UnitedHealthcare Connected | UnitedHealthcare Community Plan of Ohio (2024)

UnitedHealthcareConnected is availableto individuals who are eligible for both Medicare and Medicaid in:Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Stark, Summit, Trumbull and Wayne counties.

UnitedHealthcareConnectedis a partner in the state of Ohio’s integrated care delivery system for Medicare-Medicaid eligible enrollees called MyCare Ohio.

UnitedHealthcareConnectedis dedicated to improving quality and efficiency of care benefits for members through an individualized approach that focuses on seamless coordination of care while simultaneously easing the administrative burden for providers through assistance with higher acuity patients and claims simplification.

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Our Approach

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As an industry leader in population health management, we employ best practices to support your care plans to help members maintain and improve their health. We also support members who want to remain independent and live in the least restrictive environment possible through our comprehensive and integrated care management benefit programs.

We believe our benefits can help make coverage and care more connected, personal and flexible for everyone involved. UnitedHealthcareConnectedseamlessly combines:

  • Medicaid
  • Medicare Parts A and B
  • Behavioral health
  • Vision and dental
  • Transportation
  • Long-term care
  • Home and community-based services

A dedicated UnitedHealthcareConnectedteam will work collaboratively with family members, caregivers, health care providers, home- and community-based service providers and community organizations to help simplify care delivery and improve health outcomes for UnitedHealthcareConnectedmembers.

Care Givers

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We recognize that arranging care and services for your loved one takes a lot of time and effort. You play such a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.

Connectedcare can mean a better quality of life for the person in your care.

We recognize that arranging care and services for your loved one takes a lot of time and effort. You play a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.

A team to help you access care.

UnitedHealthcareConnectedmembers and their caregivers have access to a dedicated care team to help them navigate the entire health care system. The personal care team will:

  • Develop a comprehensive plan of care to support their physician’s care plan.
  • Coordinate Medicare and Medicaid benefits.
  • Arrange for community support services to help improve overall quality of life. This may include adding ramps for members with a physical disability, meal delivery or identifying resources for those who have trouble paying utility bills.

A higher level of care.

Our comprehensive provider network includes a variety of general and specialty doctors, therapists and nurses who are highly skilled in working with people with complex care needs.

We also partner with organizations throughout the community who offer the supports needed for individuals to live at home for as long as possible based on their health needs.

Our providers and community partners work closely with us to deliver a customized plan of care for each member as well as access to our extensive health care resources.

We look forward to helping your eligible patients transition to UnitedHealthcareConnected. If you have any questions, please don't hesitate tocontact us.

Care Providers

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Integration of Medicare and Medicaid programs eliminates the need to coordinate care separately for these two health benefits programs. We'd like to partner with you to coordinate care and compensation, so you can focus on the health of your patients and the health of your practice.

Connecting care and services for a healthier practice.

UnitedHealthcareConnectedhelps you spend more time with patients and less time on administrative tasks. Complete integration of Medicare and Medicaid benefits means you no longer have to worry about coordinating the two programs.

We do that for you. Instead of spending time figuring out which program covers what benefits, and who can deliver them, we manage all the details and logistics for you.

Our goal is to increase efficiency, minimize your administrative burden and better leverage all available resources to help you deliver the best possible care.

Your expertise and input is important to the success of UnitedHealthcareConnectedand we look forward to our partnership to improve care for members who are eligible for Medicare-Medicaid health benefits.

A single source for all you need.

With UnitedHealthcareConnected, you'll have greater flexibility to deliver the right care each patient requires. Whether they need medication compliance counseling, substance abuse treatment, nutrition counseling or other support services, just call us.

Our care coordinators include social workers and aging experts who will put the necessary resources in place.

Save time and administrative costs.

You'll have one business partner who is accountable for complete care coordination and compensation. That simplifies billing and coding for your services, which are all tracked with one UnitedHealthcare member ID number.

Working together will help save you time and administrative costs, while increasing the efficiency of care. And we're developing innovative compensation and incentive models so that quality care and efficiency are rewarded.

Special attention for community behavioral health centers.

