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Benefits

We help make sure you and your family get all your Medicaid benefits. Plus, UniCare members get extra benefits at no cost!

What you get with UniCare
  • A primary care provider (PCP) you choose
  • Low or no-cost prescriptions
  • Hundreds of doctors to choose from
  • Hospitalization
  • Specialist services
  • Chiropractic services
  • Immunizations
  • Substance abuse counseling
  • Eye glasses once a year for children and medially necessary vision care for adults
  • Dental care for children and emergency dental services for adults
Extra Benefits at no cost!
  • Weight Watchers® meetings

    — UniCare has teamed up with Weight Watchers to help eligible members lose weight.*
  • Cell phone

    — members who sign up for SafeLink® communication services and qualify for the standard services offered through SafeLink may qualify for additional benefits through UniCare. These benefits include free nationwide texting (including health reminders from UniCare) and unlimited minutes when calling the UniCare member [service line to discuss questions about your health plan.**
  • Gift card rewards

    — just for going to checkups on time!
  • 24-hour nurse help line

    — Talk to a nurse day or night, even on holidays, for medical advice when you need it.
  • Community Outreach Specialists

    — Get help connecting to local organizations for assistance with daily living.
  • Anytime Fitness® gym vouchers

    — UniCare has teamed up with Anytime Fitness to help eligible members get and stay fit.
  • Boys & Girls Club memberships

    — for members ages 6-18 at participating clubs (not summer camps).
  • Digital bathroom scale

    — for members with Congestive Heart Failure (CHF).
  • Electric toothbrush

    — for adults 21 and older.
  • Dental hygiene kit

    — kids 6-10 get items like toothbrushes, toothpaste and dental floss.
  • Hypoallergenic bedding

    — members with an asthma diagnosis get up to $100 for hypoallergenic bedding, like pillow cases and mattress covers.

* Weight Watchers® and Anytime Fitness® are registered trademarks of Weight Watchers International, Inc., and Anytime Fitness®, LLC Limited Liability Company Minnesota, respectively.
** SafeLink Wireless® is a Lifeline-supported service. Lifeline is a government benefit program. Only those who qualify may enroll in Lifeline. It can’t be transferred. It is limited to one per household. You may need to show proof of income or that you take part in the program to enroll.

Who's eligible?

Mountain Health Trust

Mountain Health Trust provides health benefits to:

  • People who get Supplemental Security Income (SSI)
  • Pregnant women
  • Children under age 19
  • Very low income families
  • People who are aged/blind/disabled
  • Medically needy children and adults
  • Adults ages 19 to 64

West Virginia Health Bridge

West Virginia Health Bridge provides health benefits to adults who:

  • Are between the ages of 19 and 65
  • Have low income
  • Meet citizenship requirements
  • Are not incarcerated (in prison)
  • Are not entitled to Medicare

Eligible for Medicaid and need a health plan?

Sign up for UniCare today!

Already a UniCare member?

Keep your benefits. Renew on time!
Are you pregnant or expecting?

Taking Care of Baby and Me® Healthy Rewards Incentives

Are you pregnant or expecting? Our Taking Care of Baby and Me program can help keep you and your baby healthy. Get helpful tips and rewards when you follow the program. You’ll also get a special self-care handbook.

What to do

What You Get

Go to your first for prenatal visit in the first trimester or within 42 days of joining UniCare Health Plan of West Virginia, Inc.

$25 reward

Go to at least six prenatal care visits

$25 reward

Go to your postpartum visit after you have your baby (within 21-56 days after delivery)

$25 reward

Take your baby’s to his/her first checkup up by 2 weeks of age

$25 reward

Take your baby to at least six well-child checkups by 15 months of age

$25 reward

For more information, visit mss.unicare.com/healthyrewards or call 1-877-868-2004 (TTY 711).

Copays

Under your plan, you may have to make copays for some services. Copays may apply to West Virginia Health Bridge and Mountain Health Trust members.

  • A copay is an amount you pay when you receive certain services.
  • You are required to pay the copays listed below until you and all family members in your household enrolled in the plan get to the household copay maximum.
  • Your household copay maximum is based on your household income.

You are assigned to a tier based on your household size and income for the quarters:

  • Tier
  • Tier 1
  • Tier 2
  • Tier 3
  • Gross quarterly income range
  • $0-$1,436.25
  • $1,436.26-$2,872.50
  • $2,872.51 and above
  • Copay maximum
  • $8
  • $71
  • $143

You will have no copays for the rest of the quarter once your household meets its copay maximum. UniCare will send you a letter when your household copay maximum has been met.

  • If you meet your copay maximum before you get our letter, tell us.
  • You should also tell us if you are charged a copay after you have met your maximum. Call our Customer Care Center to tell them you have met your copay maximum. Keep all your household copay receipts to show that you have met the copay maximum.
  • There are no copays for behavioral health services.
  • You will start each quarter with $0 in copays and build toward your copay maximum.

The tables below show the drugs and services for which your plan requires copays and the amount of those copays

  • Total cost of drug
  • $0.00-$5
  • $5.01-$10
  • $10.01-$25
  • $25.01-$50
  • $50.01 and above
  • Copayment
  • $0
  • $0.50
  • $1
  • $2
  • $3
  • Covered service
  • Inpatient hospital care
  • Office visit (physicians and nurse practitioners)
  • Nonemergency use of the emergency room (hospital only)
  • Nonemergent surgical procedures given in a physician’s office, ambulatory surgical center or any other outpatient setting excluding emergency rooms
  • Tier1
  • $0
  • $0
  • $8
  • $0
  • Tier2
  • $35
  • $2
  • $8
  • $2
  • Tier3
  • $75
  • $4
  • $8
  • $4

These members are excluded and will have no copays:

  • Children under 21 years of age
  • Pregnant women, including pregnancy-related services up to 60 days postpartum
  • Members of a Native American tribe or Alaskan natives
  • Members receiving hospice services
  • Members in nursing homes
  • Members in an intermediate care facility
  • Members receiving services for intellectual/developmental disabilities
  • Members getting behavioral health services
  • Members getting emergency services (includes three-day emergency supply of medicine)
  • Members getting family planning services
  • Members getting services through Medicaid waiver programs
  • Members getting services through the Breast and Cervical Cancer Treatment program
  • Members getting services for provider-preventable conditions
  • Members getting diabetic testing supplies, insulin syringes or needles
  • Members getting approved home infusion supplies
  • Members getting vaccines administered at the pharmacy

Your opinion counts!

Tell us what you think. If you receive a survey in the mail or by phone, please complete it. Help us make your plan better.

View Pharmacy Benefits

How to Choose

Is your provider in

our network?  

I have questions about my UniCare benefits.

Call the Customer Care Center at 1-800-782-0095, Monday through Friday from 8 a.m. to 6 p.m.