Preventive and medical care

We cover the following preventive and routine medical care:

  • Doctor and specialist visits (chiropractors, podiatrists and nurse practitioners)
  • Regular or annual well visits
  • Vaccines except those for travel such as Cholera, scarlet fever and typhoid
  • Lab work, x-rays and other imaging services
  • Allergy testing, treatment and injections
  • Family planning, including birth control (men and women)
  • HIV testing and treatment of sexually transmitted diseases
  • Services you may get at Federally Qualified Health Centers
  • Health education programs, including disease management and tobacco cessation
  • Medically necessary weight reduction services
  • Emergency and urgent care services
  • Rehabilitative therapy, including cardiac rehab, physical, speech and occupational therapies

Hospital and surgical care

When you need extra care or have an emergency, we cover:

  • Outpatient surgical services (this is when you don’t stay overnight at a hospital)
  • Chemotherapy and other drug treatments for cancer
  • Dialysis and treatment of kidney disease, including end-stage renal disease
  • Cost of a shared hospital room
  • Lab work, x-rays, imaging services, therapies and other medical supplies while you’re in the hospital

Home health care, skilled nursing services and hospice care

Sometimes, you may need long-term care. To help you get the care you need, we may cover:

  • Short-term skilled nursing home services (long-term care is provided by the state of Michigan)
  • Home health care services for members who are homebound
  • Supplies and equipment related to home health care
  • Hospice care
    • Special note: Hospice care must be approved by us. Care must take place in our service area.

Durable medical equipment

Some medical conditions need special equipment. We cover:

  • Equipment such as nebulizers, catheters, crutches, manual wheelchairs and other devices
  • Disposable medical supplies, such as ostomy supplies, peak flow meters and alcohol pads
  • Diabetes supplies, such as lancets, test strips, insulin needles, blood glucose meters and insulin pumps
  • Prosthetics and orthotics
    • Special note: Prosthetics replace a missing body part. They may also help the body function. Orthotics correct, align or support body parts that may be deformed.

To get durable medical equipment, you need a prescription from your doctor. You may also need authorization from us. You must get your item from a network provider. To find network durable medical equipment providers, call Customer Service at 1-800-228-8554. TTY users should call 1-888-987-5832.