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NHP (Northeast Health Partners) - RAE (Region 2)
Medicaid
Health First Colorado (Colorado's Medicaid program) is the Medicaid plan for children (newborn to age 18), adults aged 19 to 65 and pregnant Members who live in Colorado and meet income and other requirements. Every Health First Colorado (Colorado's Medicaid Program) Member belongs to a regional accountable entity (RAE), sometimes called regional organization.
NHP is the RAE (Region 2) for Health First Colorado members who have a primary care provider that are located in the following counties: Baca, Bent, Cheyenne, Crowley, Elbert, Kiowa, Kit Carson, Larimer, Lincoln, Logan, Morgan, Otero, Phillips, Prowers, Sedgwick, Washington, Weld, and Yuma.
NHP helps coordinate your physical and behavioral health care. This can include assessments and referrals, help accessing your benefits and making sure you get the help you need. NHP works with your primary care provider, behavioral health provider, community care teams and other local partners.
- NHP (Northeast Health Partners) - RAE (Region 2)
Find providers and coverage for this plan.
Find doctors, hospitals, behavioral health and other specialists.
Find medications covered by this plan.
Find behavioral health providers and substance use resources.
Find a pharmacy near you.
Find a dentist near you.
Benefits & features
Care Coordination is a way that NHP helps Members coordinate services for serious illnesses or injuries or helps to provide individualized support for complex or special needs. Care coordination may also be referred to as Care management or case management. Sometimes your doctor or hospital may tell NHP that an NHP Member needs a Care Coordinator. Care Coordinators also check to see if other services may work for you. This helps to make sure you are getting care that is medically necessary. You can also call and ask us for help.
Here is how to reach us:
Call the Care Coordination line at 1-888-502-4190.
If you need language assistance you can call Member Services at 800-541-6870. If you are Deaf, hard of hearing, or have a speech disability, dial 711 for Relay Colorado or use our Live chat or member secure website at myuhc.com/communityplan. Care Coordination staff are available Monday through Friday, 8:00 a.m. to 5:00 p.m. After hours you can leave a message and we will call you back the next business day.
Please visit Health First Colorado Benefits and Services webpage for information on Preventive & Wellness Services: https://www.healthfirstcolorado.com/benefits-services or https://www.healthfirstcolorado.com/benefits-services/#preventive-wellness
Mental health care
NHP covers the following Health First Colorado mental health services:
- Behavioral health assessments
- Electroconvulsive therapy
- Inpatient psychiatric hospital services
- Medication management
- Outpatient day treatment
- Outpatient hospital services
- Psychological or neuropsychological testing including administering tests, interpreting results and preparing reports (does not include educational testing, vocational testing or testing for medical conditions)
- Psychotherapy: family, individual, individual brief, and group counseling and therapeutic contact
- Targeted case management services
NHP also works closely with the Community Mental Health Centers in your area. They may also have additional services available, such as:
- Vocational services
- Intensive case management
- Prevention/early intervention activities
- Clubhouse and drop-in centers
- Residential
- Assertive community treatment (ACT)
- Recovery services
- Respite services
Some of these behavioral health care services require prior authorization. Your provider will know which services must be approved by NHP before you can receive them.
Substance Use Disorder (SUD) treatment
NHP covers the following SUD services:
- Level 4 withdrawal management (WM)
- Medically managed withdrawal management (WM) services — Level 3.7 WM
- Medically monitored intensive inpatient services — Level 3.7
- Clinically managed high intensity residential services — Level 3.5
- Clinically managed population-specific high intensity residential services — Level 3.3
- Clinically managed low intensity residential services — Level 3.1
- Alcohol/drug screening and counseling
- Detoxification in an inpatient hospital setting for medical stabilization is covered
- Detoxification for drug or alcohol use is also covered as an outpatient service or in an emergency setting
- Medication-assisted treatment
- Outpatient counseling, intensive outpatient treatment, and partial hospitalization
- Programming
- Social ambulatory detoxification is covered. These services relate to detoxification and can include the following:
- Physical assessment of detox progression, including vital signs monitoring
- Assessment of motivation for treatment
- Provide for daily living needs (can include hydration, nutrition, cleanliness and toiletry)
- Safety assessment
- SUD assessment is an evaluation that is covered to determine the most appropriate level of care, the extent of drug/alcohol use, abuse or dependence related problems, and the comprehensive treatment needs of a member with a drug or alcohol diagnosis
SUD is covered for pregnant members through Special Connections. See the Important phone numbers at the beginning of this handbook to contact Special Connections.
Transplant Patients with SUD
If you need an organ transplant and have a substance use disorder (SUD), you can get treatment for your SUD if you agree to it as part of your transplant plan. This can happen before or within six months after your transplant.
Once you agree to both the transplant and SUD treatment, your transplant team will tell the Managed Care Entity (MCE). The MCE will make a care plan for you.
A specialist will check you to decide the right level of care within 72 hours before you start SUD treatment. The MCE will approve this level of care.
The MCE will find a place that can give you the SUD services you need and make sure you get ongoing medical care at the transplant center. They’ll inform the place of any necessary pre-approvals within 48 hours of starting your SUD treatment.
The MCE will check in with the SUD treatment place every 14 days to monitor your progress and adjust the treatment plan if needed.
