Questions? Call 1-855-229-6848 The Louisiana Department of Health and Hospitals has tried to make this chart as accurate and complete as possible. However, because it must rely on the various Health Plans to provide this information, DHH cannot guarantee its accuracy. You can learn more about the Health
Plans by contacting them directly.
*Please contact the Health Plan for eligibility requirements and details for this benefit.
Revision: February 2016
It’s time to choose a Health Plan for you and your family.
How can you choose a Health Plan?
Look at the chart below to compare the extra services each Health Plan offers. Here are some things to think
about when you decide which Health Plan to choose.
• Which Health Plans do your current doctors take?
• Does one of the Health Plans have extra services you want or need?
Compare extra benefits. You can choose one plan for each family member or the same plan for more than
one family member.
W
hat is Healthy Louisiana?
Healthy Louisiana is the way most of Louisiana’s Medicaid and
LaCHIP recipients receive health care services. In Healthy Louisiana,
you choose a Health Plan that is best for you and your family.
All Plans provide the same health services you get in Medicaid or
LaCHIP, such as well child visits, maternity care while pregnant and
through delivery, medical transportation, prescription drugs, mental
health services and substance use treatment. The Plans also offer
extra services. A list of those extra services is in the chart below.
This chart details extra benefits available to members who get physical health benefits through Healthy Louisiana.
Website www.aetnabetterhealth.com/louisiana www.myamerigroup.com/LA www.amerihealthcaritasla.com www.LouisianaHealthConnect.com
Member
Services
1-855-242-0802 | TTY 711
Available 24 hours a day, 7 days a week
1-800-600-4441 | TTY 711 1-888-756-0004 |TTY 1-866-428-7588
Available 24 hours a day, 7 days a week
1-866-595-8133 |TTY 1-877-285-4514
Available Monday–Friday 7a.m.–7 p.m.
www.UHCCommunityPlan.com
1
-866-675-1607
| TTY 711
Available Monday–Friday 7a.m.–7 p.m.
Why choose us?
We focus on the whole person -
t
heir
physical, behavioral and social needs. We
provide access to quality care for people with
complex needs.
Our goal is to help you get the medical care
you need and respect you deserve. Medicaid
benefits plus support and rewards to live
your best.
Our name, AmeriHealth Caritas, stands for
care. As a mission-based organization, we
put care at the heart of our work.
Your connection to quality health care.
Helping you get the care you need with local
support, rewards and access to more than
15,000 providers.
UnitedHealthcare Community Plan helps
pregnant women, kids, families and adults
get the care they need.
Member Services can help you: find a doctor, learn about benefits, access services, file a complaint about a provider or appeal a denied service.
All Plans have a 24 hour Nurse Hotline to help you: figure out if you need to go to the Emergency Room or learn about health issues.
All Health Plans allow u
nlimited visits to in-network doctors, as needed.
Care
Management
Programs
All of the Health Plans have special programs to help members with chronic illness such as asthma, congestive heart failure, diabetes, hepatitis C, HIV, obesity and sickle cell anemia. If they do not have a program in place that fits your
needs, they will work with you to create one. They also have programs for pregnant women with a high risk of problems during pregnancy and delivery.
Circumcision All Health Plans cover newborn male circumcision. Check with the individual Plan to find out more about
t
heir rules for getting this service.
Help to Stop
Smoking
All Health Plans cover coaching and medications (with a prescription) to help members stop smoking.*
Adult Vision
(21+)
Eye exam (No co-pay)
$
80 toward glasses or contacts
(once a year)
Eye exam (N
o co-pay)
Glasses c
overed in full*
(once a year)
Eye exam (N
o co-pay)
$
100 toward glasses or contacts
(once a year)
Eye exam (N
o co-pay)
Glasses c
overed in full*
(once a year)
Eye exam every two years (N
o co-pay)
$
100 toward glasses or
$
105 toward contacts
(once every two years)
Adult Dental
(21+)
Dental exams and cleanings (twice a year)
Fillings and extractions
X-rays (once a year)
$
500 total benefit per year*
Dental exams and cleanings (twice a year)
Fillings and extractions
X-rays (once a year)
$
500 total benefit per year*
Dental exams, cleanings, fillings, extractions
and x-rays with in-network providers, up to
$
500 per year.*
Two visits each year for exams, cleanings, x-
rays, fillings, extractions, crowns and more at
Federally Qualified Health Centers.*
Dental exams, cleanings, fillings, extractions
and x-rays with in-network providers, up to
$500 per year.*
Adult Pain
Management
Members who have gone to the Emergency
Room 4+ times for pain go into a case
management program.
