UnitedHealthcare 커뮤니티 플랜 QUEST 통합 프로그램

Medicaid

UnitedHealthcare Community Plan QUEST Integration is a managed care plan offered through Hawai‘i’s Department of Human Service Med-QUEST. UnitedHealthcare 커뮤니티 플랜은 주에서 지원하는 Medicaid 가입 대상자를 위한 의료 보험입니다. 이 플랜에는 임산부, 어린이, 성인, 고령자, 특수 요구가 있는 사람, 가족 등이 포함됩니다. UnitedHealthcare 커뮤니티 플랜 QUEST 통합으로 더 나은 의료 서비스 혜택을 누릴 수 있습니다.

UnitedHealthcare의 주요 목표는 가입자가 건강하고 독립적인 삶을 살 수 있도록 지원하는 것입니다. UnitedHealthcare 커뮤니티 플랜 퀘스트 통합 플랜은 안과, 의약품, 소모품을 비롯한 의료 및 행동 건강 서비스를 제공합니다. 지금 UnitedHealthcare 커뮤니티 플랜 QUEST 통합에 문의하여 전문적인 안내와 서비스 조정을 받을 수 있는 방법에 대해 자세히 알아보십시오. 

당사의 현지 직원이 의료 서비스와 구체적인 필요 사항을 조정해 드립니다. 본사는 여러분이 복잡한 보건의료 시스템을 이해하고 담당의사 및 가족과 협력하여 건강 관련 목표를 이룰 수 있도록 돕고자 합니다.  UnitedHealthcare 커뮤니티 플랜은 매 순간 여러분을 지원할 준비가 되어 있습니다.

UnitedHealthcare 커뮤니티 플랜은 오랫동안 의료 관리 분야에서 전문성을 쌓아 왔습니다.  

UnitedHealthcare 커뮤니티 플랜에 가족의 건강을 믿고 맡기십시오.

 

Public Health Event – Pharmacy Response

IMPORTANT INFORMATION REGARDING

UnitedHealthcare Community & State, UnitedHealthcare Employee & Individual, and UnitedHealthcare Medicare & Retirement members covered under Medicaid, Medicare, and Part D prescription drug plans.

Due to Hurricane Flossie approaching Hawai‘i, UnitedHealthcare is authorizing a one-time override of the refill too soon (RTS) edit for members who reside in or may be visiting the following areas. These members may be in need of medication when traveling and mail delivery could be compromised. 

Hawai‘i

Entire State

This authorization should allow impacted UnitedHealthcare Community & State, UnitedHealthcare Employee & Individual, and UnitedHealthcare Medicare & Retirement members covered under Medicaid, Medicare, and Part D prescription drug plan to obtain early refills of their prescription medications if they have refills remaining on file at a participating retail or mail-order pharmacy. 

This policy will be reinforced through the dates listed below, unless conditions continue to warrant.

Line of Business Response Type Timeframe Membership Type

UHC C&S

 

Self-Identify

 

07/31/2019 – 08/14/2019

 

All Products

 

UHC E&I

 

Self-Identify

 

07/31/2019 – 08/14/2019

 

Fully Insured (including NIHPs) and ASO Business

 

UHC M&R Self-Identify 07/31/2019 – 08/14/2019 Fully Insured and ASO
Business

If you should receive a call from a member impacted by this emergency, please follow the standard process for administering refills during a disaster. The OptumRx Help Desk is available to assist in this process should it be needed.

 

UnitedHealthcare Community Plan provides free aids and services to people with disabilities to communicate effectively with us, such as: written information in other formats (large print, audio, accessible electronic formats, other formats). If you need these services, contact us toll-free at 1-888-980-8728 (TTY: 711).  We will provide you with the requested information, at no cost to you within five (5) business days.

이 플랜은 모든 카운티에서 이용할 수 있습니다.


 

 

UnitedHealthcare 커뮤니티 플랜 QUEST 통합을 사용하면 다음과 같은 혜택을 받을 수 있습니다.

