UnitedHealthcare Wellness4Me

The Wellness4me Plan is offered through UnitedHealthcare Community Plan, a Health and Recovery Plan, or HARP, approved by New York State. HARPs are a new kind of plan that provide Medicaid members with their health care, plus care for behavioral health, including Serious Mental Illness and Substance Use Disorders.

This plan is for New York residents age 21 and who qualify for Medicaid coverage.

UnitedHealthcare Community Plan is a special health care plan with providers who have a lot of experience treating people who may need mental health and/or substance use care to stay healthy. We also provide care management services to help you and your health care team to work together to keep you as healthy as possible.

This plan is available in the following counties:

Albany , Bronx , Broome , Cayuga , Chautauqua , Chemung , Chenango , Clinton , Columbia , Dutchess , Erie , Essex , Franklin , Fulton , Genesee , Greene , Herkimer , Jefferson , Kings , Lewis , Livingston , Madison , Monroe , Nassau , New York , Niagara , Oneida , Onondaga , Ontario , Orange , Orleans , Oswego , Queens , Rensselaer , Richmond , Rockland , Schenectady , Seneca , St. Lawrence , Suffolk , Tioga , Ulster , Warren , Wayne , Westchester , Wyoming , and Yates .

• UnitedHealthcare Wellness4Me Steps to enroll

You have chosen to enroll in

Find providers and coverage for this plan.

Search for doctors, hospitals and specialists.

Find medications covered by this plan.

Find a pharmacy near you.

Find a dentist near you.

Benefits & features

Special Services

With the Wellness4me program, UnitedHealthcare Community Plan offers new services, called Behavioral Health Home and Community Based Services (BHHCBS), to members who qualify.

BHHCBS may help you:

• Find housing or live independently.
• Return to school or find a job.
• Manage stress and prevent crises.

As a member of UnitedHealthcare Community Plan, you will also have the opportunity to enroll in a Health Home and meet with a Care Manager who will work with all your physical and behavioral health providers to pay special attention to your whole health care needs.

Well and Sick Care

Get the care you need to stay healthy — or to get better if you are injured or sick. That includes:

• Choice of Doctor. Use "Doctor Lookup" to see if your doctor is in our network or to find a new one.
• Case Management. Get personal help managing health conditions.
• Well Visits. Annual checkups to help keep you healthy.
• Medicines. Fill your prescriptions at local pharmacies with a small copay.
• Referrals. Care from a specialist when recommended by your PCP.
• Pregnancy Care. Extra care and support for both you and your baby.
• Shots and Vaccines. Routine shots to help protect against illness.

Care for Conditions

If you have asthma, diabetes or another long-term condition such as substance abuse disorder, you can depend on us. Our plan makes sure you get the care, support and services you need. Benefits include:

• Asthma and COPD Care. Exams, testing and supplies are covered.
• Case Management. Get personal help managing health conditions.
• Diabetic Support. Medicine, needles and wipes for managing diabetes.
• Mental Health. Counseling and other treatments are covered.
• Residential Care. Brief stay at a care facility while you recover from sickness or injury.

Home Care and Supplies

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Adult Day Care. Friendship and social activities in a safe setting.
• Emergency Response System. Sends an urgent request for someone to help you.
• Durable Medical Equipment. We cover wheelchairs, hospital beds and more.
• Home Health Care. Medical and personal care at home, if needed.

Vision, Dental and Hearing Care

Make sure your sight, smile and hearing are at their best. Benefits include:

• Dental. We cover cleanings, checkups and dental work.
• Hearing. Tests, checkups and hearing aids, if needed, are provided.
• Vision. Covers eye exams and glasses or contact lenses.

Other Covered Services

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Adult Day Care. Friendship and social activities in a safe setting.
• Emergency Response System. Sends an urgent request for someone to help you.
• Durable Medical Equipment. We cover wheelchairs, hospital beds and more.
• Home Health Care. Medical and personal care at home, if needed.

Adult Day Care

Companionship is important. If your Primary Care Provider (PCP) recommends it, you may be able to participate in adult day health care. Adult day health care provides care and companionship for seniors who need extra help during the day.

Caregivers also benefit, knowing their loved one is safe when they can’t provide care.

Adult day care can provide:

• Social connections and friendship.
• Bathing and personal care.
• Meals.