Members who have gone to the Emergency
room 5+ times for pain are reviewed for a
case management program.
Certified pain management coaches help
address chronic pain for members in care
management.
Members over 21 will be provided six (6)
visits per year to an in-network
chiropractor.
Available Monday–Friday 7a.m.–7 p.m.
Questions? Call 1-855-229-6848 The Louisiana Department of Health and Hospitals has tried to make this chart as accurate and complete as possible. However, because it must rely on the various Health Plans to provide this information, DHH cannot guarantee its accuracy. You can learn more about the Health
Plans by contacting them directly.
*Please contact the Health Plan for eligibility requirements and details for this benefit.
Revision: February 2016
Community
Programs
All Health Plans offer sponsorships and/or mini-grants for community organizations and members in need.*
Boy Scouts and Girl Scouts membership for
one year for eligible members.* (Ted E. Bear,
M.D. Club)
Boys & Girls Club membership for eligible
members.*
Boys & Girls Club membership for eligible
members.*
Rewards for
H
ealthy Living:
All of the Health Plans offer rewards for healthy behaviors. Unless otherwise noted rewards are: available once a year per member; in the form of a reward debit card or gift card.
Child Well Visits
(birth – 20)
$25 for annual well visit with an STI
screening (teens 16-20)
$
20 for all well visits from birth to 15 months*
$
20 for annual well visits (ages 2 – 9)
$
25 for annual well visits (ages 10+)
B
ooster seat for all well visits from birth to 6
years
$
20 for annual well visits (ages 3 – 20)
$
30 for all well visits from 2 to 15 months*
$
20 for annual well visits (ages 3 – 20)
F
eeding or dental care set for a well visit at
6 months* (Baby Blocks)
B
ath set or soft puzzle for a well visit at
15 months* (Baby Blocks)
$
20 for annual well visits (ages 1 - 17)
Adult Well Visit
(21+)
$25 for annual well visit with an STI
screening
$
15 for annual well visits
$
20 for a PCP visit within 90 days of
Enrollment, and annually after the first
year
$
20 for annual well visits
$
20 for a PCP visit within 90 days of
enrollment
Wellness
Screenings
$15 for Breast Cancer Screening,
women 21+
$
15 for Cervical Cancer Screening,
women 21–64
$
25 for Colon Cancer Screening, members
50+, one time only
$
10 for STI Screening, members 16+
$
15 for Lead screening for children,
birth – 2 years*
$
10 for Cervical Cancer screening,
women 21 - 64
$
10 for Breast Cancer Screening,
women 40-74
$
10 for Cervical Cancer Screening,
women 21-64
$
15 for STI screening (chlamydia, gonorrhea
and HIV test)
C
hildproofing kit or Goodnight Moon board
b
ook for Lead Screening, birth – 15 months*
(Baby Blocks)
Diabetic
Screening
$
15 for each: dilated eye exam, LDL and A1C
blood tests for members diagnosed with
diabetes
$10 for all: dilated eye exam, kidney
screening and A1C blood test for all
members*
: dilated eye exam, LDL and A1C
blood test for all members.*
$
50 for all: dilated eye exam, and blood
tests for LDL, A1C and kidney disease
for members diagnosed with diabetes*
$50 health product voucher for LDL and
A1C blood tests within 90 days of
enrollment for members age 21+*
Other rewards
$
15 for annual asthma assessment
$
15 for follow-up after asthma-related
Emergency Room visit
$
15 for other asthma care tasks*
$
15 - $30 for meeting weight loss goals in
Ted E. Bear M.D. Kids Weight
Management Program
$
5 for a flu shot
$
10 for a completed Health
Assessment, one per household
$10 for a flu shot
$
20 for ADHD new medication follow-up visit,
as needed (ages 6-12)
$
10 for a completed Health
Assessment within 90 days of
enrollment
$50 for a member (under age 21) at
the end of the Join for Me program
D
igital thermometer or Rubber duck bath
t
hermometer at birth of child (Baby
Blocks)
Pregnancy
Reward Program