이용 가능한 서비스

  • A Primary Care Provider (PCP) that you can choose from in our large list of providers. Here is the link to help you find one in your area
  • Referral specialty care from a Specialist Provider
  • Scheduled rides to health-related appointments
  • 24-hour/7 day NurseLineSM and on-line Nurse Chat to talk to a nurse any time you have a question
  • Language interpreter services (including Sign language)

건강 관리를 위한 지원 혜택
혜택 플랜에 따라 모든 서비스는 무료로 제공됨

  • 처방약 보장
  • Vision and eyewear coverage
  • Help with behavioral health issues such as mental, alcohol, or substance abuse
  • 예방적 건강 관리
  • Vaccines (such as for flu and other illnesses)
  • Child immunizations
  • Health education classes
  • Quarterly newsletters

Early Periodic Screening, Diagnostic, & Treatment (EPSDT) for Medicaid-Enrolled Individuals Under 21 Years of Age

혜택 및 특징

의사 선택

Each member can choose a primary care provider (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

For members who don’t have a doctor or whose doctor is not in our network, we can help find a new one close by.

때로 의료 서비스 옵션을 이해하는 데 약간의 도움이 필요할 수 있습니다. 당사에는 전화로 문의할 수 있는 담당자가 있습니다. 귀하의 질문에 이해하기 쉬운 방식으로 완벽하게 대답해 드립니다.

또한, 다음을 찾는 데 도움을 드릴 수 있습니다.

  • Home care providers.
  • Specialists.
  • 의사
  • 약국
  • 병원 또는 기타 건강 시설
  • 지역 리소스

There is no cost for covered prescriptions. We make getting your child's medicine easy. We'll provide a list of covered medicines if you have questions about what prescriptions are covered.

You can fill the prescriptions at local pharmacies in the UnitedHealthcare Community Plan network.

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

Hospitalization coverage includes:

  • 간호
  • 숙식
  • 소모품 및 장비
  • 치료 및 요법
  • 진단 검사 및 검진

퇴원한 후에도 혼자가 아닙니다. 자택에서 후속 치료를 통해 계속 치료를 받을 수 있도록 보장해 줍니다.

Build a healthier future for you and your baby — and earn great rewards — through Baby Blocks. This program helps keep you and your baby healthy during your pregnancy and your baby's first 15 months of life.

Baby Blocks includes:

  • Email appointment reminders.
  • Fun program to keep track of appointments.
  • Reward cards for clothing and more.

Once you sign up, you can choose a $20 Old Navy gift card or a stylish diaper bag. The choice is yours.

Diabetic Support

If you have diabetes, we'll make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best. 

내구성 의료 장비

Some members may need extra support to live safely at home.

Our plan covers medical equipment ordered by your child's doctor or case manager. This can include supplies like:

  • Oxygen tanks.
  • 병상
  • Wheelchairs or walkers.

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

You can earn great gifts for you or your child by doing things like:

  • Completing well-child exams.

청력 관리

청각에 문제가 있는 경우 여러 방식으로 일상생활에 영향을 줄 수 있습니다. 당사 플랜에는 청력을 보호하는 데 도움이 되는 서비스 및 지원이 포함되어 있습니다.

보장 내용은 다음과 같습니다.

  • Exams, therapy and tests.
  • Hearing aids and batteries.

In-Home Care

After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

  • An in-home medical visit.
  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.
  • Help with personal care or housekeeping.

통역자

Your doctor and you need to understand each other. 영어로 말하지 못하면 진료가 어려워집니다. We can arrange for a medical interpreter to be at your appointments.

또한, 2개국 이상의 언어를 할 수 있는 가입자 서비스 담당자도 있습니다. 당사는 여러 언어의 통역자를 보유하고 있습니다.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.

플랜의 혜택으로는 다음이 있습니다.

  • Dialysis.
  • 의약품
  • Health education and support.
  • Organ transplant if needed.

검사실 및 X-레이

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 can get information in another language. 요청하기만 하면 됩니다. This is provided at no cost to you.

Member Advocates

UnitedHealthcare가 여러분을 지켜 드립니다. Member advocates can help solve problems, provide training and education, and work on issues that concern members.

