On Oct. 1, 2022, UnitedHealthcare Community Plan (Medicaid) moved to a single pharmacy benefits manager (PBM), Gainwell Technologies. Most pharmacies in Ohio are eligible. For more information, visit the Gainwell Ohio Medicaid page or call 833-491-0344.
UnitedHealthcare Connected is available to individuals who are eligible for both Medicare and Medicaid in: Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Stark, Summit, Trumbull and Wayne counties.
UnitedHealthcare Connected is a partner in the state of Ohio’s integrated care delivery system for Medicare-Medicaid eligible enrollees called MyCare Ohio.
UnitedHealthcare Connectedis dedicated to improving quality and efficiency of care benefits for members through an individualized approach that focuses on seamless coordination of care while simultaneously easing the administrative burden for providers through assistance with higher acuity patients and claims simplification.
As an industry leader in population health management, we employ best practices to support your care plans to help members maintain and improve their health. We also support members who want to remain independent and live in the least restrictive environment possible through our comprehensive and integrated care management benefit programs.
We believe our benefits can help make coverage and care more connected, personal and flexible for everyone involved. UnitedHealthcare Connected seamlessly combines:
Medicare Parts A and B
Vision and dental
Home and community-based services
A dedicated UnitedHealthcare Connected team will work collaboratively with family members, caregivers, health care providers, home- and community-based service providers and community organizations to help simplify care delivery and improve health outcomes for UnitedHealthcareConnected members.
We recognize that arranging care and services for your loved one takes a lot of time and effort. You play such a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.
Connectedcare can mean a better quality of life for the person in your care.
We recognize that arranging care and services for your loved one takes a lot of time and effort. You play a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.
A team to help you access care.
UnitedHealthcare Connected members and their caregivers have access to a dedicated care team to help them navigate the entire health care system. The personal care team will:
Develop a comprehensive plan of care to support their physician’s care plan.
Coordinate Medicare and Medicaid benefits.
Arrange for community support services to help improve overall quality of life. This may include adding ramps for members with a physical disability, meal delivery or identifying resources for those who have trouble paying utility bills.
A higher level of care.
Our comprehensive provider network includes a variety of general and specialty doctors, therapists and nurses who are highly skilled in working with people with complex care needs.
We also partner with organizations throughout the community who offer the supports needed for individuals to live at home for as long as possible based on their health needs.
Our providers and community partners work closely with us to deliver a customized plan of care for each member as well as access to our extensive health care resources.
We look forward to helping your eligible patients transition to UnitedHealthcare Connected. If you have any questions, please don't hesitate to contact us .
Integration of Medicare and Medicaid programs eliminates the need to coordinate care separately for these two health benefits programs. We'd like to partner with you to coordinate care and compensation, so you can focus on the health of your patients and the health of your practice.
Connecting care and services for a healthier practice.
UnitedHealthcare Connected helps you spend more time with patients and less time on administrative tasks. Complete integration of Medicare and Medicaid benefits means you no longer have to worry about coordinating the two programs.
We do that for you. Instead of spending time figuring out which program covers what benefits, and who can deliver them, we manage all the details and logistics for you.
Our goal is to increase efficiency, minimize your administrative burden and better leverage all available resources to help you deliver the best possible care.
Your expertise and input is important to the success of UnitedHealthcare Connected and we look forward to our partnership to improve care for members who are eligible for Medicare-Medicaid health benefits.
A single source for all you need.
With UnitedHealthcare Connected, you'll have greater flexibility to deliver the right care each patient requires. Whether they need medication compliance counseling, substance abuse treatment, nutrition counseling or other support services, just call us.
Our care coordinators include social workers and aging experts who will put the necessary resources in place.
Save time and administrative costs.
You'll have one business partner who is accountable for complete care coordination and compensation. That simplifies billing and coding for your services, which are all tracked with one UnitedHealthcare member ID number.
Working together will help save you time and administrative costs, while increasing the efficiency of care. And we're developing innovative compensation and incentive models so that quality care and efficiency are rewarded.
Special attention for community behavioral health centers.
The UnitedHealthcare Connected approach to care can be a significant change for many behavioral health care providers. UnitedHealthcare’s experience in contracting with numerous medical, long-term care and community behavioral health systems in other states will help ensure that the transition is easy to understand and to implement.
We are working diligently to streamline procedures and payment processes. Our clinical staff will work with you to ensure easy access to our providers and promote your services as a seamless part of our plan. And we'll conduct face-to-face and web-based training sessions to solve any issues together.
We look forward to partnering with you. If you would like more information, please contact us.
We share your commitment to helping low-income elderly and people with disabilities live healthier lives. We want to work with you to build the strongest possible network of services and supports for these individuals. Together, we can create a model of efficiency, effectiveness and compassion.