Asthma and COPD Care

Do you need help trouble managing asthma, allergies or COPD symptoms? You’ll get a customized treatment plan and medicine to help:

• Manage flare-ups.
• Reduce symptoms.
• Live an active life.

Behavioral Health

Behavioral health is as important as physical health. Our behavioral health care includes mental health and substance use treatment services.

Required care is 100% covered with no copay. This includes:

• Intensive psychiatric rehab treatment (IPRT).
• Inpatient mental health treatment.
• Continuing day treatment.
• Personalized Recovery Oriented Services (PROS).
• Assertive Community Treatment Services (ACT).
• Individual and group counseling.
• Crisis intervention services.

You can also get help with alcohol or other substance use issues.

Care Management

A serious health problem requires extra care and support. We use Health Homes to coordinate services for our members.

Health Home Care Managers are in your corner. They will:

• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records.
• Your care manager will stay close by throughout the medical journey. He or she will:
• Think beyond immediate medical needs.
• Help manage ongoing medical issues like diabetes, asthma and high blood pressure
• Make sure you have support at home.

Choice of Birth Center

Where you have your baby is an important choice. That's why you can pick from 142 hospitals across New York.

We also 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.

Choice of Doctor

When you join UnitedHealthcare Community Plan, one of our providers will take care of you. Most of the time that person will be your Primary Care Provider (PCP). You may want to choose a PCP from your mental health or substance use clinic. If you need to have a test, see another specialist, or go into the hospital, your Primary Care Provider will arrange it.

Your PCP is your main doctor for:

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

Dental Care

Dental checkups and cleanings can help keep teeth and gums healthy. Covered services include:

• Regular checkups.
• Cleanings.
• X-rays.
• Treatments, including fillings and other services.

You do not need a referral from your PCP to see a dentist.

Diabetic Supplies

If you have diabetes, you may need insulin, needles, wipes and glucose strips. We cover all that and more.

Our plan also steps up with services to help you manage your diabetes, including:

• Diabetes counseling and self-management training.

Durable Medical Equipment

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

• Hearing aids.
• Prosthetics.
• Orthotics.

Hearing Care

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.

Our plan covers:

• Exams and tests.
• Hearing aids and batteries.

Home Health Care

Sometimes our members are living with a long-term health condition or disability. Others are coming out of the hospital after surgery or a serious illness. These members can receive extra support from our plan.

With approval, our plan covers:

• An in-home medical visit.
• Medical equipment like hospital beds, walkers or wheelchairs.
• In-home medical visit
• Help with day-to-day tasks like cleaning, cooking or dressing.
• Disposable medical supplies.

Hospitalization

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

Hospitalization coverage includes:

• Inpatient care.
• Outpatient care.
• Lab, X-ray, other tests.

Your Health Home Care Manager can:

• Help you safely return home after a hospital stay.

Medicines

Our plan covers prescription drugs and refills with a small copayment. Your copay is:

Over-the-counter medicines with a written order from your doctor are available for a copayment of $0.50 for each medicine.And we make getting your medicine easy. You can fill your prescriptions at:

• Local pharmacies.
• Services that deliver right to your door.

Member Services

You can call Member Services to get help any time you have a question.

You may call us to choose or change your Primary Care Provider (PCP for short), to ask about benefits and services, to get help with referrals, to replace a lost ID card, to report that you are pregnant, the birth of a new baby or ask about any change that might affect your benefits.

Residential 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.

If you are in need of long-term placement in a nursing home, your local department of social services must determine if you meet certain Medicaid income requirements.

Respite Care

Do you have family members or friends who care for you at home?

If so, we want to support their hard work too. That's why we provide respite care to give your caregivers a rest. Respite care offers caregivers time away from their loved one who is ill or has special care needs.

• Short-Term Respite — gives you a safe place to go when you need to leave a stressful situation.
• Intensive Respite — helps you stay out of the hospital when you are having a crisis by providing a safe place to stay that can offer you treatment.

Shots and Vaccines

Routine shots help protect you from illness.

So, our plan covers:

• Pneumonia, influenza and shingles shots.
• Other recommended shots and vaccines.

Vision Care

You'll get the care, eyeglasses and treatment that help you see better.

• Eye exams every two years, or as medically needed.
• Prescription lenses, including contact lenses.
• Glasses and frames.
• Specialist care when needed.

