This explains how to find UnitedHealthcare Medicaid Providers, why Medicaid is so important, and how companies like UnitedHealthcare fit into the broader managed care organization picture.
Get to Know UnitedHealthcare Medicaid Providers: A Complete Guide
- What is Medicaid?
Medicaid is a United States public health insurance plan, which pays for health care for individuals and families with limited incomes. It covers children, pregnant women, adults with disabilities, and the elderly who have low incomes. Funded jointly by the federal government and individual states, though administered by the states, both the coverage and eligibility criteria of Medicaid can vary across states. - Role of the Managed Care Organizations
Most states provide Medicaid through managed care organizations to ensure the care is delivered efficiently and with low cost. A managed care organization is a corporation that contracts with a health plan to deliver medical services to their members for a per capita monthly fee. UnitedHealthcare is one of the largest MCO’s in the country serving millions of beneficiaries with Medicaid benefits.
UnitedHealthcare’s Medicaid plans differ in each state, as they collaborate with local state agencies regarding the administration of services. They may go under different names such as Medicaid Managed Care Plans, which are intended to offer coordinated care while ensuring that appropriate medical services are available to patients within a network of participating providers.
- UnitedHealthcare Medicaid Providers Types
While you are on the UnitedHealthcare Medicaid plan, you’ll be covered under a big umbrella of health care providers who take Medicaid. They include:
Primary Care Physicians (PCPs): Usually, they should be your first point of contact whenever you feel the need for health care services. In general, they will perform routine check-ups, cases of routine care, and refer you to other specialists if the need arises.
Specialists: You can further be attended to by a specialist, say, from cardiology, depending on the condition one is suffering from, an endocrinologist, or a neurologist. Many specialists do take UnitedHealthcare Medicaid; however, sometimes patients must obtain a referral from a PCP. Hospitals and Clinics: Since UnitedHealthcare is contracted with hospitals and clinics, inpatient and outpatient care, including emergency services, surgeries, and specialist visits, is available to Medicaid participants.
Pharmacies: Many of the most valuable components of health care consist of prescription medicines. UnitedHealthcare partners with many pharmacies to ensure that Medicaid customers have their covered medicines.
Behavioral Health Providers: Mental health and substance use treatments are some of the numerous valuable services provided through Medicaid. UnitedHealthcare participates in a network made up of providers that specialize in behavioral health services.
- Why Choosing the Correct Medicaid Provider is Important
There are a number of reasons it is considered important to choose the right provider within the UnitedHealthcare Medicaid network:
Full Care: The UnitedHealthcare Medicaid network assures care within the Medicaid program, reducing probable costs from your pocket.
Coordinated Care: This may be an advantage to your primary care physician in coordinating your health care with other network providers to make sure your care is integrated among specialists.
Cost Containment: Most Medicaid enrollees have a very nominal or no copayment; it is therefore very important that you seek care from network providers to avoid unplanned charges.
Specialist Referrals: Most Medicaid plans require patients to obtain a referral from their primary care physician before seeing any specialist. Having a PCP within UnitedHealthcare’s network makes this process easier.
- How to Find UnitedHealthcare Medicaid Providers
Finding a UnitedHealthcare Medicaid network provider is relatively easy and can be done through a variety of means. The following is a step-by-step process to ensure this process goes as smoothly as it can:
5.1. Online Provider Directory
UnitedHealthcare keeps an online directory of the providers who take Medicaid. Here is how to use it:
Go to the UnitedHealthcare Provider Directory: Go to the UnitedHealthcare Find a Doctor webpage.
Choose Your Plan: Under the question about your plan, select “Medicaid.” It will show you providers in the Medicaid network.
Enter Your Location: You can locate providers closest to you by entering your ZIP code, city, or state.
Provider Type: Browse by provider type-specific primary care physician, specialist, or hospital. You can further narrow your search by selecting distance, gender, or language.
Check Availability: The online directory will indicate whether a provider is accepting new patients, along with contact information and office hours. It is always best to confirm by calling ahead.
For an easier, more portable experience, the UnitedHealthcare App is very convenient:
Download the App: iOS or Android.
Log In: Sign in using your Medicaid member information.
Provider Search Tool: Get nearest providers. On the app, you’ll have ID card, benefits and resources in one place. 5.3. UnitedHealthcare Customer Service
If you enjoy actually speaking with a live person, UnitedHealthcare does offer great support and service for customers. The Customer Service number will be pre-printed on your Medicaid ID card.
Number on Medicaid Card: You can call the number on your Medicaid card and speak to a representative. Representatives will be able to help you further and will provide a list of the Medicaid providers in your area.
Have Your Information Ready: You will need to have your ZIP, city and what you are looking for as this may include specialty and language. You can also ask for further assistance. If needed the representative can set up an appointment with you, help you get a referral, or walk you through how to download a listing of Medicaid providers in your area.
5.4. Request a Printed Directory
If you don’t have access to the internet, or if you simply would prefer a hard copy, UnitedHealthcare will mail you a physical copy of their provider directory. To do this, you can either call customer service or get in contact with your local Medicaid office.
- Key Things to Remember When You Are Selecting a Medicaid Provider
Availability: Is the provider currently accepting new patients? If using the online directory and the app, this information should be listed; however, it’s always best to confirm this with a call.
Distance: This will ensure that the provider is conveniently located. Most directories have options to filter providers based on distance from your either home or workplace.
Language Spoken: When your first language is not English, it is always better to check what providers speak your preferred language or at least a translation service.
Cultural Competency: Many like to have their providers understand their needs culturally or by religion, especially in sensitive areas like women’s health or pediatric care.
- How to access Medicaid Care with UnitedHealthcare
Keep your information up-to-date: If you move or get a new phone number, update that information with UnitedHealthcare so you don’t miss anything important about your care.
Use preventive services: Most Medicaid preventive services come at no charge: vaccinations, checkups and screenings to keep you healthy and find health problems early.
Know your coverage and what is covered under your Medicaid plan, particularly for specialists or mental health services and/or prescribed medication. Sometimes, UnitedHealthcare offers enrollees telehealth options so that you can even see a doctor from the comfort of your own home.