Orlando Harmon
UnitedHealthcare is one of the largest healthcare insurance companies in the United States, with over 1.3 million physicians and care professionals in its nationwide network. The company offers a range of insurance plans in New York, including the UnitedHealthcare Community Plan, which provides coverage for New York State residents who meet certain income or disability requirements. This plan includes access to a large network of doctors and specialists in the state. However, it is important to note that provider participation in a plan does not guarantee coverage of all benefits, and specific plans may have varying levels of coverage for specialist services.
| Characteristics | Values |
|---|---|
| Number of physicians and care professionals in the network | 1.3 million |
| Number of hospitals and care facilities in the network | 6500 |
| Website | www.uhc.com |
| Phone number | 1-844-206-1399 |
| N/A | |
| Address | N/A |
| Availability | Monday–Friday, 8 a.m.–6 p.m. EST |
| Cost | Low or no cost |
| Types of insurance accepted | Medicaid, Medicare, Child Health Plus |
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What You'll Learn
UnitedHealthcare Community Plan specialists
UnitedHealthcare is a popular health insurance provider with a large network of physicians and care professionals. The UnitedHealthcare Community Plan specialists are available to answer questions and help with the enrolment process. They can be contacted via phone or through their member-only website.
The Community Plan provides access to a range of healthcare services, including in-home medical visits, dental and vision care, and adult day health centres. They also offer assistance with substance use disorders and behavioural health problems. The plan covers required care and helps coordinate behavioural health care with your PCP.
The UnitedHealthcare Community Plan of Kentucky, for example, provides specific guidance on intensive behavioural health services. If the required behavioural health services are not provided, members can talk to their PCP or call Member Services for assistance. Similarly, the New York UnitedHealthcare Community Plan provides guidance on COVID-19 vaccine billing and breast cancer surgery service recommendations.
While the UnitedHealthcare Community Plan specialists can provide guidance and support, it is important to note that provider participation in a plan does not guarantee coverage of benefits. Certain plans may not cover all provider and hospital services, so members should refer to their handbook or contact Member Services for specific information about covered benefits under their plan.
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Medicaid and Child Health Plus
UnitedHealthcare offers a Community Plan in New York that includes Medicaid and Child Health Plus. Medicaid is a federal and state program that provides health coverage to eligible children. Children from families with incomes too high to qualify for Medicaid but too low to afford private coverage can qualify for the Children's Health Insurance Program (CHIP).
Children must be residents of New York State and under the age of 19 to be eligible for either Children's Medicaid or Child Health Plus. Eligibility depends on gross family income. Children who are not eligible for Medicaid can enrol in Child Health Plus if they don't already have health insurance and are not eligible for coverage under the public employees' state health benefits plan. There is no monthly premium for families whose income is less than 2.2 times the poverty level. Families with somewhat higher incomes pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than four times the poverty level, they pay the full monthly premium charged by the health plan. There are no co-payments for services under Child Health Plus.
UnitedHealthcare Community Plan specialists can answer questions and help with enrolment. The plan includes access to a member-only website where members can print ID cards, chat with a nurse online, and more. The plan also includes practice guidelines to help providers make healthcare decisions, based on nationally recognized sources.
For more information about Child Health Plus or Medicaid, call New York Health Options at 1-800-541-2831.
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Substance use disorder services
In New York, insurance coverage must be consistent with the Mental Health Parity and Addiction Equity Act (MHPAEA). This means that health insurance policies sold in New York must cover treatment for mental health and substance use disorders (MH/SUD).
UnitedHealthcare offers coverage for substance abuse treatment, including inpatient and outpatient treatment, counseling, and medication-assisted treatment. They also provide a 24-hour Substance Use Helpline (1-855-780-5955 / TTY 711) where you can speak to a licensed clinician who can help evaluate your situation and arrange for a face-to-face evaluation with a network professional. This service is confidential and provides support, guidance on recommended treatment options, and help finding a network provider.
To verify your UnitedHealthcare insurance benefits, you can check your insurance card, log into your online account, or contact customer service. Your insurance card will typically have information about your plan, including copayment amounts, deductibles, and covered services. Online accounts provide access to coverage details, claims history, and copayment amounts. Customer service representatives can also provide information about your coverage and what services are covered.
In addition to UnitedHealthcare, there are other resources available in New York for those seeking help with substance use disorders. The Community Health Access to Addiction & Mental Healthcare Project (CHAMP) helpline can be reached at (888) 614-5400, Monday through Friday from 9:00 AM to 4:00 PM, or by email at
It is important to note that insurance plans may vary in their specific coverage details, so it is recommended to contact your insurance provider or refer to your plan's coverage information to understand what substance abuse services are covered under your plan.
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Wellness4me Plan
The Wellness4Me Plan is a UnitedHealthcare Community Plan that is offered to New York residents aged 21 and over who qualify for Medicaid coverage. It is a Health and Recovery Plan (HARP) approved by New York State. HARPs are a new type of plan that provides Medicaid members with healthcare, as well as care for behavioural health, including serious mental illness and substance use disorders.
The Wellness4Me Plan includes benefits such as asthma and COPD care, case management, diabetic support, mental health counselling and treatments, and residential care. Enrolled members also have access to adult day care, emergency response systems, and friendship and social activities in a safe setting.
Additionally, the Wellness4Me program offers new services called Behavioral Health Home and Community-Based Services (BHHCBS) to qualifying members. These services aim to help individuals find housing, live independently, return to school or find a job, and manage stress and prevent crises.
UnitedHealthcare Community Plan specialists are available to answer questions and help with the enrollment process. They can be reached through their website or by calling the New York State of Health Exchange. It is important to note that the availability of the Wellness4Me Plan may vary depending on your ZIP code.
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Dual Special Needs plans
UnitedHealthcare offers Dual Special Needs plans (D-SNP) for people with both Medicare and Medicaid. These plans are designed for people who may need more help due to income, disabilities, age, or health conditions.
D-SNP is a type of Medicare Advantage coordinated-care plan that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, Medicaid benefits, and additional health benefits such as vision, dental, or fitness. These plans offer more benefits and features than Original Medicare, and members with Extra Help (Low-Income Subsidy) can enjoy a $0 premium.
UnitedHealthcare's Dual Special Needs plans are called UnitedHealthcare Dual Complete®. These plans offer benefits such as the ability to use your UCard to buy healthy food, over-the-counter (OTC) products, and pay utility bills.
In New York, UnitedHealthcare offers the UnitedHealthcare Community Plan, which includes Medicaid and Child Health Plus. This plan provides access to a member-only website, where individuals can print ID cards, chat with a nurse online, and access practice guidelines to help make healthcare decisions. The Community Plan specialists can answer questions and assist with enrollment.
UnitedHealthcare has a large provider network, with over 1.3 million physicians and care professionals and 6500 hospitals and care facilities nationwide. Individuals can sign in to their member account or use the guest directory to find a provider that suits their needs.
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Frequently asked questions
Yes, UnitedHealthcare has a large provider network in New York, which includes medical specialists.
The UnitedHealthcare Community Plan is a health insurance plan for New York State residents who meet certain income or disability requirements.
The Essential Plan is offered through the New York State of Health by UnitedHealthcare. It is for lower-income individuals in New York who don't qualify for Medicaid.
The UnitedHealthcare Community Plan offers value-added benefits and extras, including gym reimbursement of up to $400 per year, dental and vision coverage, and access to a member-only website.
You can sign in to your member account or search the guest directory on the UnitedHealthcare website to find a provider that's right for you. Alternatively, you can contact the insurance company or the medical specialist's office directly to verify their accepted insurance plans.
