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Tusmada Ugu Weyn

UnitedHealthcare Community Plan

Medicaid

Qorshaheena Medicaid ee TennCare wuxuu bixiyaa dheefo kala duwan. Carruurta, haweenka uurka leh, dadka waaweyn iyo dadka da'da ah ama naafada ah waxay u qalmi karaan iyadoo lagu saleynayo dakhliga. View the benefits below to see all that our Tennessee Medicaid plan offers.

Qorshahan waa laga heli karaa meel kasta oo aad uga nooshahay Tennessee.

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
Ku Saabsan: Appeals and Grievances
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, Tennessee 37243
Email: HCFA.Fairtreatment@tn.gov
Telefoonka: 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

Macaashyada & Sifooyinka

Daryeelka Dadka Caafimaadka Qaba iyo Dadka Jirran

Get the care you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get support to keep you and your baby healthy. Dheefaha Xubinta waxaa ka mid ah:

  • 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.

Ma jiro wax ka muhiimsan caafimaadka iyo fayoobaanta adiga iyo ilmahaaga. Taasi waa sababta dheefaha qorshaheenna TennCare Medicaid ay uga mid yihiin:

  • 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 Tennessee.
  • Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

If you have asthma, diabetes or another long-term condition, you can depend on us. Our TennCare Medicaid plan makes sure you get the care and services you need. Dheefooyinka waxaa ka mdi ah:

  • 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. Dheefooyinka waxaa ka mdi ah:

Aragga.

  • 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.

Ilkaha.  

  • 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. Dheefooyinka waxaa ka mdi ah:

  • 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.

Sometimes you might need a little extra help using your health plan. For those times, you can rely on:

  • 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.

Where you have your baby is an important choice. That’s why you can pick from hospitals all across Tennessee.

We encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And you’ll be more relaxed when you have your baby.

Qalabka iyo Saadka

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

Caafimaadkaaga iyo badbaadadaada guriga waa muhiim

Our plan covers medical equipment ordered by your doctor or case manager. Tan waxaa ka mid noqon kara agabka sida:

  • Hospital beds.
  • Oxygen tanks.
  • Walkers or wheelchairs.

Waxbarashada caafimaadka

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.

Healthy First Steps™

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

Waan ku caawin doonaa:

  • Choose a pregnancy provider and a pediatrician (child’s doctor).
  • Schedule visits and exams and arrange rides to your visits.
  • Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
  • Get supplies, including breast pumps for nursing moms.
  • Ku xirirannashaha dhigaalada bulshada sida adeegyada Haweenka, Dhallaanka iyo Carruurta (WIC).

Isbitaal Dhigista

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

Tani waxaa ka mid ah:

  • Nursing care.
  • Room and board.
  • Supplies and equipment.
  • Treatment and therapies.
  • Diagnostic tests and exams.

Ka dib markaad isbitaalka ka baxdo, keligaaga ma tihid. We make sure you get follow-up care to continue healing at home.

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.

Wax badan ogow

Interpreters

Your doctor and you need to understand each other. In aan si fiican loo hadlin Ingiriisi ayaa tan ka dhigaysa mid adag. Waxaan kuu diyaarin karnaa turjumaan inuu joogo ballamahaaga.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Lab and X-rays

Ogaanshaha waxa khaldan iyo in la helo goor hore ayaa wax walba samayn karta. Qorshahayagu waxa uu daboolaa:

  • Shaybaarada iyo tijaabada.
  • Raajooyinka, iskaangaraynta iyo sawir-qaadista kale.

We’ll help you get the information needed to improve your health or be at your best.

Ka caawin Luqad

You can receive information in your preferred language. Adigu un weydii. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language.

Member Services

Understanding your health care options can be confusing. We can answer your questions simply and completely.

We help you find:

  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

Caafimaadka Maskaxda

Mental health is as important as physical health. That’s why we have the same coverage for both.

Daryeelka loo baahan yahay waxaa la daboolay 100% iyadoo la isla bixinayn. Tani waxaa ka mid ah:

  • Mental health therapy.
  • Substance abuse treatment.
  • Daawooyinka.

No Copays

Members have no copayments for:

  • Preventive care.
  • Annual checkups.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

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

Khadka Taleefanka Kalkaaliyaha

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: 

  • Listen to the symptoms.
  • Guide you on self-care.
  • Kaala talin doonaan ku helida daryeel booqashada dhakhtarka ama xarunta daryeelka degdegga ah.
  • Kaa caawin doonaan inaad ogaato goorta aad aadi doonto qolka gargaarka degdega ah.

Prenatal Visits

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

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

  • Make sure you and your baby are healthy.
  • Explain what to expect at each stage of your pregnancy.
  • Answer your questions.

Bixiyaha Daryeelka ee Aasaasiga ah

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). 

PCP-gaaga ayaa ah dhakhtarkaaga ugu muhiimsan ee loogu tala galay:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

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.

Joojinta Tubaakada iwm

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.

Xabado iyo Tallaal

Routine shots help keep you healthy. So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots.

Gaadiid-raaca

In case of emergency call 911

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

  • Wac 1-866-405-0238, TTY 711 si aad u ballansato gaadiid 
  • 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 
  • Hayso oo diyaar ka dhigo kaarkaaga aqoonsiga xubintaada 
  • If you have more than one appointment on the same day, you can get a ride to all covered services. Please give Tennessee Carriers information for each appointment
  • Ogow ciwaanka bixiyaha daryeelka caafimaadkaaga iyo taariikhda iyo waqtiga ballantaada 
  • Si gaar ah u sheeg halka aad u baahan tahay inaad gaadiidka u raacdo 
  • Haddii dhakhtarkaagu ku siiyo rijeeto, waxaad mari kartaa farmashiyaha si aad u hesho 
  • Nala soo socodsii haddii aad qabto baahiyo gaar ah sida gure-gure 
  • 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 Tennessee 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.

Booqashooyinka Wanaagsan

Well visits with your doctor can help keep you healthy. These visits can help catch health problems early so they can be treated. Adeegyada ka hortagga waxaa ka mid ah:

  • Baaritaannada ku aaddan dadka waaweyn iyo carruurta.
  • Daryeelka ilmaha wanaagsan.
  • Daryeelka haweenka uurka leh.
  • Tallaalada joogtada ah iyo tijaabooyinka.
  • Raajada naaska.

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.

Dhigaalada Xubinta

Healthier Tennessee 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

Eeg Dhigaalada La Heli karo (wuxuu furaa Bogga Xiran)
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