rest and heal.
Our plan covers these services and more:
- 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。
Language and Interpretation
醫師和您需要相互瞭解，We can explain information in 英文 or in your primary language. If you are visually or hearing impaired, special help can be provided.
腎臟病照護
腎臟病是一種嚴重的疾病。After the kidneys stop working regular treatments, called renal dialysis, or an organ transplant are needed to live. 透析使用機器清潔血液，如同健康腎臟做的工作一樣。
Our services may include:
- 透析。
- Needed equipment and supplies.
- Home support services.
- Health education and training.
藥物
Our plan includes prescription drugs and refills for prescriptions written by your doctor or specialist. Thousands of drugs are covered.
You pay a co-pay amount, if needed, and you can get your prescription drugs at any in-network pharmacy.
Member Services Representative
Every member of the health plan gets a personal Members Services representative. This person can help you get the most of your benefits. 他們能夠：
- Welcome you to the plan and help you understand your benefits.
- Arrange for extra support services.
- Complete a health risk assessment.
- Help you access community services.
Mental Health and Substance Use Disorder Treatment Services
Get help with personal problems that may affect your mental or physical health. These may include stress, depression, anxiety or drugs and alcohol abuse. Our services also include:
- Therapy
- Counseling
- 藥物
Nurse Advice
在不方便的時間發生醫療問題和疾病。當您有關於健康方面的疑問時，可致電護士，服務時間一週 7 天，一天 24 小時。
我們的護士將：
- 聽取您的症狀。
- 協助自我照護。
- 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。
Obesity Care
Obesity is common and serious. It can also lead to other health problems. To help our members be their best, our plan includes:
- Screening for obesity.
- Counseling for obesity.
戒煙
大部分人都瞭解吸菸對健康有害，且自己知道需要戒菸。We support our members with coaching while they quit.
治療服務
Therapy can help you recover from a serious injury or illness, or simply reach your full potential. Members receive needed:
- 職業治療。
- 物理治療。
- Respiratory therapy.
- 語言治療。
緊急護理
您可能會發生不危及生命但需要立即診治的傷害或急症，因此，我們的計劃承保下列地點的照護：
- 緊急護理中心。
- Federally qualified health centers.
- 其他無需預約的診間。
視力照護
Eye exams are covered every year for members age 21-59.
UnitedHealthcare Connected® for MyCare Ohio（Medicare-Medicaid 計劃）
深入了解
UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) H2531-001-000