P
romise Program Taking Care of Baby and Me
®
Bright Start Start Smart for Your Baby Program Baby Blocks
Prenatal Exams
$
10 for prenatal visit in the first trimester, or
within 6 weeks of joining the plan*
$
80 for at least 7 prenatal visits and a post
partum visit o
r
$
125 for at least 8 prenatal visits and a post
partum visit o
r
$
150 in baby products for at least 11
prenatal visits and a postpartum visit
$
25 for prenatal visit in the first 6 weeks of
pregnancy
P
ortable crib or an infant car seat for 7
prenatal visits
$
50 for attending most recommended
prenatal visits
$10 for each prenatal visit, up to $110 per
pregnancy
N
ursing cover or teething rattle for
a prenatal visit at 24 weeks* (Baby
Blocks)
First aid kit or tabletop toy for a prenatal
visit at 32 weeks* (Baby Blocks)
Postpartum
Exam
$10 for a postpartum visit (3 – 8 weeks after
delivery)
$
50 for a postpartum visit
$
25 for a postpartum visit $50 for a postpartum visit
$
20 or Fisher Price sorting blocks for
a postpartum visit * (Baby Blocks)
Other Pregnancy
Rewards
Receiving blanket with matching cap and
“
Happiest Baby on the Block” DVD/book
when a member enrolls in Bright Start
$
30 for completing a Notice of Pregnancy
form
B
reast Pump and NICU Care Kit for members
in Case Management when needed
$
20 or Diaper Bag when a member enrolls in
Baby Blocks
H
ealthy Pregnancy Care Book when a
member tells UnitedHealthcare they are
pregnant
Extra Pregnancy
Benefits
In-home postpartum visit
$10 for all
Questions? Call 1-855-229-6848 The Louisiana Department of Health and Hospitals has tried to make this chart as accurate and complete as possible. However, because it must rely on the various Health Plans to provide this information, DHH cannot guarantee its accuracy. You can learn more about the Health
Plans by contacting them directly.
*Please contact the Health Plan for eligibility requirements and details for this benefit.
Revision: February 2016
Asthma Benefits
Home assessment for members diagnosed
with asthma.
Inhaler sensor to help control asthma for
members diagnosed with asthma*
Asthma
t
ablet for eligible members to help
manage their asthma, includes an
emergency medication tracker.
Home assessment for eligible members with
moderate to severe asthma (once per year)
Other Benefits
Acupuncture for members 19+ up to $
150
reimbursement
Respite Services for Caregivers – Up to 8
hours each month for caregivers of children
up to age 20
GED registration fees voucher – receive a
voucher to pay for the cost of taking the GED
exam
Members age 21+ receive one hearing exam
and one set of hearing aids every two years.
Adult Weight
Management
Weight Watchers® meetings for eligible
members age 18 and older
Every Calorie Counts: Members in the
program get two visits with a registered
dietician each year
Up to 10 Weight Watchers® meetings for
eligible members age 13+ (with a referral
from PCP)
Pediatric Weight
Management
Program
Ted E. Bear, MD Club participants get
nutritional sessions, weight checks and can
earn rewards. (See other rewards)*
Healthy Families - a program to help families
get fit and healthy
Every Calorie Counts: Members in the
program get two visits with a registered
dietician each year.
Raising Well program guides you in helping
your child be healthy by eating right and
being active.
Join for me: 16 weeks of fun family activities
led by a trained coach. Those who finish the
program earn a reward.
Pharmacy
Copays
N
o copays
There are no copays for children, pregnant women, family planning supplies, members in the hospital, Native American or Alaska Native members. For others, if the medicine is:
$10 or less = $0.50 copay $10.01 - $25 =$1 copay $25.01 - $50 = $2 copay Over $50 = $3 copay
Rides to
Appointments
All Health Plans will set up a ride for members who don’t have a way to get to medical appointments.