Well Visits

Well visits with your doctor can help you stay healthy. These visits can catch health problems early, so they can be treated. Preventive services include:

• Checkups for adults and children.
• Well-baby care.
• Care for women expecting a baby.
• Routine shots and tests.
• Mammograms.

There are no copayments for preventive care.

Member resources

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Member Resources

UnitedHealthcare Wellness4Me

Welcome letter

When you join as a new member, UnitedHealthcare wants you to become familiar with all the benefits and resources available to you as a member. This welcome letter provides a brief overview of the plan and what to expect as a UnitedHealthcare member.

Getting started guide

As a member, we want to provide you with all the resources and information you need. This useful guide provides a quick resource for getting started, finding help, your benefits, how to connect, getting care and so much more.

Getting started guide

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How to Contact Us

If you have questions about your health plan, please call us. Our toll-free Member Services number is 1-866-433-3413, TTY 711. We are open Monday through Friday, 8 am to 6 pm EST.

For a Mental Health or Substance Abuse Crisis dial the member services number then press 8.

Member handbook

Member Handbook

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Renewing your coverage

Every year, members enrolled in a New York State sponsored health insurance programs must renew their health care coverage. This process is called annual recertification or renewal of health care coverage.

Make sure to maintain your UnitedHealthcare Community Plan Coverage.

UnitedHealthcare cares about you. Our mission is to help people live healthier lives. To stay a UnitedHealthcare member, you have to renew your Medicaid coverage. Call us at 1-866-433-3413, TTY 711, or visit one of our office locations, and we will be happy to help you with questions about renewing your coverage

Renew Your Coverage

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Find a provider

There are many ways to choose a health care provider. It is important to find providers who are a good fit for you. Ideas include:

• Talk to a friend or family member about who they see.
  
• Call the provider office and ask questions.
• Choose based on where the office is located.
• View a list of providers that accept your health plan

Wewant you to feel good about the quality of the providers you choose. Health care providers include:

• Primary Medical Providers (PMPs)
  
• Specialists
• Behavioral health providers
• Dentists
• Eye doctors
• Hospitals
• Urgent care clinics
• Labs
• Medical equipment companies

Of course, you can also call your Member Services Advocate at 1-866-433-3413. We will help you make the choice that’s right for you.

NY Medicaid Member Notification PCP Referral Letter

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Orthopedic Prior Authorization Requirements

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Specialty Referral Requirements

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Nurseline

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-877-597-7801, TTY 711.

Our nurses will:

• Listen to your symptoms
• Help with self-care
• Advise if you can get care at your next doctor visit or need an urgent care center
• Help you know when it is time to go to the emergency room

myUHC member portal

This is your secure member website. See your covered benefits, search for providers, view your member handbook and much more.

UnitedHealthcare mobile app

It’s designed for people on the go and includes many of the same features as the member website. Find it at the App Store or Google Play.

"Preventative Care, Wellness and Health Conditions Guides"

Getting to the doctor when you are healthy is important. We have guides to help you know what to expect at each well visit. You can also talk to your Member Services Advocate for support and information.

We also have helpful guides for most health problems and conditions. You can also talk to your Member Services Advocate for support and information.

Our educational materials can be found on myuhc.com/CommunityPlan .

You will find condition-specific and general health topics, including:

• Physical Health
  
• Arthritis
  
• Asthma
• Cancer
• Children's Health
• Chronic Pain
• Diabetes

Enterovirus D68

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Coronavirus

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Health Tips Flyer

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Mammogram

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Men's Health Flyer

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Blood Pressure

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National Flu Campaign Questions and Answers

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Flu Shot Reminder

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Aids institute and HIV testing

For information on HIV and on HIV counseling, testing, referral, and partner notification (CTRPN) services including Perinatal HIV Prevention & Newborn Screening see the link to the NYSDOH web site below:

Additionally, the link below to the AIDS Institute will provide consumer information you might find helpful:

Member forms

UnitedHealthcare Community Plan members are not responsible for payment for any covered services. Some services may have small co-payments, which can be waived if you cannot afford them.

You should not pay out-of-pocket upfront for any services. There are no out-of-network benefits except in a few cases. A surprise medical bill certification form may be required at those times. See your member handbook for times when you can go to an out-of-network provider. Reimbursement is not guaranteed.

