Medicaid plans

Referrals from your PCP

Your PCP can handle most routine health care needs. If you need to see a network specialist or other network provider, you may need to get a referral from your PCP. Your PCP will make a referral based on your health situation. They may or may not refer you to a particular specialist in this directory who you want to see. Generally, your PCP will provide follow-up care, as needed. Please see the Evidence of Coverage for information about access to specialists. This directory provides a list of skilled nursing facilities for all networks. Contact your PCP for a referral to a network skilled nursing facility. The "network providers" listed in this directory have agreed to provide you with your health care coverage. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. Check your Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up for optional supplemental riders before making appointments for dental, vision or hearing services.

If you don’t have your copy of the Provider Directory, you can request a copy from Customer Service.

Florida

Some providers may choose not to carry out certain services for religious or moral reasons.

Looking for state resources?

Kansas

Online Provider Directories are updated more frequently than the printed directory.

Ohio

Looking for specialty disclaimers?

UHC Community Plan of Ohio uses Medical Service Company (MSC) for Respiratory Supplies

Ohio Medicaid members must order respiratory supplies from one vendor. The vendor is Medical Service Company. To get supplies contact the Medical Service Company team:

Medical Service Company Dedicated Intake Team

Hours from 8:30 am to 5:00 pm Monday - Friday

Note: Ohio Medicare Dual SNP and MyCare are excluded. Members under the age of 7 are excluded. Please use the online directory to find a supplier.

UHC Community Plan of Ohio uses Edgepark for Incontinence Supplies

Ohio Medicaid members must order incontinence supplies from one vendor.  The vendor is Edgepark. To get supplies contact the Edgepark team:

Edgepark’s Dedicated Intake Team

Note: Ohio Medicare Dual SNP is excluded. Please use the online directory to find a supplier.

Tennessee

EPSDT

The EPSDT or Early and Periodic Screening, Diagnostic, and Treatment Program is called TennCare Kids in Tennessee. It is the name for the program that provides health care for your child and teen. TennCare Kids is a full program of check ups and health care services for your child, which can be conducted by a Primary Care Provider (PCP) that accepts patients under the age of 21. These check ups are important even if your child seems healthy. They help your PCP find and treat problems early. In TennCare Kids, check ups for children are free until they reach age 21. TennCare Kids also pays for all medically necessary care and medicine to treat problems found at your child’s check up. This includes medical, dental, speech, hearing, vision, and behavior or mental health problems.

TennCare Kids check ups include:

  • Health history
  • Complete physical exam
  • Lab tests (as needed)
  • Immunizations
  • Vision/Hearing screening
  • Developmental/Behavioral screening (as needed)
  • Advice on how to keep your child healthy

Children should have a TennCare Kids check up when they are:

  • at birth
  • 3 – 5 days old
  • 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • 30 months
  • Every Year: Ages 3 – 20

Your child can also have PCP visits at other times if needed. For example, a teacher might see something that calls for a PCP visit. These visits are part of the TennCare Kids program.

To schedule a TennCare Kids visit, call your child’s PCP or Member Services at 1-800-690-1606, TTY 711.

Texas

STAR/CHIP/STAR+PLUS
Need help finding a provider or setting up a visit?
Call Member Services at 1-888-887-9003, TTY 7-1-1, Monday-Friday 8 a.m.-8 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.

¿Necesita ayuda para encontrar un médico o programar una consulta?
Llame al teléfono de servicio al cliente 1-888-887-9003, TTY 7-1-1, de Lunes a Viernes de 8 a.m. a 8 p.m. o envíe un correo electrónico a memberservices_uhccp@uhc.com con gusto le ayudaremos encontrar un médico o programar una consulta.

STAR Kids
Need help finding a provider or setting up a visit?
Call Member Services at 1-877-597-7799, TTY 7-1-1, Monday-Friday 8 a.m.-5 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.

¿Necesita ayuda para encontrar un médico o programar una consulta?
Llame al teléfono de servicio al cliente 1-877-597-7799, TTY 7-1-1, de Lunes a Viernes de 8 a.m. a 5 p.m. o envíe un correo electrónico a memberservices_uhccp@uhc.com con gusto le ayudaremos encontrar un médico o programar una consulta.

Washington

Need information on whether referrals or prior authorizations are needed?

Check with your plan's benefit documents and with the provider you wish to see to find out if a referral is required. If you still have questions, call the number on the back of the health plan ID card.

Gender Affirming Treatment

We cover primary care, hormone therapy, speech therapy, and mental health services. If you need assistance accessing one of these services, contact your plan to request a list of providers. The number can be found on the back of your member ID card.

Other gender-affirming treatments are covered directly by Apple Health fee-for-service and not by your managed care plan. To find a list of providers for other gender affirming treatments, including surgeries and hair removal, email applehealth.transhealth@hca.wa.gov.

You can find more information about Apple Health transhealth benefits online at the Transhealth program webpage: www.hca.wa.gov/transhealth.

Telemedicine

Telemedicine appointments may be available through your provider including video or audio-only services via phone permitting real-time communication between the patient and healthcare professional for the purposes of diagnosis, consultation, or treatment. Please contact your provider to determine what telemedicine services may be available. 

Beginning January 1, 2023 for audio-only telemedicine services, the covered person must have an established relationship with the provider or has been referred by another provider who has had at least one in-person appointment within the past year.