The UnitedHealthcareConnectedapproach to care can be a significant change for many behavioral health care providers. UnitedHealthcare’s experience in contracting with numerous medical, long-term care and community behavioral health systems in other states will help ensure that the transition is easy to understand and to implement.

We are working diligently to streamline procedures and payment processes. Our clinical staff will work with you to ensure easy access to our providers and promote your services as a seamless part of our plan. And we'll conduct face-to-face and web-based training sessions to solve any issues together.

We look forward to partnering with you. If you would like more information, pleasecontact us.

Community Partners

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We share your commitment to helping low-income elderly and people with disabilities live healthier lives. We want to work with you to build the strongest possible network of services and supports for these individuals. Together, we can create a model of efficiency, effectiveness and compassion.

Together, we can help shape the future of care in Ohio.

Big change brings big opportunities. Organizations like yours are vital to a healthy community. We want to work with you to build the strongest possible network of services for the low-income elderly and people with disabilities. By working together, and sharing ideas and expertise, we can help create a model of efficiency, effectiveness and compassion.

A trusted partner.

All successful partnerships are built on trust and respect. We are committed to working with you to promote the wellbeing and protect the best interests of the people you serve. And through our advisory council, you can have a direct voice and the opportunity to make suggestions that will improve our health plan in Ohio.

Ask us. We're happy to help.

Many community organizations are facing increasing budget challenges. That can make it difficult to assemble all the resources you need to further your mission. Or, it may limit what you can offer to those you serve. UnitedHealthcare can provide a wide range of technical supports and assistance to organizations of all types and sizes.

Whether you need help solving issues with claims and billing, writing applications for grants and funding, providing health-related educational materials, or delivering health and nutrition programs at your facility, just ask. We're eager to partner with you.

We look forward to working with you. If you would like to learn more, pleasecontact us.

Our Experience

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UnitedHealthcare is an industry leader in providing comprehensive coverage to Medicare and Medicaid members that centers on person-centric care. Our expertise in coordinating physical health care services, long-term care and behavioral health services helps ensure this unique population has access to comprehensive care to address their often complex care needs.

  • We’ve managed plans for both Medicare and Medicaid for nearly 30 years. Today, we serve more than 250,000 people who are Medicare and Medicaid eligible and one in five Americans who are covered by Medicare.
  • We are a pioneer and national leader in developing and operating integrated managed care plans for acute and long-term care.
  • We have more than 20 years of experience developing person-centered models of care that have improved quality, driven increased customer satisfaction and reduced unnecessary and costly utilization.
  • Through our partnership with OptumHealth, a UnitedHealth Group company, we offer cutting-edge population management practices and comprehensive behavioral health services.

Our Mission for Providers and Members

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To be the preeminent provider of state health care solutions for the aged, blind, and disabled, as well as those in need of long-term care and behavioral health care, who are Medicare-Medicaid enrollees.

We will accomplish this through:

  • Support of Medicare and Medicaid services through coordinated or contractually integrated models.
  • Relationships with best-in-class providers.
  • Support of members’ choices to maintain independence and prevent functional decline through comprehensive and integrated care management programs.
  • Provider incentives tied to quality measures.

Provider Resources

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We are committed to helping our extensive provider network learn more about all aspects of this health plan by offering training opportunities and/or materials to support your participation in this network and to help you leverage the technology and tools developed to support your care of our members.

Online Training Sessions help you learn more about Claim Submission, Care Coordination, Plan Benefits and Prior Authorizations.

Training Aids for Electronic Transactions

Customized for MyCare Ohio providers, training aids were developed to assist you in filing claims, verifying member eligibility, checking status of a claim and handling paper claim payments.

  • UHCprovider.com/EDI

Electronic Visit Verification (EVV)

On August 5, 2019, managed care providers will be required to use Electronic Visit Verification (EVV) for home care services, such as aide and nursing services. The Ohio Department of Medicaid is administering the EVV program and leading all training on how to use the EVV system and device. Please visit https://medicaid.ohio.gov/evv to learn about this new program and read through helpful materials. There are a series of trainings you can register for including in-person, live webinar, and self-paced online training. PLEASE REGISTER FOR TRAINING. You MUST complete training in order to get access to the EVV system, and EVV will be required.