Together, we can help shape the future of care in Ohio.
Big change brings big opportunities. Organizations like yours are vital to a healthy community. We want to work with you to build the strongest possible network of services for the low-income elderly and people with disabilities. By working together, and sharing ideas and expertise, we can help create a model of efficiency, effectiveness and compassion.
A trusted partner.
All successful partnerships are built on trust and respect. We are committed to working with you to promote the wellbeing and protect the best interests of the people you serve. And through our advisory council, you can have a direct voice and the opportunity to make suggestions that will improve our health plan in Ohio.
Ask us. We're happy to help.
Many community organizations are facing increasing budget challenges. That can make it difficult to assemble all the resources you need to further your mission. Or, it may limit what you can offer to those you serve. UnitedHealthcare can provide a wide range of technical supports and assistance to organizations of all types and sizes.
Whether you need help solving issues with claims and billing, writing applications for grants and funding, providing health-related educational materials, or delivering health and nutrition programs at your facility, just ask. We're eager to partner with you.
We look forward to working with you. If you would like to learn more, please contact us.
UnitedHealthcare is an industry leader in providing comprehensive coverage to Medicare and Medicaid members that centers on person-centric care. Our expertise in coordinating physical health care services, long-term care and behavioral health services helps ensure this unique population has access to comprehensive care to address their often complex care needs.
We’ve managed plans for both Medicare and Medicaid for nearly 30 years. Today, we serve more than 250,000 people who are Medicare and Medicaid eligible and one in five Americans who are covered by Medicare.
We are a pioneer and national leader in developing and operating integrated managed care plans for acute and long-term care.
We have more than 20 years of experience developing person-centered models of care that have improved quality, driven increased customer satisfaction and reduced unnecessary and costly utilization.
Through our partnership with OptumHealth, a UnitedHealth Group company, we offer cutting-edge population management practices and comprehensive behavioral health services.
To be the preeminent provider of state health care solutions for the aged, blind, and disabled, as well as those in need of long-term care and behavioral health care, who are Medicare-Medicaid enrollees.
We will accomplish this through:
Support of Medicare and Medicaid services through coordinated or contractually integrated models.
Relationships with best-in-class providers.
Support of members’ choices to maintain independence and prevent functional decline through comprehensive and integrated care management programs.
We are committed to helping our extensive provider network learn more about all aspects of this health plan by offering training opportunities and/or materials to support your participation in this network and to help you leverage the technology and tools developed to support your care of our members.
Online Training Sessions help you learn more about Claim Submission, Care Coordination, Plan Benefits and Prior Authorizations.
Training Aids for Electronic Transactions
Customized for MyCare Ohio providers, training aids were developed to assist you in filing claims, verifying member eligibility, checking status of a claim and handling paper claim payments.
On August 5, 2019, managed care providers will be required to use Electronic Visit Verification (EVV) for home care services, such as aide and nursing services. The Ohio Department of Medicaid is administering the EVV program and leading all training on how to use the EVV system and device. Please visit https://medicaid.ohio.gov/evv to learn about this new program and read through helpful materials. There are a series of trainings you can register for including in-person, live webinar, and self-paced online training. PLEASE REGISTER FOR TRAINING. You MUST complete training in order to get access to the EVV system, and EVV will be required.
You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them. Our partnership will be the foundation for a higher level of care for members.
UnitedHealthcare Connected means working together to serve people better.
You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them.
Our partnership will be the foundation for a higher level of care for members. That’s why we’d like to work side-by-side with you to help give the people of Ohio a higher level of care and to serve more people, more effectively.
The full benefit of our combined expertise.
Like you, we are firm believers in the value of home- and community-based services (HCBS). In fact, UnitedHealthcare has long been integrally involved in the movement to care for people at home. That goes back to 1989, when we helped Arizona pioneer its program to find HCBS as alternatives to nursing home care.
Over the last 20 years, we've managed HCBS and long-term care programs in seven states including Massachusetts, New Mexico and Tennessee. We want to use our knowledge and best practices to help you strengthen and enhance your plan of care and service offerings.
Save time and administrative costs.
UnitedHealthcare Connected integrates all Medicare and Medicaid benefits into one plan. That's not only better for those you serve, it's also easier and more efficient for you.
You'll enjoy faster communication and greater efficiency having just one business partner who is accountable for complete care coordination.
Having just one entity responsible for compensation also helps reduce the complexity and duplication of administrative work - saving you time, while lowering your administrative costs.
Opportunities for increased growth.
Partnering with community organizations has always been our business model, making you an integral part of our work. And, as our member base grows, the opportunities for you to expand and serve more people can increase too, just as it has for our physicians, specialists and other healthcare professionals and service partners in communities throughout the country.
We look forward to working with you. If you would like to learn more, please contact us.