Medicaid SSI

Care manager

Do you have a serious health problem? If so, our care managers are in your corner. They will:

• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records.

The care manager will stay close by throughout the medical journey. He or she will:

• Think beyond your immediate needs.
• Make sure you have support at home.

Chiropractic services

Whether chiropractor services are your primary or alternative treatment method, you're covered. Members 21 and over are covered for chiropractic care visits.

This is a benefit provided by the State of Wisconsin.

Choice of doctor

Each member can choose a primary care physician (PCP). Use the "Doctor Lookup" tool to see if your doctor is in our network.

You get a primary care physician (PCP), who is your main doctor. If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.
• Referrals to specialists for certain conditions.

Choice of birth center

Where a mother has her baby is an important choice. That's why women who are pregnant can pick from a large number of hospitals across Wisconsin.

We encourage mothers-to-be to tour the hospital's birthing center. This way they will be familiar with it. And be more relaxed when they have their baby.

Dental care

Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well. There is no copayment for exams and cleanings.

If you live in Kenosha, Milwaukee, Ozaukee, Racine, Washington or Waukesha Counties, your dental benefits are provided by UnitedHealthcare Community Plan.

If you live outside of Kenosha, Milwaukee, Ozaukee, Racine, Washington or Waukesha Counties, you may get dental services from any dentist who will accept your ForwardHealth ID card. Your dental services are provided by the State, not UnitedHealthcare.

Disease management

If you have chronic or high-risk illnesses, our disease management services are designed to support you.

We have special programs for:

• Chronic obstructive pulmonary disease (COPD)
• Coronary artery disease (CAD)
• Congestive heart failure (CHF)
• Diabetes
• High Risk Pregnancy and NICU
• Sickle Cell Disease

Equipment and supplies

Some members may need extra support to live safely at home.

Our plan covers medical equipment ordered by member's doctor or case manager. This can include supplies like:

• Hospital beds.
• Oxygen tanks.
• Wheelchairs or walkers.

There is no copayment for medical equipment and supplies.

Federally qualified health centers (fqhcs)

Your UnitedHealthcare Community Plan is proud to offer you access to Federally Qualified Health Centers (FQHCs) across the state.

Federally Qualified Health Centers (FQHCs) “are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary health care services to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans.” *

In addition to primary care, FQHCs provide access to important services such as pharmacy, mental health, substance use disorder treatments and oral health services (dental). This means that you may be able to get all of these important services at one place.

To find a FQHC in your community, the state of Wisconsin maintains a list of FQHCS in the state. You can also contact member services and they can help find a primary care provider within a FQHC to be your provider.

* https://bphc.hrsa.gov/about-health-centers/what-health-center

Foot care

We provide the exams needed to help keep feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

• Routine foot exams.
• Tips about foot care and choosing the right shoes.
• Information about nerve damage warning signs.

There is no copayment per visit.

Hearing care

Trouble hearing can affect a person's life in many ways. Our plan includes services and support to help protect your hearing.

We cover:

• Exams, therapy and tests.
• Hearing aids and batteries.

There is no copayment per visit.

Healthy First Steps®

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Connect with community resources such as Women, Infants and Children (WIC) services.

Home health care

After surgery or a serious illness — or if you have disability — you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. With approval from your doctor, our plan covers:

• In-home medical visits.
• Medical equipment like hospital beds, walkers or wheelchairs. 
• Disposable medical supplies.
• Help with personal care.

Hospitalization

This plan pays for expenses related to a hospital stay. Our plan covers:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.

Interpreters

UnitedHealthcare offers services to help you if you do not speak English or have hearing or speech barriers.  Interpreter services are offered free of charge.  

To ask for help with interpreter services, please call 1-800-504-9660, TTY 711.  Representatives are available Monday through Friday from 7:00 a.m.-7:00 p.m. Central Time.  

You also have the right to have an interpreter with you during a covered service.  You can ask your doctor to arrange for an interpreter to assist during your visit.

Lab and x-rays

Knowing what's wrong and finding it early can make all the difference. Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We'll help you get the information needed to improve your health or be at your best.

Language help

You can receive information in your preferred language. Just ask. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language.

Medicines

Prescriptions and certain over-the-counter items are provided by the State of Wisconsin.

