음.. 브라우저가 오래된 것 같습니다.
더 빠르고 안전한 사이트 경험을 즐길 수 있도록 브라우저를 업데이트해 보겠습니다.
UnitedHealthcare Medi-Cal is no longer active as of January 1, 2023
- UnitedHealthcare Medi-Cal은 2023년 1월 1일부터 더 이상 유효하지 않습니다. 2023년 1월 1일 이전에 받은 서비스에 관한 질문이 있는 경우, 자주 묻는 질문 사이트로 가시기 바랍니다. To lean more about your health plan choices call Health Care Options at 1-800-430-4263 for TTY 1-800-430-7077 Monday – Friday 8 am to 6 pm, local time or go to www.healthcareoptions.dhcs.ca.gov. You may contact the Ombudsman at 1-888-452-8609 Monday – Friday 8am to 5pm, local time, or by email MMCDOmbudsmanOffice@dhcs.ca.gov.
UnitedHealthcare Community Plan of California Medi-Cal
메디케이드
UnitedHealthcare Community Plan of 캘리포니아 includes a range of benefits. Children, pregnant women, families, adults and seniors and people with disabilities may qualify based on income. View the benefits below to see what our plan covers.
- UnitedHealthcare Community Plan of California Medi-Cal
Renewing Your Medi-Cal Coverage
If you have Medi-Cal benefits, your coverage will need to be renewed every year. The county will send you a Medi-Cal renewal form. Complete this form and return it to your local county human services agency. You can also visit or call your local human services agency. To find an office near you, visit the San Diego Health & Human Service Agency website.
If you lose Medi-Cal coverage, you may enroll in health insurance coverage through Covered 캘리포니아 in the special-enrollment period due to a loss of coverage.
중요: Are you enrolled in Medi-Cal?
지난 2년 동안 귀하의 연락처 정보가 변경되었습니까? Give your county office your updated contact information so you can stay enrolled. Find your local county office.
의료 서비스 제공자와 이 보험의 보장 범위를 검색하십시오.
의사, 병원 및 전문가를 검색할 수 있습니다.
Find medications for Medi-Cal Rx
가까운 약국을 찾아보십시오.
혜택 및 특징
케어 관리사
Do you have a serious health problem? If so, our case managers are in your corner. 다음을 수행합니다.
- 의학 용어를 쉬운 말로 설명합니다.
- Coordinate your doctor appointments.
- Provide your care team with your medical records.
The care manager will stay with you throughout your medical journey. 다음을 수행합니다.
- Think beyond your medical needs.
- Make sure you have support at home.
의사 선택
Each member can choose a primary care physician (PCP). Use the “Doctor Lookup” tool to see if your doctor is in our network.
귀하의 PCP는 다음을 주로 담당하는 주치의입니다.
- 예방적 건강 관리
- 질병 또는 상해에 대한 치료
- 특정 상태에 대한 전문가 소개
주치의가 없거나 의사가 당사 네트워크에 속해 있지 않은 가입자의 경우 가까운 새 의사를 찾아 드릴 수 있습니다.
Community supports
캘리포니아 Advancing and Innovating Medi-Cal (CalAIM) establishes the framework to address social determinants of health and improve health equity statewide.
A key feature of CalAIM is the introduction of a menu of in lieu of Community Supports.
What Are Community Supports?
Community Supports are services or settings that the Plan may offer in place of services or settings covered under the 캘리포니아 Medicaid State Plan and that are medically appropriate, cost-effective alternatives to a State Plan covered service.
Community Supports are optional for the Plan to offer and for Members to utilize. The Plan will not require Members to use Community Supports instead of a service or setting.
Community Supports that may be offered are:
- Housing Transition and Navigation Services
- Housing Deposits
- Housing Tenancy and Sustaining Services
- Short-Term Post-Hospitalization Housing
- Recuperative Care (Medical Respite)
- Respite Services
- Medically Supportive Food/ Meals/Medically Tailored Meals
- Sobering Centers
For more information, call Member Services at 1-877-650-1477 (TTY 711)
Diabetes Prevention Program
Diabetes Prevention Program is a covered benefit offered to our eligible members designed to assist in preventing or delaying the onset of Type 2 Diabetes by making lifestyle changes.
UnitedHealthcare Community Plan is pleased to offer a healthy lifestyle program at no cost to qualified members. The program can help you make small changes to live a healthy life, lose weight and lower your chance of developing type 2 diabetes.
To see if you qualify:
- Take a 1-minute quiz at solera4me.com/UHC.
- Or call 1-888-305-6015, TTY 711, Monday - Friday, 6 a.m. - 6 p.m. PT.
질병 관리
당사 질병 관리 서비스는 만성 질병 또는 고위험 질병을 앓고 있는 가입자를 위해 설계되었습니다.
당사는 다음 질병에 대해 특별한 프로그램을 마련하고 있습니다.
- 만성 폐쇄성 폐 질환(COPD)
- Coronary artery disease (CAD)
- Congestive heart failure (CHF)
- 당뇨병
- High Risk Pregnancy and Neonatal Intensive Care Unit
- 겸상적 혈구병
장비 및 소모품
가정에서 안전하게 생활하기 위해 추가적인 지원이 필요한 가입자도 있습니다.
