Unitedhealthcare Connected 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. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
You can get this document for free in other formats, such as large print, braille, or audio. Call , TTY 711, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.
You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.
Language Line is available for all in-network providers.
Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al , TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.
Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.
Los servicios Language Line están disponibles para todos los proveedores dentro de la red.
Kentucky Medicaid Plan Eligibility
Get the health care you deserve.
Kentuckys managed care Medicaid program provides comprehensive medical benefits to adults, families, people with disabilities, children and pregnant women who meet income requirements.
Anyone between ages 19 to 64 who meets income standards, is eligible. There are no pre-existing condition restrictions.
To see if you qualify, go to kynect.ky.gov or call
For more information on Kentucky Medicaid, please visit the Department for Medicaid Services website
We can also assist with interpreter services, including American Sign Language. To ask for help, please call , TTY 711, Monday through Friday, 7:00 a.m. to 7:00 p.m. EST.
The UnitedHealthcare Community Plan specialists can answer questions and help you enroll.
The UnitedHealthcare Community Plan specialists can answer questions and help you enroll.
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PDF 664.58KB – Last Updated: 10/20/2021
Vision And Hearing Care
Make sure your sight and hearing are at their best. Benefits include:
- Hearing. Benefits for members under 21 years exams and testing with referral by physician to audiologist benefits shall not exceed the members benefit of $800.00 per ear every 36 months.
- Vision. Annual vision exam for all members. Lenses, frames and repairs are covered for those under 21 years and pregnant women.
- New 2022 value added benefit: One pair of eyeglasses for adult members 21+yrs every two years with valid prescription. To receive benefit, members can visit their local eye doctor that accepts UHC Medicaid to get their vision exam and order eyeglasses OR can call member services.
- Preventive care: 2 cleanings every 12 months, fluoride treatments and sealants
- Medically necessary exams and x-rays
- Medically necessary dental treatment
- Preventive care: 1 cleaning every 12 months
- Medically necessary exams and x-rays
- Medically necessary dental treatments
Get the medical care and equipment you or a family member needs to recover or live at home. For qualifying individuals with disabilities and ongoing health conditions, benefits include:
- Personal Care. Someone to help with dressing, bathing and dining.
- Equipment and Supplies. In-home medical and safety equipment is covered.
- Home Health Care. Medical and personal care at home, if needed.
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See What Unitedhealthcare Has To Offer
Its your health. Its your choice.
Everyone deserves affordable health care, including you.
Working adults, people with disabilities, pregnant women, and children who qualify for Medicaid, should check out UnitedHealthcare Community Plan.
We have the Medicaid services and extras that can make a real difference in your life. All at no cost to you.
- Find a doctor you trust in our network.
- Connect to a doctor using Telehealth.
- Annual vision exam for all members.
- Dental coverage.
- 24/7 NurseLine to answer your health questions.
Sometimes, you might need a little extra help. Get extras not covered by Medicaid.
- Earn rewards for keeping you and your baby healthy.
- Earn gift cards for getting preventative services.
- Meal Delivery for members meeting specific eligibility requirements.
- Boys & Girls Club membership for members 6 through 17
- 30 acupuncture visits per year
We also offer resources to help you make the most of your plan. Including:
- Member Advocates
- 24/7 behavioral health hotline with licensed clinicians
- Health Education Tools
- Care Management
To see if you qualify for Medicaid benefits or to enroll visit Kynect dot ky dot gov.
Helping you live a healthier life.
We are here for you, Kentucky
Remember to choose UnitedHealthcare Community Plan.
And get the Plan that gets you more.
To learn more about UnitedHealthcare Community Plan, visit UHCCommunityPlan dot com forward slash KY.
Looking for the federal governments Medicaid website? Look here at Medicaid.gov.
Health Insurance Coverage For Multiple Years
TriTerm Medical Insurance,2 underwritten by Golden Rule Insurance Company, is short term health insurance that offers coverage for preventive care, doctor office visits, and prescriptions.
- Apply once for insurance coverage terms that equal one day less than 3 years.
- $2 million lifetime maximum benefit per covered person on most plans.
- Eligible expenses for preexisting conditions are covered after 12 months on the plan.
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Dual Special Needs Plans In 2022
Kentuckians on a UnitedHealthcare Dual Special Needs Plan receive many benefits beyond those with traditional Medicare.
- $0 drug copays on all tiers of covered medications with option for home delivery
- Up to $125 per month on a debit card to buy healthy food or OTC items at many retailers, online or by catalog
- Up to $2,500 for covered types of preventive and comprehensive dental services
- Debit card with credits to buy OTC health products, and more
Kentucky Medicaid Program Routine Vision And Eye Medical
As of January 1, 2013, WellCare of Kentucky has expanded into Region 3/31 and Avesis will administer the routine eye care benefit and eye medical benefits for those members. Region 3/31 consists of the following counties: Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble, and Washington.