They can:

  • Provide information about your plan.
  • Teach you to get the care you need.
  • Help with doctor issues or complaints.

정신 건강

정신 건강도 육체 건강 못지않게 중요합니다. 당사가 둘 다를 보장하는 이유입니다.

다음이 포함됩니다.

  • 행동요법
  • 약물 남용 치료
  • 의약품

NurseLine℠

Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.

Our nurses will:

  • 증상을 경청합니다.
  • Help with self-care.
  • 의사 방문 시 또는 응급 치료 센터에서 진료를 받는 방법에 관해 조언합니다.
  • 응급실에 가야 할 때를 알려드립니다.

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.
  • Answer any questions and concerns.

Nutrition Coaching

Healthy eating goes a long way to helping you stay at your best. A nutritionist can meet with you to review your eating habits and food choices.

You'll come away with new ideas for:

  • Making good choices for quick meals and snacks.
  • Preparing healthy meals on a budget.

Outpatient Services

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

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

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

  • Dressing.
  • Bathing.
  • Feeding.

태아기 진료

A pregnancy is a journey that’s better with the help of friends, family and a pregnancy doctor, or OB/GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

이러한 진료 시 클리닉에서는 다음을 수행합니다.

  • Make sure both mom and baby are healthy.
  • 임신의 각 단계에서 예상되는 상황을 설명합니다.
  • Answer questions.

금연

Most people know the bad health effects of smoking. And they know they need to quit. We support our members while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture.

Rehabilitation Care

After a serious illness, surgery or injury you may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:

  • Nursing home services.
  • 24-hour nursing care.
  • Help with activities of daily living.
  • Physical, occupational and speech therapy.

유예가료

자택에서 가입자를 간호해 주는 가족이나 친구가 있습니까?

그렇다면 당사에서 가족이나 친구의 고생을 덜어 드리겠습니다. That's why we provide respite care to give your caregivers a rest. 유예가료는 질병을 앓고 있거나 특별한 요구가 있는 가족을 돌보는 간병인에게 휴가를 제공해 줍니다.

예방 주사 및 백신

Routine shots help protect you from illness.

따라서 당사 플랜은 다음을 보장합니다.

  • 권장 예방 주사 및 백신
  • 인플루엔자 예방 주사

Social Services

Many communities offer additional benefits for children in this plan. Social Services helps members connect to these local programs and services, such as:

  • WIC and financial support.
  • School services.
  • 유예가료.

Speech Therapy

Speech therapy visits and exercises can help those who have difficulty speaking.

Prior authorization needed except for  physical, occupational,  or speech therapy.

Text4baby

Text4baby can help new and expecting mothers keep themselves and their babies healthy.

You'll get text messages throughout your pregnancy and your baby's first year. Each text contains health and safety tips for topics like:

  • Prenatal care.
  • Labor and delivery.
  • Breastfeeding.
  • Safe sleep.
  • Nutrition.
  • Car seat safety.

So you and your baby can make a great start on life.

Therapy Services

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.

Our plan provides:

  • 작업 치료
  • 물리 치료
  • 언어 치료

Unlimited Doctor Visits

There may be times when your or a family member’s health requires repeated visits to a primary care provider (PCP). Our plan does not limit the number the number of times you can see your PCP. This way you get care need when you need it. And your doctor can see how your health is progressing.

Urgent Care

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

  • 응급 치료 센터
  • Medical aid units.
  • Other walk-in clinics.

건강 진료

Well visits with your doctor are important for good health. 이러한 방문으로 건강 문제를 조기에 발견하여 치료를 받을 수 있습니다. 예방 서비스에는 연간 건강검진이

  • Checkups for adults and children.
  • 건강한 육아 진료
  • Care for women expecting a baby.
  • 정기 예방 주사 및 검사
  • 유방 X선 사진

There are no copayments for preventive care.

가입자 자료

사용 가능한 리소스 보기

자세히 알아보기

UnitedHealthcare 커뮤니티 플랜 QUEST 통합 프로그램

Powered by Translations.com GlobalLink OneLink Software