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STAR Kids

Medicaid

At UnitedHealthcare Community Plan, we understand that the health care system can be complex and confusing. We know it can be especially stressful when your health care plan changes. UnitedHealthcare Community Plan will be with you every step of the way.

We want to make sure our members have access to the quality care they need and deserve. Our large network includes the doctors you already know and trust. That’s what you can count on with UnitedHealthcare Community Plan. View the list below to see what STAR Kids includes.

Language and Interpreter Services

UnitedHealthcare Community Plan has staff that speaks English and Spanish. If you speak another language or are hearing impaired and need help, call Member Services at 1-877-597-7799 or TTY 711 for hearing impaired.

If you need materials in audio, Braille, larger print and in other languages at your request. Please call 1-877-597-7799 for help.

  • STAR Kids Các Bước Ghi danh
  • Kiểm tra Tính đủ điều kiện(mở cửa sổ phương thức)

Need help finding a provider or setting up a visit?

Gọi cho Dịch vụ Hội viên theo số 1-877-597-7799, TTY 7-1-1, thứ Hai-thứ Sáu 8 SA-5 giờ chiều/CHhoặc gửi email đến memberservices_uhccp@uhc.com để được trợ giúp tìm người chăm sóc hoặc sắp xếp một buổi thăm khám.

Các Quyền lợi & Tính năng

Chăm sóc sức khỏe định kỳ và khi ốm đau

Get the assistance you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get extra support to keep you and your baby healthy. Bao gồm:

  • Hospital Care. You pay nothing for care in a hospital.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Transportation. We pay for rides to and from medical visits or pharmacy.
  • Well Visits. Annual checkups can help keep you healthy.

If your child has asthma, diabetes or another long-term condition, you can depend on us. The STAR Kids Plan makes sure your child gets the care and services he or she needs. Các quyền lợi bao gồm:

  • Case Management. Personal support from an experienced professional.
  • Asthma Support. Individual care to help control asthma or COPD.
  • Mental Health. Counseling and other treatments are available.

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

  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Thính giác. Xét nghiệm, kiểm tra và trợ thính, nếu cần, được cung cấp.
  • Dental. Most children and young adults age 20 and younger with Medicaid or CHIP coverage get dental services through a managed care dental plan. The dental plans listed below provide services across the state for all Medicaid and CHIP members who qualify for dental coverage. 
    • DentaQuest
    • UnitedHealthcare Dental

Get the medical equipment, assistance and supplies you need to live safely at home. Các quyền lợi bao gồm:

  • Personal Care. Someone to help with dressing, bathing and dining.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Chăm sóc tạm thời. Trợ giúp tại nhà để người chăm sóc của quý vị có thể nghỉ ngơi.

Sometimes you might need a little extra help using your child's health plan. Những lúc đó, quý vị có thể dựa vào:

  • Transportation. We offer rides to and from medical visits or the pharmacy.
  • Interpreters. An interpreter can go with you to medical visits.
  • Language Help. Translated medical materials are available at no cost.
  • Member Services. Your benefit questions are answered 24/7.

Read about all the extras your child could get as a STAR Kids member:

  • Exercise Kit. Includes one pedometer, one pack of resistance bands, and one water bottle for members who want to become more active. 
  • Online Mental Health Resources. Access articles, videos, and other resources at LiveandWorkWell.com 
  • Healthy First Steps®. Pregnant members who enroll in Healthy First Steps Babyscripts will receive access to free educational content, resources, and rewards for going to prenatal and postpartum visits.
  • Extra Benefits. Sports and school physicals offered at no cost

Learn more about Value-added Services English | Tiếng Tây Ban Nha

If your child or young adult is disabled or living with an illness, your child’s health needs are unique. Our job is to make it as easy as possible for you to meet those needs. We make sure you get all your Medicaid benefits and more.

  • Choice of Doctor. Find a primary doctor in your neighborhood. Your doctor can send you to thousands of specialists too.
  • Nurse HotlineSM. Your caregiver can call our nurses for advice 24/7.
  • Medicines. Get the medicine you need at a pharmacy near you or by mail order.
  • Thị giác và nha khoa. Khám mắt và răng định kỳ. Chúng tôi cũng bao trả cho mắt kính và kính sát tròng.
  • Mental Health. Counseling and other treatments are covered.
  • Service Coordinator. Someone to help you manage complex health conditions.
  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • Value-added benefits. Earn free gift cards when you take healthy steps. You’ll get rewards for yearly wellness exams, along with other benefits.