The MCE will approve 90 days of Residential and High Intensity Outpatient services, including various levels of care, based on ongoing assessments. They’ll also coordinate with other organizations if additional services like Recovery Living are needed.
This plan ensures you get the support you need throughout your care journey.
Some SUD services do require a prior authorization.
SUD Treatment and services is managed by NHP Behavioral Health Utilization Team. Prior authorization for treatment and services may be required. Please talk to your provider about contacting NHP before you receive SUD services.
After all Medicaid appeals processes have been exhausted, Members/Providers may request an external medical review when there is a denial or reduction for residential or inpatient substance use disorder treatment.
If you or your loved one needs immediate crisis support, contact the Colorado Mental Health Line by calling or texting 988. You can also visit: Colorado Mental Health Line | 988. Crisis support from the Colorado Mental Health Line is free, confidential and immediate, 24 hours a day, 7 days a week and 365 days a year.
Please visit Health First Colorado Benefits and Services webpage for information on Maternity and Newborn care: https://www.healthfirstcolorado.com/benefits-services/ or https://www.healthfirstcolorado.com/benefits-services/#maternity-newborn
NHP offers programs for pregnancy care as well. WellHop & SimpliFed are programs to provide support for expectant moms during their pregnancy and beyond.
Through DentaQuest; Learn more about Adult Dental Benefits and DentaQuest (https://hcpf.colorado.gov/dental-benefits) Contact DentaQuest to find out more: 1-855-225-1729, TTY: 711 DentaQuest.com/Colorado
Dental Services through DentaQuest include: Services include cleanings, fillings, root canals, crowns, and partial dentures. There are no co-pays applicable. Limit: Annual adult (21 years old and up) benefit of up to $1,500 per state fiscal year which runs from July 1 – June 30. Emergency and dentures benefits are not subject to this limit. There is no limit for children’s services (21 years old and under). There are no exclusions. Sometimes a prior authorization is needed, check https://www.healthfirstcolorado.com/glossary/prior-authorization-request-need-one/ to determine if a prior authorization is needed.
Have questions? Visit myuhc.com email us at nhp_member_services@uhc.com, or call Member Services at 1-800-541-6870, TTY 711, 8 am – 5 pm, MST, Monday - Friday.
Please understand that any email you send to us outside of the myUHC portal may have your protected health information in it. That email will be sent unencrypted. When an email is sent unencrypted there might be a risk that someone else could read it. The contents of the unencrypted email could be disclosed.
Home-and Community-Based Services (HCBS)
Home-and Community-Based Services help you and your family in your home. You may qualify for home health care and non-skilled home help. You can ask your doctor or an NHP Care Coordinator for help setting up this service.
If you are new to NHP and you have special health care needs and are seeing a doctor that is not on our list, you can:
- Keep seeing your previous primary care doctor for 60 calendar days. You can keep getting the same ongoing care you received before you joined NHP.
- Keep seeing your other doctors for 75 calendar days. You can keep getting the same care you received before you joined NHP.
- Keep seeing your previous primary care doctor if you are in your fourth through ninth month of pregnancy. You can keep seeing your previous primary care doctor until you finish the care you need following the birth of your child.
If you have a question, need help with your health care, or have a special need, please contact us.
We’re here to help. Call Member Services at 1-800-541-6870. Representatives are available Monday–Friday, 8:00 a.m.–5:00 p.m. If you are deaf, hard of hearing, or have a speech disability, dial 711 for Relay Colorado or use our Live Chat or myuhc.com/communityplan.
If you need help with the information in any NHP document, including written/oral translation; or in a different format like large print or as an audio file, we can help you at no cost. You can get help by calling NHP at 1-800-541-6870 or State Relay 711 for callers with speech or hearing disabilities.
Si necesita ayuda con la información en cualquier documento de NHP incluida la traducción oral/escrita, un formato diferente (como letra grande), o un archivo de audio, podemos ayudarlo sin costo. Puede obtener ayuda llamando NHP al 1-800-541-6870 o State Retransmisión 711 para personas con discapacidad auditiva o del habla.
Nurse hotline
Health First Colorado Nurse Advice Line:
The Health First Colorado Nurse Advice Line gives you free medical information and advice 24 hours a day, every day of the year. Call 800-283-3221 (State Relay 711) to:
- Talk to a nurse who will answer medical questions, give care advice, and help you decide if you should see a provider right away.
- Get help with medical conditions such as diabetes or asthma, including advice about what kind of provider may be right for your medical condition.
The Nurse Advice Line cannot help with clinic appointments or medication refills. Call your provider's office if you need help with these.
Phone services
Colorado Lifeline Service is a government assisted wireless service that provides discounted home phone or cell phone services to eligible low income families and individuals. Colorado Lifeline Service discounts are offered to qualified Colorado customers who meet certain eligibility requirements such as, government assistance or a household income that is at or below 135% of the federal poverty level. Customers can check their Eligibility for the Program, apply online and avail the benefits, along with Discounts and Offers.
Select the prepaid plan that best fits your needs. There are several prepaid plans available under TAG Mobile Colorado Lifeline Services. You can change your plan every month to fit your lifestyle or you can add minutes anytime at your convenience.
Free Lifeline Government Cell Phone Service in Colorado (tagmobile.com)
Quit using tobacco or vaping products
Free QuitLine tobacco cessation counselor — Call 800-QUIT-NOW (800-784-8669) or visit www.coquitline.org