Healthy Michigan Plan

Checkups and emergency care are covered. Exams and cleanings to help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well.

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If you become pregnant while you are a Healthy Michigan Plan member, you're covered.

Our benefits include:

• Choice of Doctor. Find a doctor and dentist you trust in our network.
• Choice of Birth Centers. Deliver at one of 100 hospitals in Michigan.
• Prenatal Visits. Care for you before your baby is born.
• Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
• Transportation. Get a ride or gas reimbursement to medical visits.
• Maternal Infant Health Program (MIHP). is free for Medicaid eligible pregnant women, infants up to age one and their families. MIHP providers help pregnant women and families with newborns understand how to stay healthy. All pregnant women, infants and their families enrolled in MIHP have care plans developed just for them.

If you have diabetes or another health condition, you can depend on us. Our plan makes sure you get the care and services you need. Benefits include:

• Mental Health. Counseling and other treatments are covered.
• Care Management. Personal support from an experienced professional.
• Asthma and COPD Care. Individual care for asthma, allergies or COPD.
• Diabetic Support. Insulin, needles and wipes ordered by your doctor.
• Heart Care. Extra support for members who have coronary artery disease.
• Pregnancy Care. Special programs and extra support for members who become pregnant.

Make sure your sight, speech and hearing are at their best. Benefits include:

• Vision. Covers exams and eyeglasses Including designer-style frames.
• Speech. Screenings and needed short-term therapies are covered.
• Hearing. Exams to determine if a hearing problem exists.

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Equipment and Supplies. In-home safety materials are covered.
• Nurse Visits. Medical care to help you recover at home.

Sometimes you might need a little extra help using your health plan. For those times, you can rely on:

• Transportation. Get a ride or gas reimbursement to medical visits.
• Language Help. Connect to a translator through Customer Services.
• Customer Services. Your benefit questions are answered by our friendly representatives.
• Quitting Tobacco. Coaches and supplies to help you quit using tobacco.

Do you have trouble managing asthma, allergies or COPD symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:

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

Do you or a family member have a serious health problem or a high-risk pregnancy? If so, our 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 you on your medical journey. He or she will:

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

So you can focus on getting better.

If you become pregnant while you are a Healthy Michigan Plan member:

Where you have your baby is an important choice. That's why you can pick from nearly 100 hospitals across Michigan.

We encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you have your baby.

You get a primary care provider (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.

Referrals to specialists for certain conditions.

Understanding your health care options can be confusing. Now you have someone you can call. We can answer your questions simply and completely.

We help you find:

• Doctors.
• Pharmacies.
• Hospitals or other health facilities.
• Local resources.

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

If you have diabetes you may need insulin, needles, wipes and glucose strips. We cover all that and more.

Our plan also steps up with services to help you manage your diabetes including:

• Coordinating doctor care.
• Dedicated team to help you understand your condition and manage it.

Your health and safety at home are important.

Our plan covers medical equipment ordered by your doctor. This can include items like:

• Hospital beds.
• Oxygen tanks.
• Walkers or wheelchairs.

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Connect with community resources such as Women, Infants and Children (WIC) services.

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to determine whether a hearing problem exists.

We cover:

• Exams, therapy and tests.
• Hearing aids and services.

This plan pays for medical expenses related to a hospital stay.

Our plan covers:

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

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing.

Knowing what's wrong and finding it early can make all the difference. Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We'll help get the information needed to improve your health or be your best.

We have people at our customer services center who speak more than one language. Chances are, we have someone who speaks your language.

Our plan includes prescription drugs and refills. Refer to the FAQ's for information on co-pay amounts.

We also cover many medically needed, over-the-counter medicines with a written order from your doctor. There is no copay for these medicines.

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

• Network pharmacies.

Mental health is as important as physical health. That's why we cover both.

Required short-term care is covered. This includes:

• Behavioral therapy.
• Medications.

Sometimes you may need continued care after you leave the hospital or urgent care. If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:

• Provide medical care for you.
• Answer your questions and concerns.

If you become pregnant while you are a Healthy Michigan Plan member:

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

• Make sure you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Routine shots help protect against illness. So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach your full potential.

Our plan provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.
• Language therapy.
• Habilitative therapy.

With a doctor's request your coverage includes short term physical, occupational, speech, language and/or other therapy visits each year.

Our plan provides a ride for you to and from health care locations. That includes rides to:

• Doctor or therapy visits.
• Health departments.
• Vision clinics.

You can also be reimbursed for gas for driving to and from health care visits:

ModivCare Member Gas Reimbursement Instructions
ModivCare Mileage Reimbursement App
ModivCare Member Gas Reimbursement Form
ModivCare Standing Order Form

To learn more visit https://www.mymodivcare.com

There may be times when your health requires repeated doctor visits. Our plan does not limit the number of times you can see your primary care provider. This way you get the care you need when you need it. And your doctor can see how your health is progressing.

Regular eye exams and glasses, if needed, can help you see more clearly. We also include:

• Prescription lenses.
• Designer-style frames.

Call Member Services at 1-800-903-5253 for vision services and providers.

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:

• Checkups for adults.
• Routine shots and tests.
• Mammograms and Pap Smears.
• Colorectal Screenings.