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STAR+PLUS

메디케이드

Our 텍사스 STAR+PLUS plan is for older adults (65 and older) and adults with disabilities (21 and older), who often need extra support and care. We also offer additional services called Value Added Services (VAS). You qualify based on income and health needs. View the list below to see what STAR+PLUS includes.

Important News for STAR+PLUS Members -- UnitedHealthcare’s coverage areas are changing

New Service Delivery Areas: UnitedHealthcare coverage begins on 9월 01, 2024
If you live in a new service delivery area (SDA), click on Steps to Enroll below for simple steps to join the STAR+PLUS plan. Your coverage will begin on 9월 01, 2024.

  • Bexar (San Antonio area): Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, and Wilson counties
  • Dallas (Dallas area): Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties
  • Hidalgo (Valley area): Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and  Zapata Counties
  • Tarrant (Fort Worth area): Denton, Hood, Johnson, Parker, Tarrant, and Wise counties

Current Service Delivery Areas: UnitedHealthcare coverage continues on 9월 01, 2024
UnitedHealthcare coverage is not changing in current SDAs, no action is required to continue coverage. UnitedHealthcare members in these areas can stay on their health plan and continue to see the health care providers they know and trust.

  • Harris (Houston area): Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller, and Wharton counties
  • Central 텍사스: Bell, Blanco, Bosque, Brazos, Burleson, 콜로라도, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, and Washington counties
  • Northeast 텍사스: Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague, Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, and Wood counties
  • Travis (Austin area): Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis, and Williamson counties

If you live in these SDAs and would like to change your STAR+PLUS coverage to UnitedHealthcare, click on Steps to Enroll below for simple steps to join our plan. Coverage will begin on 9월 01, 2024, or sooner.

Exiting Service Delivery Areas: UnitedHealthcare coverage will end on 8월 31, 2024
UnitedHealthcare members in these areas can stay in our health plan and continue seeing health care providers they know and trust through 8월 31, 2024. 

  • Jefferson (Beaumont area): Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker counties
  • Nueces (Corpus Christi area): Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio, Victoria

In March and June 2024, the 텍사스 Health and Human Services (HHSC) will send letters to UnitedHealthcare members telling them about their new health plan options.  If a member in an exiting SDA does not choose a new health plan by 7월 10, 2024, HHSC will select one for them. Coverage with the new health plan will begin on 9월 01, 2024.

혜택 및 특징

건강 및 질병 관리

Get the assistance you need to be at your best — or to get better if you are injured or sick. 다음이 포함됩니다.

  • Service Coordinator. Specially trained professional to help you receive the services you need based on a person centered plan.
  • Well Visits. Annual checkups can help keep you healthy or reach your potential.
  • Medicines. Fill your prescriptions at local pharmacies.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Hospital Care. You pay nothing for care in a hospital.

If you have asthma, diabetes or other long-term conditions, you can depend on us. Our STAR+PLUS plan makes sure you get the care, support and services you need. 혜택에는 다음이 포함됩니다.

  • Service Coordination. Support from an experienced professional.
  • Disease Management. Individual care to help you manage chronic medical conditions such as diabetes, asthma, COPD, Kidney Failure and Heart Failure.
  • Mental Health Support. Counseling and other treatments are available.

Help protect your sight, hearing and smile with these benefits:

  • Vision. Includes exams and $105 toward frames or contact lenses as a value added service.
  • Hearing. Tests, checkups and hearing services are provided.
  • Dental. Checkups are covered as part of a value added service, and emergency care is covered.

Get the medical equipment, assistance and supplies you need to live safely at home. 혜택에는 다음이 포함됩니다.

  • Personal Care. Someone to help with personal care tasks for individuals that qualify based on your primary care physician determination of a functional need and an assessment process.
  • Day Activity Health Services. Supervised care in a group setting with nursing support during the day.
  • Equipment and Supplies. In-home medical and safety equipment are covered as medically necessary.

때로 건강 보험을 이용하는 데 몇 가지 추가적인 도움이 필요할 수 있습니다. 그러한 경우에 다음과 같은 지원을 받을 수 있습니다.

  • Transportation. Rides to and from medical visits or the pharmacy.
  • Nurse HotlineSMCall our nurses for advice 24/7.
  • Interpreters. As needed for medical appointment or assessments.
  • Member Services. Your benefit questions are answered 24/7.