Stop at the pharmacy after your appointment
to get medications.
Stop at the pharmacy after your appointment
to get medications.
Stop at the pharmacy after your appointment
to get medications.
Stop at the pharmacy after your appointment
to get medications.
Over the
Counter (OTC)
Medications
Free with a doctor's prescription.
$
50 monthly benefit per household for
OTC vitamins and health products.
Available with a prescription, see copays
above.
Some available with a prescription, see
copays above.*
Available with a prescription. See copays
above.
Available with a prescription. See copays
above.
Extra Medication
Supply for
School
Asthma inhaler
EpiPen®
Diabetes testing meter
Asthma inhaler
EpiPen®
Asthma inhaler
EpiPen®
Diabetes testing meter
Adult
Vaccinations
All Health Plans cover adult vaccinations for HPV (human papilloma virus), pneumonia and the flu (influenza).
Tdap (Tetanus/Diphtheria/Whooping Cough) Shingles and Meningitis
Td (Tetanus/Diphtheria) and Tdap
(Tetanus/Diphtheria/Whooping Cough)
Cell Phone
All Health Plans work with Safelink Wireless to give eligible members a free cell phone. Phones come with 250 free minutes, unlimited texting and free calls to Member Services.
BONUS: 500 Safelink minutes your first 4
months and then 100 extra minutes each
month
BONUS: 500 Safelink minutes your first 4
months, then 100 extra minutes each month
and another 100 extra minutes for your
birthday
BONUS: 500 Safelink minutes your first 4
months and then 100 extra minutes each
month
BONUS: 250 extra Safelink minutes each
month for eligible members.* For members
not eligible for Safelink, Connections Plus
may provide a phone.*
BONUS: 500 Safelink minutes your first 4
months and then 100 extra minutes each
month
Texting and
Social Media
Programs
Text4Baby, Text4Kids, Text4Health,
Care4Life (diabetes coaching)
Text4Baby, Text4Kids, Text4Health, My
Advocate
Text4Baby, Text4Kids, Text4Health Text4Babies, Text4Kids, Text4Health
Twitter: @UHCPregnantCare (In Spanish:
@UHCEmbarazada), Text4Baby, Text4Kids,
Text4Health
Access to Health
Information
Online
www.teladoc.com
Video chat with a U.S. board certified doctor.
Many conditions can be treated with teladoc:
sinus problems, bronchitis, allergies, cold
and flu symptoms, respiratory infection, ear
infection, and more!
www.livehealthonline.com
Video chat with a doctor through LiveHealth
Online.
It’s an easy way to see the doctor when you
can’t make it to the doctor’s office.
Great for getting help with colds, flu, fevers,
rashes, infections and allergies.
www.mystrength.com
Resources to improve mental health and
overall well-being, including help with
depression and anxiety.
www.kidshealth.org - our online program
includes health and wellness resources to
encourage healthy behaviors among
children, young adults and their parents.
Content includes assistance for high-risk
members with managing conditions such as
diabetes, asthma and stress. Videos, written
and spoken articles are also provided.
Mobile
A
Member a
t
o Comm
Servic
e
Commu
Health Ou
t
A
pps
• Fin
d
• Vie
w
clai
m
• Vie
w
• Vie
w
• Vie
w
• Cre
a
t
as
k
• Lin
k
• Sen
d
ccess
unity
e
s
Communit
y
Preparedn
e
members
w
build a hea
nity
t
reach
•
•
•
•
•
•
•
•
Aetna Better Healt
h
d
or change your prov
w
your medical and p
r
m
s
w
your current medic
a
w
your benefits
w
or request your ID
c
a
te a support circle a
n
k
s
k
to health education
d
messages to Healt
h
y
Resource and Emer
g
e
ss links on website t
w
ith information and
r
lthy and safe comm
u
h
ider
r
escription
a
tions
c
ard
n
d assign
h
Plan
•
V
•
E
p
• I
•
H
g
ency
o connect
r
esources to
u
nity.