As of October 1, 2011, Avesis Third Party Administrators, Inc. became the eye care program administrator for WellCare of Kentucky within the Kentucky Department of Medicaid Services. Avesis administers the routine eye care benefit and eye medical benefits for WellCare of Kentucky members.
If you are currently an Avesis participating provider and are interested in participating in the Kentucky Medicaid program for these groups, please sign and return the addendum located here. Please note that all providers will need a Kentucky Medicaid member.
If you are not currently an Avesis contracted provider and are interested in participating in these programs, please complete the Provider Credentialing and Contracting paperwork by following the link below.If you have any questions please contact one of our Provider Services Representatives at 855-469-3368.
Please click here to access KY Medicaid Eye Care Program Provider Forms.
Send Completed Materials by mail to Provider Services
Mail To:
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Required Documents For Those Applying For New Edi Submitter Ids
The following documents are required enrollment documents that must be completed, signed and returned to the KY Medicaid office prior to initiation of electronic claims submission or inquiry.If you are a Provider1. EDI Application If you are a billing agency,
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Ensure you have completed an Electronic Agreement for an existing approved Medicaid provider,
If you have any questions regarding any of the documentation required, please contact the EDI Support Help Desk anytime Monday through Friday, 7:30 a.m. to 6:00 p.m. EST at 1800-205-4696
We can now process 276/277 requests . If this is a transaction you would like to utilize please make sure to enroll with the payer.
Select Provider or if youre a Billing Service select Billing Agent
Enter your demographic information
Enter the contact information for the main contact person in your office
Electronic Agreements on File with the Commonwealth of KY
Map 380 No
Map 246 – No
Select ALL Applicable transaction types:
837 Professional
835 Remittance/277 Pended Claims
Signature information
***Please submit this form first. You will be given your submitter ID, and then you may fill out the additional forms listed below***
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Enter the Day, Month, and Year
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Enter the Providers Name and Demographic information
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Write the Type of Provider, the Provider Number, and NPI
Page 2
Kentucky Healthtalk Member Newsletter
Our KY HealthTalk newsletter is now online. The newsletters are a great way to learn about our Kentucky Medicaid plan, programs from the Kentucky Cabinet for Health and Family Services and other important health topics.
You can read it whenever, wherever you want. Check back quarterly for a new edition.
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Unitedhealthcare Healthy First Steps
Build a healthy future for you and your baby and earn great rewards with UnitedHealthcare Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus, you can earn $15 just for signing up.
We will help you:
- Choose a pregnancy provider and a pediatrician
- Schedule visits and exams and arrange rides to your visits
- Earn rewards for going to visits throughout your pregnancy and babys first 15 months of life
- Get supplies, including breast pumps for nursing moms
- Connect with community resources such as Women, Infants and Children services
Unitedhealthcare Connected For Mycare Ohio
UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.
Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .
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Wellcare Of Kentucky Plan Documents
Your Member Handbook explains your plan coverage in detail. It includes important information about your benefits, your rights, and key contact addresses and phone numbers.
WellCare of Kentucky is proud to b e working with SafeLink Wireless to offer the LifeLine program at no cost to you!
Use this claim form to be reimbursed for eligible out-of-pocket medical expenses. Please submit one form per member.
The Over-the-Counter Catalog includes a detailed list of available items from allergy medications to sunblock to vitamins. It also includes easy instructions on how to order.
The Over-the-Counter Catalog includes a detailed list of available items from allergy medications to sunblock to vitamins. It also includes easy instructions on how to order.
This document outlines the causes, symptoms and treatment of attention deficit/hyperactivity Disorder .
The Mommy and Baby Matters Booklet contains important information for moms-to-be including prenatal, postpartum and newborn care.
Choose A Birth Center
Where you have your baby is an important choice. That’s why you can pick from a large network of hospitals across Kentucky.
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.
- Preventive care: 2 cleanings every 12 months, fluoride treatments and sealants
- Medically necessary exams and x-rays
- Medically necessary dental treatment
- Preventive care: 1 cleaning every 12 months
- Medically necessary exams and x-rays
- Medically necessary dental treatments
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See Why Kentuckians Choose Unitedhealthcare
Whatever plan you choose, UnitedHealthcare will help you get the care you need.
- Large variety of network doctors/providers
- No-cost virtual/telehealth visits
- Low- or no-cost prescription drugs
Stay informed about coronavirus in Kentucky. A list of Federally Qualified Health Centers and their vaccine sites are located below.