You may receive a prescription from a UnitedHealthcare doctor, specialist or dentist.  You can fill your prescription at any pharmacy that is a provider for Medicaid SSI.  Just show your ForwardHealth ID card to the pharmacy when you get your prescriptions filled.  For questions about pharmacy, please contact the State of Wisconsin at 1-800-362-3002.

You may have copayments or have limits on covered medications that are administered by the State of Wisconsin.

Member Advocate

We're looking out for you. Our local member advocates can help solve problems, provide training and education, and work on issues that concern members. Local member advocates are available at 1-800-504-9660 Monday through Friday, 8:00 a.m.-4:30 p.m. Central Standard Time.

Our Member Advocates can:

• Answer your questions about your benefits.
• Help with doctor issues or complaints.
• Help you recertify your health care benefits.

Member services

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24 hours a day, 7 days a week.

You can connect with one of our member call center advocates Monday through Friday from 7am to 7pm by calling 1-800-504-9660, TTY 711. We'll answer your questions simply and completely.

We can answer your questions about UnitedHealthcare benefits and coverage, and help you find:

• A primary care provider for you and your family.
• Home care providers.
• Dentists and vision providers.
• Adult day health centers.

In addition, when you have questions about your health, you can call a nurse 24 hours a day, 7 days a week, at no cost to you via our Nurse Hotline 1-866-827-0806.

Mental health

Mental health is as important as physical health. That's why we have coverage for both.

Required care includes:

• Behavioral therapy.
• Substance abuse treatment.
• Medications.

There is no copayment per service.

Nurse hotline

Medical questions and situations sometimes happen at bad times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.

Our nurses will:

• Listen to symptoms.
• Help with self-care.
• Advise you about getting care at a doctor visit or an urgent care center.
• Help you know when to go to the emergency room.

Personal care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

• Dressing.
• Bathing.
• Feeding.

Prenatal visits

A pregnancy is a journey Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. with the help of friends, family and a pregnancy doctor, or OB-GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

• Make sure both you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Quitting tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members to help them quit. The only thing they won't get from us is a lecture.

When you are ready to make the change and are looking for more information, the Wisconsin Tobacco Quit Line can help you. Call 1-800-QUIT-NOW, text READY to “200-400” or log onto www.quitline.wisc.edu to learn more about supports and services that can help you quit.

Residential care

After a serious illness, surgery or injury, you may need extra nursing and therapy. In these situations, our plan covers short stays in a rehabilitation center where you can heal. Included are:

• Nursing home services.
• 24-hour nursing care.
• Help with activities of daily living.
• Physical, occupational and speech therapy.

Social drivers of health

Did you know that 80% of our health comes from where we work and play and not the doctor’s office? Food, housing, employment and education all play an important role in our health and the health of our families.

To help you and your family achieve their best health, we offer screenings to identify barriers to key social drivers of health such as food insecurity and poor housing. Based on your individual responses, we can help identify local community resources to help you address these barriers and access supports that will help you reach your health goals.

Text4baby

Text4baby can help new and expecting mothers keep themselves and their babies healthy.

You'll get text messages throughout your pregnancy and your baby's first year. Each text contains health and safety tips for topics like:

• Prenatal care.
• Labor and delivery.
• Breastfeeding.
• Safe sleep.
• Nutrition.
• Car seat safety.

So you and your baby can make a great start on life.

Therapy services

Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.

Our plan covers visits for:

• Occupational therapy.
• Physical therapy.
• Speech therapy.
• In-home therapy.

There is no copayment for these visits.

Transportation

Transportation services are provided by the State of Wisconsin.

Members can get round trip transportation to and from health care locations. That includes trips to:

• Doctor or therapy visits.
• Health departments.
• Vision clinics.
• Urgent care centers.

There is a copayment for some of these services.

To schedule a ride, contact 1-866-907-1493.

Vision

Members can get the care, eyeglasses and treatment that let them see life more clearly. Benefits include:

• Eye exams.
• Prescription lenses and frames.

There is no copayment for each service.

This benefit is offered by March Vision.

Well visits

Well visits with your doctor can help keep you healthy. These visits can catch health problems early, so they can be treated.

Preventive services include:

• Checkups for adults.
• Routine shots.
• Cardiovascular screening.
• Breast and colorectal cancer screening.

There are no copayments for preventive care.