A
m
e
with
find
in y
o
•
•
•
•
Amerigrou
p
V
iew your ID card
E
mail or fax your car
d
p
harmacy or other se
nteractive symptom
c
H
ealth A to Z Encyclo
p
e
rigroup Community
R
h
an easy to search t
o
free or low-cost serv
o
ur area.
Free dow
n
Mobile
d
to your doctor,
rvice provider
c
hecker
p
edia
R
esource Link, a site
o
ol that can help you
i
ces and resources
n
load for members in
AmeriHealth Ca
r
• View ID Car
d
• Get directio
n
• Find a new
d
• Keep list of
m
• View additio
n
care manag
e
• Ability for m
e
directly to
Center
A list of helpful li
n
about AmeriHealt
AmeriHealth Cari
t
Advocacy Service
s
information to m
e
low-cost physical
health services in
AmeriHealth Cari
t
Team has memb
e
communities, sch
members to provi
t
heir health care
s
much more.
•
•
•
•
•
the Apple App Store
r
itas Louisiana Mobil
e
n
s to appointments
d
octor or specialist
m
edications
n
al providers on me
m
e
ment team
e
mbers to send inqui
r
n
ks to access inform
a
h Caritas Louisiana
t
as Community and
s
Link, which gives
e
mbers to help find fr
health and behavior
a
their area.
t
as Community Educ
a
e
r statewide visiting l
o
ools and homes of
de assistance in acc
e
s
ervices, resources,
a
and on Google Play.
e
App
m
bers’
r
ies
a
tion
•
P
•
S
•
T
•
W
•
F
•
V
ee or
a
l
a
tion
o
cal
e
ss
a
nd
MemberC
o
you find d
o
and under
s
•
•
•
•
Start Smart Louisi
a
P
regnancy advice an
d
S
ymptom checker
T
rack milestones
W
eekly pregnancy u
p
LA Health Conne
c
F
ind a facility or prov
V
iew your ID card
o
nnections statewid
e
o
ctors, get communi
t
r
stand your benefits.
na
d
reminders
p
dates
c
t
i
der
•
•
•
•
•
•
•
e
team to help
y
resources
C
o
m
co
o
ho
m
pr
o
ob
t
co
n
mu
Find doctors, ERs a
n
centers near you
Call Nurseline
View your ID card
Read your Member
H
Get help and suppo
r
Learn about your be
n
Contact Member Se
r
m
munity Health Wor
k
o
rdinators to local co
m
m
es of members to a
o
vide assistance in a
c
t
aining transportatio
n
n
necting services in t
h
ch more.
•
•
•
•
•
•
•
•
n
d urgent care
H
andbook
t
in your community
n
efits
r
vices
k
er Program: brings
m
munities and the
nswer questions
c
cessing their PCP
n
to appointments
h
e community and
AmeriHealth Caritas Contact
Back
-
to
-
school drives
Community baby showers
Community health fairs
Community garden
Diaper
drives
Food drives
Health
education events
Ted E. Bear, M.D. Health Fair
Back
-
to
-
school supply drives
Diaper
drives
Health educators
Health
fairs
Back
-
to
-
school supply drives
Bright Start/
c
ommunity
b
aby
s
howers
Diaper
d
rives
Health
e
ducators
Health
f
airs
Back
-
to
-
school supplies
“Diaper Days”
b
aby
s
howers
Health
e
ducators
Health
f
airs
Baby
s
howers
Back
-
to
-
s
chool Events
Bullying
p
revention
p
rogram
Computer
d
onations
Food 4
T
hought
Health
f
airs and
m
inistries
Heart
S
mart
S
isters
Lunch &
L
earn
p
rograms
Questions? Call 1-855-229-6848 The Louisiana Department of Health and Hospitals has tried to make this chart as accurate and complete as possible. However, because it must rely on the various Health Plans to provide this information, DHH cannot guarantee its accuracy. You can learn more about the Health
Plans by contacting them directly.
*Please contact the Health Plan for eligibility requirements and details for this benefit.
Revision: February 2016
