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UnitedHealthcare Community Plan How To Enroll
Information on eligibility and enrollment can be found by visiting the Ohio Medicaid website or by calling the Medicaid Hotline at 1-800-324-8680. TTY users should call Ohio Relay at 7-1-1.
If you are already eligible for Ohio Medicaid and would like to enroll with UnitedHealthcare Community Plan, please call the Managed Care Enrollment Center at 1-800-605-3040 (TTY: 1-800-292-3572).
Already a member and need to renew your Medicaid eligibility?
It is important to keep your Medicaid eligibility current to keep your UnitedHealthcare Community Plan benefits. Contact your local County Department of Job and Family Services to renew your eligibility.
OhioRISE
Who is eligible to enroll into OhioRISE?
You must be:
- Under the age of 21.
- Determined eligible for Ohio Medicaid.
- Not be enrolled in a MyCare Ohio plan.
- Have one of the following:
- Certain needs for behavioral healthcare, identified by the Ohio Children’s Initiative Child and Adolescent Needs and Strengths (CANS) assessment
-
- Have a recent inpatient hospital stay for mental illness or
substance use disorder
- Have a recent inpatient
stay in a Psychiatric Treatment Facility (PRTF)
- Have a recent inpatient hospital stay for mental illness or
substance use disorder
What is OhioRISE’s rolling enrollment policy?
OhioRISE will use a rolling enrollment policy for all youth, rather than enrollment beginning at the first day of the next month. This means that following a Ohio Children’s Initiative Child and Adolescent Needs and Strengths (CANS) assessment, youth who are determined eligible for OhioRISE will be enrolled as of the date their CANS assessment is submitted;
For more information, please visit: https://medicaid.ohio.gov/home/contact-us
What is the process for referring children/families for a CANS assessment?
To ask for a CANS assessment, contact:
- A child or youth’s managed care organization
- Aetna Better Health of Ohio,
- A local care management entity,
- The Medicaid Consumer Hotline, or
- Behavioral health providers or Family and Children First Councils, which may have a CANS assessor onsite or be able to link to one.
What is the timeline for a CANS assessment and OhioRISE determination?
- Expect to have a CANS assessment appointment to decide if your child is eligible for OhioRISE within 72 hours after referral.
- The CANS assessment is completed within 10 business days. You should expect to hear the determination within the 10 days.
If you are unhappy with OhioRISE or our providers, or do not agree
with a decision we made, contact us as soon as possible. You, or
someone you want to speak for you, can contact us. If you want someone
to speak for you, you will need to let us know. OhioRISE wants to
help.
To contact us, you can:
- Call Member Services at 1-833-711-0773 (TTY: 711).
- Fill out the Standard Appeal form in your member handbook on page 32. You can call Member Services to ask for a printed copy.
- Visit our website at AetnaBetterHealth.com/OhioRISE.
- Write a letter telling us what you are unhappy about. Please include your first and last name, the number from the front of your member ID card, your address, and your telephone number. You should also send any information that helps explain your problem.
Mail the form or your letter to:
Aetna Better Health of Ohio
c/o
OhioRISE Plan
Appeal and Grievance Department
PO Box
81139
5801 Postal Road
Cleveland, OH 44181
Fax: 1-833-928-1259
OhioRISE will send you something in writing if we decide to:
- Deny a request to cover a service for you,
- Reduce, suspend, or stop services before you receive all the services that were approved, or
- Deny payment for a service you received that is not covered by OhioRISE.
- We will also send you something in writing if we did not:
- Decide on whether to cover a service requested for you, or give you an answer to something you told us you were unhappy about.
Learn more
UnitedHealthcare Community Plan