Effective January 1, 2021, all Presumptive Eligibility Medicaid members in Kentucky will be enrolled in managed care and assigned to UnitedHealthcare Community Plan. LEARN MORE
Upcoming Quarterly Member Advisory Committee Meeting: Join us on 6/28/22, 9/27/22 and 12/13/22 all from 12 pm – 1 pm EST to share your opinions. To RSVP, call , TTY 711, 7 am – 7 pm EST.
Its your health. Its your choice.
Everyone deserves affordable health care, including you.
Working adults, people with disabilities, pregnant women, and children who qualify for Medicaid, should check out UnitedHealthcare Community Plan.
We have the Medicaid services and extras that can make a real difference in your life. All at no cost to you.
- Find a doctor you trust in our network.
- Connect to a doctor using Telehealth.
- Annual vision exam for all members.
- Dental coverage.
- 24/7 NurseLine to answer your health questions.
Sometimes, you might need a little extra help. Get extras not covered by Medicaid.
We also offer resources to help you make the most of your plan. Including:
- Member Advocates
- 24/7 behavioral health hotline with licensed clinicians
- Health Education Tools
- Care Management
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 plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
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Mental Health Crisis Services
What if I have a behavioral health crisis?
You are always covered for a behavioral health emergency. An emergency means a behavioral health condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated. You may have a mental health, drug, or alcohol use emergency.
Emergency services are covered anywhere in the United States. If you think you have a life threatening emergency, call 911 or go to the nearest hospital location where emergency providers can help you.
As soon as possible, call us to arrange for follow-up behavioral health care after an emergency.
A mental health crisis is a moment when someone’s behavior can put themselves or others in danger, especially if they do not get help, such as:
- Threatens to or talks about hurting or killing themselves
- Feels hopeless
- Feels rage or uncontrolled anger
- Feels trapped, like there is no way out
- Engages in reckless behaviors
- Feels anxious, agitated, or unable to sleep
- Increases alcohol or drug use
- Withdraws from friends and family
- Encounters dramatic mood changes
- Sees no reason for living
Crisis Services:If you think you have an emergency, no matter where you are, call 911 or go to the nearest hospital location where emergency providers can help you. As soon as possible, call your doctor or behavioral health provider to arrange for follow-up care after the emergency is over.
If you are experiencing a mental health crisis, call the Behavioral Health Crisis line at
Dual Special Needs Plans
Dual Special Needs Plans are for people who get both MississippiCAN and Medicare. Dual plans cover doctor visits, hospital stays and prescription drugs. They offer more benefits and extras than Original Medicare. Youll keep all your Mississippi Medicaid benefits MississippiCAN too.
Looking for the federal governments Medicaid website? Look here at Medicaid.gov.
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Kentucky Department For Medicaid Services
Myers and Stauffer LC is a certified public accounting firm that provides professional accounting, consulting, data management and analysis services to government-sponsored healthcare programs. Myers and Stauffer LC is a contractor for the Kentucky Department for Medicaid Services.
Important Contact Information150 Flynn Avenue, Suite 200Frankfort, Kentucky 40601
All other provider types contact:General:Tara Clark, CPA
Case-Mix Report Questions Help Desk:Phone: 800.773.8609
Please find helpful downloadable documents for nursing facilities along with MDS documents.
CMHC
Provider Training
There are currently no scheduled seminars, webinars, or teleconferences at this time. Resources from prior trainings are available at the right.
CMHC Training
Myers and Stauffer has met every challenge and, in doing so has developed a valuable consulting relationship with our staff. They are the contractor we turn to first when a question arises.
State Principal Financial Specialist
We have been extremely pleased with the services that Myers and Stauffer provides and recommend them without hesitation to assist you with your audit needs.
State Medicaid Client
Myers and Stauffer has established itself as more than an audit contractor. They are who we turn to first when a question arises.
State Principal Financial Specialist
Association Director
State Medicaid Client
They have never, ever disappointed me. Theyve always been outstanding.
State Principal Financial Specialist
Quality And Member Access Committee
The UnitedHealthcare Quality and Member Access Committee provides members, community agencies, and providers with an opportunity to learn more about the services available, provide input on programs offer and feedback on ways to increase quality and satisfaction to our plan membership.
Quality and Member Access Committee meetings are held statewide with a virtual option four times a year.
Members can receive a $50 stipend for attending each QMAC meeting.
If you are a UnitedHealthcare Community Plan member and would like to participate, please contact Member Services at , TTY: 711.
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For additional community resources, please contact Member Services |
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