Our plan covers medical equipment ordered by a member's doctor or care manager. 다음과 같은 소모품이 필요할 수 있습니다.
- 산소 탱크
- 보행보조기구 또는 휠체어
발 관리
We provide the exams needed to help keep feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.
발치료 보험 적용 범위는 다음과 같습니다.
- Routine foot exams.
- 발 관리 및 알맞은 신발 선택에 대한 팁
- 신경 손상의 위험 신호에 대한 정보
Healthy First Steps®
Healthy First Steps를 통해 귀하와 아기의 건강한 미래를 준비하고 많은 리워드까지 받으세요. 저희 프로그램은 귀하와 아기를 건강하게 유지하기 위한 올바른 조치를 취할 것입니다. 게다가 가입만 해도 20달러를 받을 수 있습니다.
당사는 다음과 같은 경우에 가입자에게 도움을 드립니다.
- 임신 진료 제공자 및 소아과 의사(소아 의사)를 선택하는 경우.
- 진료 및 검진을 예약하고 병원 방문을 위한 교통편을 준비하는 경우.
- 전체 임신 기간과 출산 후 첫 15개월 동안 방문할 때마다 리워드를 받는 경우.
- 수유모를 위한 유축기 등 소모품을 받는 경우.
- 여성, 영유아 및 어린이(WIC) 서비스와 같은 커뮤니티 리소스에 연결하는 경우.
가정간호
After surgery or a serious illness, you may need extra help with day-to-day tasks. 회복 상태를 확인하기 위한 가정 방문 진료가 필요할 수도 있습니다. With approval from your doctor, our plan covers:
- In-home medical visits.
- 병원 침대, 보행 보조기, 휠체어 등의 의료 장비
- 일회용 의료 소모품
- Help with personal care.
입원
This plan pays for all expenses related to a hospital stay - the member will never be changed. 당사 플랜은 다음을 보장합니다.
- 숙식
- 소모품 및 장비
- 치료 및 요법
- 진단 검사 및 검진
And after leaving the hospital, you are not alone. We make sure the follow-up care is available to continue healing at home.
통역자
UnitedHealthcare offers services to help you talk with your doctor or other health care workers. You can get this service if you do not speak 영어 or have hearing and speech barriers. You do not need a referral from your doctor to get these services.
Interpreter services are offered free of charge.
Labs and X-Rays
문제가 무엇인지 알고 또 이를 일찍 발견할 수 있다면 그 차이는 큽니다. 당사 플랜은 다음을 보장합니다.
- 검사실 및 검사
- X-레이, 스캔 및 기타 영상 처리
건강을 개선하거나 최상의 상태를 유지하는 데 필요한 정보를 얻을 수 있도록 지원해 드립니다.
언어 지원
You may be able to receive information in your preferred language or format, including Braille. 요청하기만 하면 됩니다. We also have people at our member service centers who speak more than one language. 당사는 여러 언어의 통역자를 보유하고 있습니다. All languages required by the State of 캘리포니아 are covered, plus more.
의약품
Prescriptions and certain over-the-counter items are covered by our plan.
You may receive a prescription from a UnitedHealthcare doctor or specialist. You can fill your prescription at any UnitedHealthcare contracted pharmacy. Just show your State Benefit Identification Card (BIC) and your UnitedHealthcare Identification card to the pharmacy when you get your prescriptions filled.
가입자 지원 담당자
We’re looking out for you. Our local member advocates can help solve problems, provide training and education, and work on issues that concern you.
가입자 지원 담당자는 다음 서비스를 제공할 수 있습니다
- Answer your questions about your benefits.
- 의사 문제 또는 불만을 해결하도록 돕습니다.
- Help you clarify your health care benefits.
가입자 서비스
때로 의료 서비스 옵션을 이해하는 데 약간의 도움이 필요할 수 있습니다. 당사에는 전화로 문의할 수 있는 담당자가 있습니다. We’ll answer your questions simply and completely.
또한, 다음을 찾는 데 도움을 드릴 수 있습니다.
- Find a doctor.
- Change your primary care physician.
- Questions on benefits.
Just call 1-866-270-5785, TTY: 711 Monday - Friday, 7:00 오전 – 7:00 오후 PT.
No Copays
보장되는 서비스에는 어떤 비용도 지급하지 않습니다.
While your health care is low-cost or free, the care quality is high. 제공되는 혜택은 다음과 같습니다.
- Care from highly skilled and compassionate doctors.
- Treatments at respected hospitals and clinics.
- Prescription drugs and over-the-counter medicines.
On My Way
UnitedHealthcare OMW™ (On My Way) is a mobile-friendly website aimed at helping young adults through the process of transitioning into adulthood. This interactive website also makes it fun to learn as you go. Register at www.uhcomw.com and begin the journey.
Outpatient Mental Health
정신 건강도 육체 건강 못지않게 중요합니다. 이런 이유로 당사는 두 가지를 모두 보장해드립니다.
Mental Health Screening:
- A mental health screening will be completed to determine if you are in mild or moderate distress or have acute impairment of mental, emotional or behavioral functioning.