Read about all the extras you could get when you become a STAR+PLUS member:

  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Adult Dental Services. Includes $500 towards routine exams, cleanings, and x-rays.
  • Diabetic Management. Shoe insoles for members with diabetes.
  • Online Mental Health Resources. Access articles, videos, and other resources at LiveandWorkWell.com
  • Exercise Kit. Includes one pedometer, one pack of resistance bands, and one water bottle for members who want to become more active. 
  • Learn more about Value-added Services 영어 | Español
  • Read all about the extras you could get when you become a STAR+PLUS Nursing Facility Member 영어 | Español

If you're elderly, disabled or living with an illness, your health needs are unique. Our job is to make it as easy as possible for you to meet those needs. The STAR+PLUS HCBS Waiver program provides an array of services and supports for individuals meet the state criteria and have medical necessity for Nursing Facility Level of Care to assist them to live safely in the setting of their choice. Some of the benefits provided in this program include (not an all inclusive list):

  • Specialized Nursing
  • 식사 배달 서비스
  • 위탁 서비스
  • 치과 서비스
  • Adaptive aids
  • 간단한 주택 개조

의사 선택

귀하의 주치의가 되는 PCP(일차 진료 의사)를 배정받습니다. Doctor Lookup(의사 찾아보기) 도구를 사용하여 담당 의사가 당사 네트워크 소속인지 확인할 수 있습니다.

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. 

귀하의 PCP는 다음을 주로 담당하는 주치의입니다.

  • 예방적 건강 관리
  • 질병 또는 상해에 대한 치료
  • 특정 상태에 대한 전문가 소개

입원

This plan pays for all expenses related to a medically necessary hospital stay.

After you leave the hospital, you are not alone. 자택에서 후속 치료를 통해 계속 치료를 받을 수 있도록 보장해 줍니다.

재가 치료

질환이나 부상 후에는 기본적인 활동을 스스로 하기가 힘들 수 있습니다. 필요한 경우 다음을 보조할 사람을 제공합니다.

  • 옷입기
  • 목욕
  • 식사

통역자

담당 의사와 귀하는 서로를 이해해야 합니다. 영어로 말하지 못하면 진료가 어려워집니다. We can arrange for an interpreter for your appointment.

We have people at our phone centers that speak more than one language. A service lets us connects with others that speak hundreds of languages.

언어 지원

You can ask to receive information in another language. Then anything we write to you will only be in that language. 이 혜택은 무료로 제공됩니다.

의약품

We make getting your medicine easy.

There are no copays for covered drugs. You can fill your prescriptions at:

  • 현지 약국
  • Services that deliver routinely right to your door.
  • Mail order services.

가입자 서비스

때로 의료 서비스 옵션을 이해하는 데 약간의 도움이 필요할 수 있습니다. With us, you have someone you can call 24/7. We’ll answer your questions simply and completely.

정신 건강

정신 건강도 육체 건강 못지않게 중요합니다. That's why we have the same coverage for both.

필요한 진료가 본인 부담금 없이 100% 보장됩니다. 다음이 포함됩니다.

  • 행동요법
  • Substance use treatment.
  • 의약품

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 coverage.

간호사 핫라인

곤란한 경우에 의학적 문제 및 상황이 발생하기도 합니다. When you have questions about your health or your child's health, you can call a trained nurse 24 hours a day, 7 days a week.

Our Nurse Hotline nurses will: 

  • 증상을 경청합니다.
  • 자기 관리를 안내합니다.
  • 의사 방문 시 또는 응급 치료 센터에서 진료를 받는 방법에 관해 조언합니다.
  • Suggest you go right to the emergency department.

금연

귀하는 흡연이 건강에 미치는 악영향을 알고 있습니다. 금연해야 한다는 사실을 알고 있습니다. We will support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Service Coordination - Cornerstone of the STAR+PLUS program

  • 의학 용어를 쉬운 말로 설명합니다.
  • Coordinate your doctor appointments and other services or treatments you may need.
  • Connect you with community resources.

Your case manager will stay with you on your medical journey. 다음을 수행합니다.

  • Think beyond just your medical needs.
  • Make sure you have support at home as needed.

교통편

Whether you live in the city or in the country, rides are available. Our plan provides round trips to and from plan locations. This includes trips to and from the pharmacy to fill your prescriptions.

시력 관리

You'll get the care, eyeglasses and treatment that let you see life more clearly. Coverage includes $105 each year toward frames or contact lenses.

This benefit is offered by certain stores and retailers.

가입자 자료

가입자 자원(모달 창 열기)

가입 정보

The 텍사스 STAR+PLUS plan specialists can answer questions.

전화 문의:
1-888-887-9003 / TTY: 711

월요일 - 금요일 8:00 오전 - 8:00 오후(현지 시간)

가입 방법
Face-to-face assessments return
  • As of January 2023 some types of assessments will require a face-to-face visit. This means a United Healthcare staff member will need to visit with you in your place of residency.​
  • Please be advised that missing your assessment could impact your services or eligibility. If you have questions, please contact your Service Coordinator or Member Services.​
  • Call Member Services at 1-888-887-9003, TTY 7-1-1, Monday-Friday 8 a.m.-8 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.​
세부 정보

Visit the 텍사스 CHIP & Medicaid site for more information on eligibility and enrollment.

