UnitedHealthcare Community Plan and Healthy Michigan

CSHCS is a state of Michigan program that serves children, and some adults, with special health care needs. CSHCS covers more than 2,700 medical diagnoses. Our specialty trained team members are here to help you, just call us at: (800) 903-5253.

Additional Benefits for Medicaid Health Plan Enrollees with Children’s Special Health Care Services:

Help from your Local Health Department with:

• Community resources — schools, community mental health, financial support, childcare, Early On, and the Women, Infants and Children (WIC) program
• Transitioning to adulthood
• Orthodontia Only for specific CSHCS qualifying diagnosis, such as cleft palate/cleft lip Medically necessary, related to condition Not for cosmetic purposes
• Respite Care CSHCS covers 180 hours of respite care annually when a beneficiary requires skilled nursing and a CSHCS nurse consultant determines appropriate

Help from the Family Center for Children and Youth with Special Health Care Needs

• CSHCS Family Phone Line — a toll-free phone number (1-800-359-3722) available Monday through Friday from 8 a.m. to 5 p.m.
• Parent-to-parent support network
• Parent/professional training programs
• Financial help to go to conferences about CSHCS medical conditions and “Relatively Speaking,” a conference for siblings of children with special needs

Help from the Children’s Special Needs (CSN) Fund

The CSN Fund helps CSHCS families get items not covered by Medicaid or CSHCS.

To see if you qualify for help from the CSN Fund, call 1-517-241-7420.

Examples include:

• Wheelchair ramps
• Van lifts and tie downs
• Therapeutic tricycles
• Air conditioners
• Adaptive recreational equipment
• Electrical service upgrades for eligible equipment

Dental care is important. We offer dental coverage to all beneficiaries ages 19 and above enrolled in Healthy Michigan Plan, as well as all enrollees ages 21 and older, enrolled in Medicaid.

UnitedHealthcare covers a wide range of dental treatments and services. These services include preventative, diagnostic and minor restorative and oral surgery.
Dental Guide

Please note: Children under age 21 and enrolled in Medicaid are automatically enrolled into the Healthy Kids Dental program. The two plans available are Blue Cross Blue Shield of Michigan and Delta Dental of Michigan. You will get an identification card and Member Handbook from the dental plan you are enrolled in. If you are enrolled in this program, please refer to your Healthy Kids Dental Member Handbook for information on your dental benefits. You can also call the Michigan
Beneficiary Helpline toll-free at 1-800-642-3195 for help.

Blue Cross Blue Shield of Michigan
Michigan Health Insurance Plans | BCBSM
Phone: 1-800-936-0935

Delta Dental of Michigan
Individual Dental Plans | Delta Dental of Michigan (deltadentalmi.com)
Phone: 1-866-696-7441

UnitedHealthcare Community Plan is offering food services to improve your health.

Medically Tailored Home Delivered Meal (MTM)

If you live in one of these counties, you may qualify for MTM:

• Allegan, Barry, Clinton, Eaton, Genesee, Huron, Ingham, Ionia, Kent, Lake, Lapeer, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana, Osceola, Ottawa, Saint Clair, Sanilac, Shiawassee, or Tuscola

Through MTM, you will receive up to two healthy meals per day delivered to your home for up to 3 months. These meals are tailored to your health needs. You will also get help from a registered dietitian who will guide you on choosing healthy foods.

This service is for members who:

• Cannot get enough food when they need it
• Cannot shop for and cook their own healthy meals
• Are at risk for nutritional deficiency due to food insecurity
• Have an illness that can be improved with a healthy diet, like diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD), hypertension, human immunodeficiency virus (HIV), cancer with malnutrition, sickle cell disease, renal/kidney disease, diabetes during pregnancy, or other pregnancy complications; OR
• Have been in a hospital or skilled nursing facility in the last 60 days.

Produce Prescription

If you live in one of these counties, you may qualify for Produce Prescription:

• Clinton, Eaton, Genesee, Huron, Ingham, Lapeer, Saint Clair, Sanilac, Shiawassee, or Tuscola

Through Produce Prescription, you will receive a voucher to buy fruits and vegetables for up to 3 months.

This service is for members who:

• Cannot get enough food when they need it
• Are at risk for nutritional deficiency due to food insecurity
• Have an illness that can be improved with a healthy diet (e.g., diabetes, heart conditions, stroke, lung disorders, hypertension, HIV, cancer, obesity, oral health disease, sickle cell disease, renal/kidney disease, substance use disorder, or mental health disorder)
• Have been in a hospital or skilled nursing facility in the last 90 days
• Are likely to end up in the hospital or another facility if they cannot access healthy food
• Are pregnant and have or are at risk of complications from pregnancy (e.g., diabetes while pregnant, preeclampsia, preterm labor, infection, mental health condition)
• Used to be in foster care and are at risk of developing an illness
• Are a child with too much lead in their blood, live in a stressful environment, or will develop an illness without access to healthy food
• Are eligible for the Children’s Special Health Care Services (CSHCS) program
• Are an adult eligible for the Persons with Special Health Care Needs (PSHCN) program
• Have a disability

You can only receive one of the food services (MTM or Produce Prescription) at a time.

It is up to you whether you use a food service if you qualify. Your Medicaid coverage and access to other medical services will stay the same whether you use a food service or not.

You can file a grievance or appeal about the food service, for example, if you are not approved for a food service. Information on how to file a grievance or appeal can be found in your member handbook.

If you have any questions, call toll-free 1-800-903-5253 for more information.

We cover a long list of prescription medicines or drugs. Medicines that are covered are shown on the Preferred Drug List (PDL). The list of covered drugs is reviewed by the Michigan Department of Community Health on a regular basis and may change when new generic drugs are available. You can find the PDL for your plan on our website at myuhc.com/CommunityPlan. There, you can also search for a medicine by name.

Some medicines are covered by the State and not UnitedHealthcare Community Plan. You may
have a copay for those medicines. The pharmacist will tell you if the medicine you need is covered
by the State. To see the list of medicines covered by the State, go to: https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/beneficiaries/resources/medicaid-health-plan-pharmacy-benefit. You will use your mihealth card to get the medicine.

Over-the-counter (OTC)
You can get OTC products and medicines with a prescription from an in-network practitioner. There is no copay when you take your OTC prescription to a participating pharmacy OTC medications include pain relievers, allergy, cough & cold medicine, first-aid cream, vitamins and more.