If you have received a bill for covered services or need help fining a participating provider, please call us at 1-866-433-3413, TTY 711 for assistance.

"Emergency Services and ""Surprise"" Bills"

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Notices and Bulletins

Dental services important information

Your member handbook has been changed to include additional services.

Dental services

Starting January 31, 2024, UnitedHealthcare Community Plan will be covering crowns and root canals in certain circumstances so that you can keep more of your natural teeth.

In addition, replacement dentures and implants will only need a recommendation from your dentist to determine if they are necessary. This will make it easier for you to access these dental services.

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Specialty Referral Requirements

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New York Independent Assessor MMC Guidance and Member Notice

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Pharmacy Provider Options Available for the COVID-19 and Influenza 2023-2024 Vaccine Season

NY Medicaid has posted COVID-19 vaccine billing guidance for this season.

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Notice:

New York State Department of Health has stated – Medicaid recipients should receive breast cancer surgery services at high volume facilities (those facilities performing 30 or more mastectomy and lumpectomy procedures associated with a breast cancer diagnosis on average over a three-year period).

See the listing of low-volume facilities that will not be reimbursed for breast cancer surgeries provided to Medicaid recipients.

This policy does not affect a facility's ability to provide diagnostic or excisional biopsies, and post–surgical care (chemotherapy, radiation, reconstruction, etc.) for Medicaid patients.

Clinical Practice Guidelines

UnitedHealthcare Community Plan has practice guidelines that help providers make healthcare decisions. These guidelines come from nationally recognized sources. UnitedHealthcare Community Plan has practice guidelines for preventive health and other health conditions.

Call our Member Services at 1-866-433-3413 (TTY: 711) to request a printed copy.

Member newsletters

The quarterly newsletter is a great way to learn about our health plan and important health topics. Our HealthTalk newsletter is available online allowing you to read it whenever and wherever you want.

2024

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2023

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2022

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Healthy First Steps

Our Healthy First Steps program makes sure that both mom and baby get good medical attention.

We will help you:

• Get good advice on nutrition, fitness and safety
• Choose a doctor or nurse midwife
• Schedule visits and exams
• Arrange rides to doctor’s visits
• Connect with community resources such as Women, Infants and Children (WIC) services
• Get care after your baby is born
• Choose a pediatrician (child’s doctor)
• Get family planning information

Behavioral health

Behavioral health is about how you feel and act. It is also called mental health. Your mental health is very important. The UnitedHealthcare Community Plan of New York includes mental health and substance use disorder services. You or your provider can call Optum Behavioral Health anytime for help at 1-844-206-1399.

Covered services include:

• All inpatient mental health and substance use disorder services (including alcohol and substance use disorder).
• Most outpatient mental health services (contact plan for specifics).
• Medicaid recipients who receive SSI or who are certified blind or disabled get mental health and substance use disorder services from any Medicaid provider by using their Medicaid Benefit Card.
• Detoxification services are covered by UnitedHealthcare Community Plan as a benefit.

Member Handbook Updates - Behavioral Health Update

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Quit using tobacco or vaping products

Quitting is hard, but we can help. Did you know that 20 minutes after you quit, your heart rate drops to a normal level? And within 24 hours after quitting the carbon monoxide level in your blood drops to normal.

Talk to your doctor about quitting. 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.Or call 1-800-QUIT-NOW (1-800-784-8669) to get free coaching, counseling and supplies to help you quit.

Social needs & community services

Being healthy is not always about your urgent medical needs. Sometimes you may need help connecting to resources out in the community. We call these social needs. These are things like housing, getting food every day or feeling safe. We can also help you with finishing your education. You can call your Member Services Advocate for more information. Or you can visit findhelp.org

We also offer special programs that include:

• Low-cost internet service at home
  
• Free phone service through SafeLink/TracFone Wireless
• Money back if you use alternative medicine, such as home herbal remedies, vitamins, acupuncture or therapeutic massage
• On My Way online program that guides and supports teens as they start their journey to independence and adulthood

Advance directives

Advance directives are instructions you give about your future medical care in case there is a time you can’t speak or make decisions for yourself. They help your family and physician understand your wishes.

With advance directives, you can:

• Let your doctor know if you would or would not like to use life-support machines
  
• Let your doctor know if you would like to be an organ donor
• Give someone else permission to say “yes” or “no” to your medical treatments

Advance directives are only used if you can’t speak for yourself. It does not take away your right to make a different choice if you later become able to speak for yourself.