텍사스 STAR+PLUS.

For information in alternate formats, like large print, Braille or audio, please call Member Services. Contract information can be found on STAR PLUS Contract Operational (texas.gov)

가입자 정보

가입자 전용 웹 사이트에 액세스할 수 있습니다. ID 카드 등을 인쇄하실 수 있습니다. 아래의 당사 핸드북을 참조하십시오.

Member information is available in paper form, at no cost, upon request, and sent by the health plan within five business days.

가입자 웹사이트

다른 형식이 필요하십니까?

큰 활자, 오디오 파일, 점자로 된 자료들을 제공해 드립니다. 다른 형식의 정보가 필요한 경우 지금 바로 저희에게 전화해 주십시오. 

웹 보기를 변경하는 방법

도움이 필요하십니까? 여기를 클릭하세요!

UnitedHealthcare가 어떤 서비스를 제공하는지 동영상으로 확인하세요.

여러분이 받을 의료 서비스는 여러분이 선택하세요.

여러분을 포함한 모든 사람이 저렴한 의료 서비스를 받을 자격이 있습니다.

Seniors and people with disabilities, who qualify for Medicaid’s STAR+PLUS Program, should check out UnitedHealthcare Community Plan of 텍사스

저희는 여러분의 삶에 실질적인 변화를 실현할 수 있는 Medicaid 혜택과 추가 혜택을 제공합니다. 모두 무료입니다.

  • Find a Primary Care Physician you trust in our network to be your main doctor.
  • Vision coverage.
  • Transportation to and from doctor appointments.
  • 24/7 Nurse Hotline to answer your health questions.

가끔은 추가 지원이 필요할 수도 있습니다. Medicaid로 보장되지 않는 추가 혜택을 받아보세요.

  • Receive one fire and waterproof bag per fiscal year to safely store important documents, medications and personal items when experiencing a natural disaster.
  • Receive an exercise kit to help you adopt an active lifestyle or to lose weight.
  • Online mental health services.
  • Help getting a ride when traditional Medicaid transportation is not available.

저희는 여러분이 플랜을 최대한 활용할 수 있는 자원도 제공합니다. 예를 들어,

  • 가입자 지원 담당자
  • Service Coordinators
  • Health Education Tools
  • 의료 관리

Visit yourtexasbenefits.com for more information.

여러분의 더 건강한 삶을 지원합니다. We are here for you, 텍사스

Remember to choose UnitedHealthcare Community Plan. And get the Plan that gives you more.

To learn more about UnitedHealthcare Community Plan, visit UHCCommunityPlan dot com forward slash TX. 

At UnitedHealthcare we want to make sure you can access all the benefits your plan provides.

If you’ve had a change in your health status and your doctor determines you need a wheelchair, your plan is here for you.

To make sure you get the equipment you need with the coverage you have, follow these simple steps.

You may need a wheelchair evaluation referral from a healthcare provider in your plan’s network for wheelchairs with special features.

Next a Durable Medical Equipment or DME vendor in your health plan network is located.

In many cases, your healthcare provider can help locate an in-network provider and send the referral.

If the health care provider does not complete this step we can help you find an in-network provider and schedule an appointment.

It is important to understand what your insurance does and does not cover, so that you don’t have unexpected expenses.

And we can help you with that.

Once the referral has been sent to the identified provider the evaluation will be performed by a physical therapist, an occupational therapist or a physiatrist who specializes in determining proper seating and positioning.

This evaluation may take place in your home or in the DME provider’s office.

If the assessment takes place at the provider office, be sure to bring your wheelchair with you if you have one.

During the visit you may be asked to provide additional information including your health status and risk factors, transportation needs, and information on your home environment (if the assessment does not take place in your home).

Wheelchairs may take anywhere from 60 to 90 calendar days to be delivered.

Factors such as supply chain issues and availability of parts may cause additional delay.

Your DME provider can assist you with a loaner chair during the waiting period if needed.

When your new wheelchair is delivered be sure to sit in it to ensure proper fit and adjustments.

And even if you have experience with wheelchairs do take the time for the vendor to provide instructions on the use of the chair and its features, care and maintenance.

If any equipment you are requesting is not a covered benefit you may be asked to pay out of pocket for the equipment.

The vendor should provide you with a clear explanation of why it is not part of your benefits.

Generally, a wheelchair should last at least five years, although growing children may need a new chair more often.

If you already use a wheelchair and it’s damaged and unable to be repaired you may also be eligible for a new wheelchair.

Over time your insurance and DME providers may change.

So, be sure and keep all the information about the chair, the DME provider, the coverage and any documentation on any repairs or changes made.

Remember, if you have any questions or need more information visit myuhc.com/CommunityPlan or call member services at the number on the back of your member ID card.

 

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