- This screening can be completed by a PCP, UnitedHealthcare Community Plan of 캘리포니아, Inc. or county mental health plan.
Outpatient Mental Health Services- Covered by UnitedHealthcare Community Plan of 캘리포니아:
- If your mental health screening results determine you are in mild to moderate distress, UnitedHealthcare Community Plan of 캘리포니아 covers the following outpatient mental health services:
- Outpatient mental health services
- Individual and group mental health evaluation and treatment (psychotherapy)
- Psychological testing when clinically indicated to evaluate a mental health condition
Psychiatric consultation for medical management - Screening and Brief Intervention (SBI)
- Outpatient laboratory, supplies and supplements
- Drugs (excluding anti-psychotic drugs which are covered by Medi-Cal fee-for-service)
- Family Counseling
- Neuro behavioral testing
- Neuro psychological testing
- Outpatient mental health services do not require a referral from your PCP.
- For help finding more information on mental health services provided by UnitedHealthcare Community Plan of 캘리포니아, Inc., call 1-866-270-5785, TTY 711.
Specialty Mental Health Services- Covered by County Mental Health Plan
- If your mental health screening results determine you have acute impairment of mental, emotional or behavioral functioning, you may be eligible for specialty mental health services.
- Your PCP or UnitedHealthcare Community Plan of 캘리포니아, Inc. can refer you to the county mental health plan to receive an assessment.
- County mental health plans cover specialty mental health services for Medi-Cal beneficiaries who meet criteria.
- Specialty mental health services may include the following inpatient and outpatient services:
- Outpatient specialty mental health services:
- Mental health services (assessments, plan development, therapy, rehabilitation, and collateral)
- Medication support services
- Day treatment intensive services
- Day rehabilitation services
- 위기중재 서비스
- Crisis stabilization services
- Targeted case management services
- Therapeutic behavioral services
- Intensive care coordination (ICC)
- Intensive home-based services (IHBS)
- Therapeutic foster care (TFC)
- Residential services:
- Adult residental treatment services
- Crisis residental treatment services
- Inpatient services:
- Acute psychiatric inpatient hospital services.
- Psychiatric inpatient hospital professional services.
- Psychiatric health facility services.
- Outpatient specialty mental health services:
- For help finding more information on specialty mental health services provided by the county mental health plan, call the county at 1-888-724-7240.
개인 위생
질환이나 부상 후에는 기본적인 활동을 스스로 하기가 힘들 수 있습니다. If needed, we provide help with:
- 옷입기
- 목욕
- 식사
태아기 진료
Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.
당사 플랜에서는 권장되는 모든 태아기 임상 진료 및 검사가 보장됩니다.
이러한 진료 시 클리닉에서는 다음을 수행합니다.
- Make sure both you and your baby are healthy.
- 임신의 각 단계에서 예상되는 상황을 설명합니다.
- 질문에 대답해 드립니다.
금연
대부분의 사람들은 흡연이 건강에 미치는 악영향을 알고 있습니다. 금연해야 한다는 사실도 압니다. We support our members to help them quit. 단순히 강의만 제공하는 것은 아닙니다.
Text4baby
Text4baby는 초보 엄마와 예비 엄마가 본인과 아기의 건강을 지키는 데 도움을 줍니다.
You’ll get text messages each week throughout your pregnancy and your baby’s first year. 각 문자는 다음과 같은 주제로 건강 및 안전 팁을 제공합니다.
이 문자를 참조하여 엄마와 아기로서 첫발을 잘 내딛을 수 있습니다.
치료 서비스
Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.
Our plan covers limited visits for:
- 작업 치료
- 물리 치료
- 언어 치료
- 재가 치료
교통편
- Members can schedule a ride at 844-772-6623
- 운영 시간: Monday - Friday, 7 a.m. – 7 p.m.
- TTY 711 or 844-488-9724
Rides can be scheduled at least 30 days in advance, and no later than 3 business days before your appointment. Scheduling your ride at least 3 business days in advance will help you to have the best experience. Urgent care and other urgent types of trips, like dialysis or chemotherapy, can be scheduled on the same day.
Members can get round trip transportation to and from health care locations as needed, including rides to:
- 의사 또는 치료 방문
- Pickup prescription drugs that cannot be mailed directly to the member
- Pickup medical supplies, prosthetics, orthotics and other equipment
- Specialty mental health services
- 약물 사용 장애 서비스
- Dental and any other benefits covered through Medi-Cal
안과 서비스
The plan covers:
- Routine eye exam once every 24 months; UnitedHealthcare Community Plan of 캘리포니아, Inc.
may pre-approve (prior authorization) additional services as medically necessary. - Eyeglasses (frames and lens) once every 24 months; contact lens when required for medical
conditions such as aphakia, aniridia and keratoconus.
건강 진료
Well visits with your doctor can help keep you and your family healthy. 이러한 방문으로 건강 문제를 조기에 발견하여 치료를 받을 수 있습니다. 예방 서비스에는 연간 건강검진이
자세히 알아보기
UnitedHealthcare Community Plan of California Medi-Cal