Developmental Disabilities Program

Members with asthma, diabetes or another long-term condition can depend on us. Our plan makes sure they get the care and services needed. Benefits include:

• Care Coordination. Personal support from an experienced professional as needed.
• Asthma Support. Individual care to help you control asthma or COPD as needed.

We make sure the sight, smile and hearing of members are at their best:

• Vision. Eye exams, frames and lenses including replacement and repair are covered for members under the age of 21. 
• Dental. We pay for cleanings, checkups, and dental work through age 20. 
  • Emergency (members 21 and older have a $1,000/year limit) 
  • Routine preventive and therapeutic services (DD members 21 and older have a $1,000/year limit)
• Hearing. Tests, checkups and hearing aids are included.

Members recovering from a serious illness or surgery often need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Equipment and Supplies. In-home medical and safety equipment are covered.
• Incontinence supplies are covered

Sometimes members need a little extra help using their health plan. For those times, they can rely on:

• Transportation. Our plans provide trips to and from medical, behavioral health visits or the pharmacy. To arrange a medically necessary visit, call MTBA at 1-888-700-6822.
• Interpreters. An interpreter can go with you to medical or behavioral health visits.
• Language Help. Translated materials are available at no cost.
  
• Social Services. Sometimes a person's health and safety requires help from community programs. We help members connect to community services. Here they can get information about a variety of programs, like:
  • Food and housing assistance.
  • Community childcare.

  They can help members get much needed relief in many ways.

• Member Services. Our member services team can help answer questions. They are available Monday - Friday from 8 a.m. - 5 p.m.

Having trouble managing your COPD or asthma symptoms? A nurse who specializes in breathing issues can really help. Benefits include a customized treatment plan and medicine to: 

• Manage flare-ups.
• Reduce symptoms. 
• Help you stay active. 

Need help managing your health care? If you qualify for care management, care managers are in your corner. They will:

• Explain medical terms in plain language. 
• Coordinate your doctor appointments.
• Provide your care team with your medical records. 

Your care manager will stay with your loved on the medical journey. He or she will:

• Think beyond your medical needs.
• Make sure you have support at home.

So you can focus on helping your loved one being at his or her best.

Every member gets to choose a primary care physician (PCP) who is his or her main doctor. Use the Doctor Lookup tool to see if your doctor is in our network. 

For those who don’t have a doctor or whose doctor is not in our network, we can help find a new one close by.  

The PCP is the member’s main doctor for:

• Preventive care.
• Treatment for injuries or sickness.
• Referrals to specialists for certain conditions.

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• Checkups and dental care are covered for members up to age 21.
• Exams and cleanings every six months help teeth and gums stay strong and healthy. 
• Emergency (members 21 and older have a $1,000/year limit)
• Routine preventive and therapeutic services (DD members 21 and older have a $1,000/year limit)

If there is a dental problem that needs to be fixed, that’s covered as well.

Our plan covers medically necessary equipment ordered by your doctor. This can include supplies like: 

• Hospital beds.
• Incontinence supplies
• Oxygen supplies.
• Walkers or wheelchairs.

We cover: 

• Exams, therapy and tests.
• Hearing aids.

This includes:

• Nursing care.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams. 

And after leaving the hospital, we make sure each member gets follow-up care, if needed, to continue healing at home.

Your doctor and you need to understand each other. We can arrange for a medical interpreter to be at your appointment at no cost to you.

We also have people at member services who speak more than one language. Chances are, we have someone who speaks your language.

You can get information in your preferred language. Just ask. We provide this service at no cost to you.

Our plan includes prescription drugs and refills. 

We also cover some over-the-counter medicines with a written order from your doctor. 

And we make getting your medicine easy. You can fill your prescriptions at:

• Local network pharmacies.
• Services that deliver right to your door.

We help you find:

• Doctors and behavioral health providers..
• Pharmacies.
• Hospitals or other health facilities.
• Local resources.

Our plan provides trips to and from medical appointments. 

Members in the plan receive vision coverage up to age 21. This coverage includes:

• Regular exams.
• Frames and lenses.

This benefit is offered by Vision Service Plan.

Well visits with your doctor can help keep you healthy. These visits can catch health problems early so they can be treated. Preventive services include: 

• Annual checkups.
• Well-baby care.
• Routine shots and tests.
• Mammograms.