Our STAR Kids Plan is for persons on the HCBS waivers CLASS, HCS, TxHML, DBMD and in ICF-IDD facilities. Learn more here

Chăm sóc bệnh hen suyễn và COPD

One hypoallergenic mattress cover and one hypoallergenic pillowcase for qualifying members with a diagnosis of severe asthma.

Quản lý theo trường hợp

Con quý vị có vấn đề nghiêm trọng về sức khỏe không? Nếu vậy, người phụ trách trường hợp sẽ hỗ trợ quý vị. Họ sẽ:

  • Giải thích các thuật ngữ y khoa bằng ngôn ngữ thông thường.
  • Điều phối các cuộc hẹn với bác sĩ của quý vị.
  • Cung cấp hồ sơ y tế cho đội ngũ chăm sóc của quý vị.

Your case manager will stay with you on your child's medical journey. Họ sẽ:

  • Nghĩ xa hơn nhu cầu y tế của quý vị.
  • Đảm bảo rằng quý vị được hỗ trợ tại nhà.

Vì vậy, quý vị có thể tập trung vào việc giúp con quý vị khỏe mạnh hơn.

Chọn lựa bác sĩ

Your child gets a primary care physician (PCP) who is his or her main doctor. Sử dụng công cụ Tìm kiếm Bác sĩ để xem bác sĩ của con quý vị có trong mạng lưới của chúng tôi không.

If your child doesn't have a doctor or if their doctor is not in our network, we can help you find a new one close to you.

PCP của quý vị là bác sĩ chính để:

  • Chăm sóc phòng bệnh.
  • Treatment if your child is sick or injured.
  • Giới thiệu đến các chuyên gia đối với những tình trạng bệnh lý nào đó.

Chăm sóc răng miệng

Checkups, routine and emergency care are covered.

Khám và vệ sinh răng miệng mỗi sáu tháng giúp giữ răng và nướu chắc khỏe. If there is a dental problem that needs to be fixed, that's covered as well.

Thiết bị và nguồn tiếp liệu

Chương trình của chúng tôi bao trả thiết bị y tế do bác sĩ của quý vị hoặc người phụ trách trường hợp đặt hàng. Điều này bao gồm:

  • Hospital bed.
  • Oxygen tank.
  • Walker or wheelchair.

Extra Benefits

Sports and school physicals at no cost to you.

Our plan covers up to two free physicals each year so your child can:

  • Go to camp.
  • Join a team.
  • Play a school sport.

Nhập viện

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

Điều này bao gồm:

  • Chăm sóc điều dưỡng.
  • Phòng bệnh và tiền cơm.
  • Nguồn tiếp liệu và thiết bị.
  • Điều trị và các liệu pháp.
  • Kiểm tra và xét nghiệm chẩn đoán.

After your child leaves the hospital, you are not alone. We make sure your child gets follow-up care to continue healing at home.

Thông dịch viên

Your child's doctor and you need to understand each other. Việc không thành thạo tiếng Anh sẽ khiến điều này trở nên khó khăn. We can arrange for a medical interpreter to be at your child's 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.

Trợ giúp ngôn ngữ

You can ask to receive information in another language. Then anything we write to you will only be in that language. Dịch vụ này được cung cấp miễn phí cho quý vị.

Thuốc

Chúng tôi giúp trẻ của quý vị nhận được thuốc dễ dàng.

Không có khoản đồng trả cho thuốc được bao trả. You can fill your child's prescriptions at:

  • Nhà thuốc địa phương.
  • Services that deliver routinely right to your door.

We also cover over-the-counter medicines with a written order from your child's doctor.

Dịch vụ Hội viên

Sometimes you might need a little help understanding your child's health care options. Với chúng tôi, quý vị có một người mà quý vị có thể gọi 24/7. Chúng tôi sẽ trả lời các câu hỏi của quý vị một cách đơn giản và hoàn chỉnh.