If you have any questions, you may find the answer on https://medicaid.ohio.gov/evv or you can email EVV@medicaid.ohio.gov for more assistance.

UHCprovider.com and Link

A comprehensive resource for physicians and health care professionals to obtain information related to their practice and care of UnitedHealthcare Community Plan members.

  • UHCprovider.com
  • - including live webinars, on-demand videos and slide presentation for UnitedHealthcareOnline.com and Optum Cloud Dashboard

Click theResourceslink belowto view important sources of support and information for our UnitedHealthcareConnectedfor MyCare Ohio providers.

Service Providers

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You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them. Our partnership will be the foundation for a higher level of care for members.

UnitedHealthcareConnectedmeans working together to serve people better.

You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them.

Our partnership will be the foundation for a higher level of care for members. That’s why we’d like to work side-by-side with you to help give the people of Ohio a higher level of care and to serve more people, more effectively.

The full benefit of our combined expertise.

Like you, we are firm believers in the value of home- and community-based services (HCBS). In fact, UnitedHealthcare has long been integrally involved in the movement to care for people at home. That goes back to 1989, when we helped Arizona pioneer its program to find HCBS as alternatives to nursing home care.

Over the last 20 years, we've managed HCBS and long-term care programs in seven states including Massachusetts, New Mexico and Tennessee. We want to use our knowledge and best practices to help you strengthen and enhance your plan of care and service offerings.

Save time and administrative costs.

UnitedHealthcareConnectedintegrates all Medicare and Medicaid benefits into one plan. That's not only better for those you serve, it's also easier and more efficient for you.

You'll enjoy faster communication and greater efficiency having just one business partner who is accountable for complete care coordination.

Having just one entity responsible for compensation also helps reduce the complexity and duplication of administrative work - saving you time, while lowering your administrative costs.

Opportunities for increased growth.

Partnering with community organizations has always been our business model, making you an integral part of our work. And, as our member base grows, the opportunities for you to expand and serve more people can increase too, just as it has for our physicians, specialists and other healthcare professionals and service partners in communities throughout the country.

We look forward to working with you. If you would like to learn more, pleasecontact us.

Resources

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Here you’ll find links to important sources of support and information for our UnitedHealthcareConnectedfor MyCare Ohio providers.

If you are looking for a particular resource that you didn’t find, please email our Integrated Care Delivery System (ICDS) team at:ICDSProvider@uhc.com

  • UnitedHealthcare ConnectedTMfor MyCare Ohio Medicare-Medicaid Product Provider Administrative Manual

Pharmacy

State Supported Resources

UHC 1099 Assistance

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Direct all tax questions to UHC 1099 Assistance at1-866-343-0236.

Please select from the following options:

  1. Copy of 1099 Tax Form
  2. Demographic Change
  3. Payment History Report due to discrepancy on 1099 form
  4. Speak to a Representative
UnitedHealthcare Connected | UnitedHealthcare Community Plan of Ohio (2024)

FAQs

What is United Healthcare Community Plan of Ohio? ›

Our Ohio Medicaid plan covers eligible families, pregnant women of any age, infants, children and young adults. The plan also offers extra support and care to adults and children with a disability, long-term illness or special health care needs. Members can choose a primary care doctor from our network.

What is the best Ohio Medicaid plan? ›

Buckeye Health Plan Rated Best Medicaid Health Plan for Quality Performance. The Ohio Department of Medicaid (ODM) awarded Buckeye Health Plan the highest quality rating among all Ohio managed care plans with 20 stars across the five categories on its 2018 Managed Care Plans Report Card published today.

Does Ohio Medicaid cover weight loss medication? ›

Drugs that fall into one of the following categories are non-covered by the Ohio medicaid pharmacy program: (1) Drugs for the treatment of obesity. (2) Drugs for the treatment of infertility. (3) Drugs for the treatment of erectile dysfunction.