You can make an advance directive by:

• Talking to your doctor and family
  
• Choosing someone to speak or decide for you, known as a health care representative
• Creating a Power of Attorney and/or Living Will

You can look at advance directive and health care proxy forms here:

Translation resources

UnitedHealthcare Community Plan provides member materials to you in a language or format that makes it easier for you to understand. Our provider network includes many doctors who are multilingual.

Our provider directory shows which languages doctors speak. Additionally, many of our Member Services Advocates speak multiple languages, so when you call they will be able to help you or connect you with our interpreter service which covers more than 170 languages.

If you have trouble hearing over the phone you can use a text telephone. This free service allows persons with hearing or speech disabilities to place and receive telephone calls. Call 711, give them the Member Services number, 1-866-433-3413 and they will connect you to us.

You can also get information in large print, Braille or audio files on a CD. We can also assist with interpreter services, including American Sign Language. To ask for help, please call us Monday through Friday, 8 am to 6 pm EST.

Our toll-free Member Services number is 1-866-433-3413, TTY: 711.

Notice of privacy practices

We have a Notice of Privacy Practices that tells you how health information about you may be used and shared. We are required by law to let you know that the Notice is available, and how you can get a copy of it. View a copy of our Notice of Privacy Practices

Your rights and responsibilities

We want to hear from our members about any questions, complaints or concerns you may have. If you have a grievance, please call Member Services toll-free, at1-866-433-3413, TTY 711.

If you are not happy with the response from your Member Services Advocate, Care Manager or Member Services, you may file a grievance. You may file a complaint or grievance against us (the health plan) or a provider with us at any time.

Members may file a grievance verbally with their Member Services Advocate from 8 am to 6 pm EST, Monday through Friday, at 1-866-433-3413, TTY 711. All members can file a grievance through this process.

You have other rights that include appeals and a State Fair Hearing. For detailed information about complaints and appeals, contact Member Services or view the Appeals and Grievances section of the Member Handbook.

"Fraud, Waste and Abuse"

Fraud, waste and abuse are serious problems. There can be penalties under law. To make a report, call the UHC Fraud Hotline at 1-844-359-7736. You can also call Member Services at 1-866-433-3413. We will not use your name in your report. You will not get in trouble for reporting this. We will look into the matter for you.

More information about fraud, waste or abuse, or to make a report online.

UnitedHealth Group is 100% owner of UnitedHealthcare of New York, Inc

Learn more

• FAQs
• Glossary
• Links to health information

Member information

You have access to our member-only website. Print ID cards and more. View our handbook below.

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Member information

You have access to our member-only website. Print ID cards and more. View our handbook below.

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Enrollment information

The UnitedHealthcare Wellness4Me plan specialists can answer questions and help you enroll.

8 a.m. – 6 p.m. Monday – Friday

You have chosen to enroll in

This plan is not currently available in the ZIP code entered.

Enrollment information

The UnitedHealthcare Wellness4Me plan specialists can answer questions and help you enroll.

8 a.m. – 6 p.m. Monday – Friday

You have chosen to enroll in

This plan is not currently available in the ZIP code entered.

Please select your county.

To learn more about applying for health insurance, including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit nystateofhealth.ny.gov or call 1-855-355-5777. To find out if you qualify for Medicaid Managed Care or Child Health Plus offered by UnitedHealthcare Community Plan, please call 1-888-617-8979. UnitedHealthcare does not discriminate on the basis of race, color, national origin, sex, age or disability in health programs and activities. We provide free services to help you communicate with us. Such as, letters in other languages or large print. Or, you can ask for an interpreter. To ask for help, please call Member Services at 1-800-493-4647, TTY 711, 8 a.m. – 6 p.m., Monday – Friday ATTENTION: Language assistance services, free of charge, are available to you. Call 1-800-493-4647, TTY 711. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-493-4647, TTY 711. 注意：您可以免費獲得語言援助服務。請致電 1-800-493-4647, TTY 711 ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-493-4647 (телетайп: TTY 711).

Last Updated: 08.21.2024 at 10:19 PM CDT

Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

• Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
• Where applicable, requirements for gatekeeper referrals are waived in full;
• Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
• The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.