Chúng tôi cũng có thể giúp quý vị tìm:

  • Các nhà cung cấp dịch vụ chăm sóc sức khỏe tại nhà.
  • Nha sĩ và nhà cung cấp thị giác.

Sức khoẻ Tâm thần

Sức khỏe tâm thần cũng quan trọng như sức khỏe thể chất. Đó là lý do chúng tôi có cùng khoản bảo hiểm cho cả hai.

Dịch vụ chăm sóc yêu cầu được bao trả 100% và không có khoản đồng thanh toán. Điều này bao gồm:

  • Liệu pháp hành vi.
  • Thuốc trị liệu.

Quý vị không phải thanh toán chi phí cho các dịch vụ được bao trả.

Không áp dụng Khoản đồng thanh toán

While your health care is low-cost or free, the care quality is high. Quý vị nhận được:

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Home medical equipment and supplies to help your child be at his or her best.

Đường dây nóng của Y tá

Các câu hỏi và tình huống y tế phát sinh vào lúc không thuận tiện. 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.

Các y tá trực Đường dây Y tá của chúng tôi sẽ:

  • Lắng nghe các triệu chứng.
  • Hướng dẫn quý vị tự chăm sóc.
  • Tư vấn cho quý vị về việc được chăm sóc tại văn phòng của bác sĩ hoặc trung tâm chăm sóc khẩn cấp.
  • Suggest you go right to the emergency department.

Personal Visits

Nếu cần, chúng tôi sẽ gửi một người đến giúp:

  • Mặc áo quần.
  • Tắm rửa.
  • Ăn uống.

Chăm sóc tạm thời

We provide respite care to give caregivers a rest. Respite care offers caregivers time away from their loved one who has special care needs to run errands or just relax.

Điều Phối Viên Dịch Vụ

Every STAR Kids member gets a service coordinator. Your child’s service coordinator will visit with your family in person to go over your child’s health care needs. At these visits you will talk about the services your child is getting and other services your child may need. 

Together you will create a care plan that works best for your family. Your care plan may include:

  • Acute medical services.
  • Dịch vụ chăm sóc sức khỏe hành vi.
  • Primary care services.
  • Special care services.
  • Value-added services.

Your service coordinator can also help you.

  • Arrange care with your primary care provider and with specialists.
  • Connect your family with community programs and additional services.
  • Answer questions about benefits.
  • Help coordinate benefits with other providers.

Transition Specialist

What is a Transition Specialist? What will a Transition Specialist do for me?

For children with special health care needs, the transition to adulthood often brings many changes. A Transition Specialist can help you understand and plan for these changes. All STAR Kids members have access to a Transition Specialist.

How can I talk to a Transition Specialist?

If you want to speak with a Transition Specialist or have a Transition Specialist as part of your Care Team, let your Service Coordinator know and he or she can help you.

Vận chuyển

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

Vaccines and Immunizations

All of the immunizations your child needs are covered.

Chăm sóc thị giác

Your child can get the care, eyeglasses and treatment that lets him or her see life more clearly. Coverage includes $105 each year toward frames or contact lenses.

This benefit is offered by certain stores and retailers.

Nguồn trợ giúp cho Hội viên

Nguồn thông tin Dành cho Hội viên (mở cửa sổ phương thức)

Thông tin Ghi danh

The Texas STAR Kids plan specialists can answer questions and help you enroll.

Gọi cho chúng tôi:
1-877-597-7799 / TTY: 711

8:00 SA đến 5:00 giờ chiều/CH, giờ địa phương, 7 ngày một tuần

Các bước đăng ký
Nhận thông tin chi tiết

Visit the Texas giờ chiều/CHIP & Medicaid site for more information on eligibility and enrollment.

Texas STAR Kids

For information in alternate formats, like large print, Braille or audio, please call Member Services.

Thông Tin Hội Viên

Đã là hội viên? Quý vị được quyền truy cập vào trang mạng chỉ dành cho thành viên của chúng tôi. In thẻ ID, trò chuyện trực tuyến với y tá, và nhiều hơn nữa. 

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

Trang web dành cho hội viên

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 https://member.uhc.com/communityplan or call member services at the number on the back of your member ID card.

 

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