Does Ohio Medicaid cover OTC products? ›

The Ohio Department of Medicaid (ODM) provides coverage of both prescription and over-the-counter drugs. The links below allow both providers and members to find information about drug coverage.

What food can I buy with my UnitedHealthcare OTC card? ›

With your healthy food credits, you could buy a wide range of approved groceries, like:
  • Fruit & vegetables.
  • Frozen produce & meals.
  • Dairy products.
  • Meat & seafood.
  • Beans & legumes.
  • Pantry staples – flour, sugar, spices, etc.
  • Healthy grains – bread, cereals, pastas, etc.
  • Nutritional shakes & bars.

How do I check my UnitedHealthcare benefits? ›

Members can view and manage their benefits and rewards online in the UCard Hub section of the member site and the UnitedHealthcare app to do things like: Check benefit balances and available rewards.

What is the highest income for Medicaid in Ohio? ›

Income & Asset Limits for Eligibility
2024 Ohio Medicaid Long-Term Care Eligibility for Seniors
Type of MedicaidSingleMarried (both spouses applying)
Income LimitIncome Limit
Institutional / Nursing Home Medicaid$2,829 / month*$5,658 / month*
Medicaid Waivers / Home and Community Based Services$2,829 / month†$5,658 / month†
1 more row
May 31, 2024

Can you have both Medicare and Medicaid in Ohio? ›

MyCare Ohio is a managed care program designed for Ohioans who receive BOTH Medicaid and Medicare benefits. This program has a team approach to coordinating your care based on your needs – a team with you at the center.

Which state has the best Medicaid program? ›

The top states—ranked from 1 to 10—are Massachusetts, Nebraska, Vermont, Alaska, Wisconsin, Rhode Island, Minnesota, New York, Washington, and New Hampshire.

How do you get $25 wegovy? ›

Without insurance or discounts, Wegovy can cost more than $1,200 a month. If you're eligible for Novo Nordisk's Wegovy savings card program, you could get a 28-day supply or one box of Wegovy for $25.

How do I get Ozempic for $25 a month? ›

If you have commercial or private insurance, you may PAY AS LITTLE AS $25 for a 1-month, 2-month, or 3-month supply of Ozempic® for up to 24 months. To receive offer, prescription must be for a 1-, 2-, or 3-month supply.

How much is Ozempic without insurance? ›

Each box of Ozempic contains 4 weekly doses of Ozempic, which is roughly a monthly supply. The cost of a 30-day supply of Ozempic is $935.77 without insurance. However, the amount you pay will depend on your insurance coverage, the pharmacy you use, and any Ozempic coupons you may be eligible for.

Can you buy potato chips with OTC card? ›

Items that do not qualify include non-food and pet items, alcohol, baby formula, candy, chips, coffee shop items, desserts, fresh baked goods, soda, and tobacco. To check if an item is approved, members can download the Healthy Benefits Plus app, scan the product and it will advise if item is allowable.

What is my balance on my OTC card? ›

You may check check the balance on your OTC benefit card by calling the number on the back of your card or signing in to your OTC plan provider's online member portal.

Can I use my OTC card in Walmart? ›

You can create a Walmart.com account and add your OTC Network card to your wallet or enter your OTC Network card as a payment method during check-out.

What is the difference between HMO and PPO UnitedHealthcare? ›

HMO PlansFor most plans, you're required to use health care facilities or doctors that are in the HMO network. Out-of-network care is typically allowed in emergency cases only. PPO PlansWhen you choose a provider in the network, you may have lower out-of-pocket costs than if you choose out-of-network providers.

Who qualifies for CareSource in Ohio? ›

Medicaid health care coverage is available for eligible Ohioans with low income, pregnant women, infants and children, older adults and individuals with disabilities. CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

Why did UnitedHealthcare send me a check? ›

UnitedHealthcare intends to include its self-funded (ASO) plans in the virtual card payment program. ASO customers can elect to opt out of participation in the program. In those circ*mstances, you may receive a paper check for claims for members of ASO plans that have opted out.

What is the difference between UnitedHealthcare and United Health Group? ›

UnitedHealthcare is the health benefits business of UnitedHealth Group, a health care and well-being company working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences.

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