Core Benefits
Blue Cross Complete of Michigan wants to help you get, stay and be healthy. That means health care benefits that give you the care you need, when you need it.
Blue Cross Complete of Michigan wants to help you get, stay and be healthy. That means health care benefits that give you the care you need, when you need it.
Blue Cross Complete members have a wide range of benefits, including:
Information about benefit requirements can be found in your Blue Cross Complete Member Handbook (PDF) and Certificate of Coverage (PDF). A list of programs and services available to you can be found in the Benefits Snapshot (PDF). Information about recent changes to your benefits and services can be found in the Policy and Procedure Updates (PDF). For additional questions, call Customer Service at 1-800-228-8554. TTY users, call 1-888-987-5832.
A health assessment is a short screening about your health history and habits. It helps us understand your needs and how to best support you with the right programs and services. Complete the assessment so we can help you with your health and basic needs. We can refer you to resources in your community for food, housing, utilities and more. We can also connect you to a care manager to help address your needs through an individualized plan.
The health assessment is easy to fill out. You can complete your health assessment online or over the phone. It should take less than 10 minutes to complete.
To complete your health assessment online, log in to your online account. Once you’re logged in, click Health Assessment to get started. Or, call 1-888-687-0171 from 8:30 a.m. to 7 p.m., Monday through Friday to complete your assessment over the phone.
Some services require your doctor to submit a request to Blue Cross Complete to treat your condition. This is known as an authorization. The Prior Authorization Requirements Form (PDF) explains which services require an authorization.
As a Blue Cross Complete member, you’re not required to pay for medically necessary, covered services from Blue Cross Complete network providers.
If you get a bill or statement, call Customer Service at 1-800-228-8554, 24 hours a day, seven days a week. TTY users, call 1-888-987-5832.
You may have to pay when:
Transitioning your care
If you're currently receiving services from a provider prior to enrolling with Blue Cross Complete, we can help you with a smooth transition. You may be able to continue getting these services at the time of enrollment for 90 days. This may also include certain prescriptions without prior authorizations. You can request continuity of care by calling the Rapid Response Outreach Team at 1-888-288-1722 or your care manager. TTY users, call 1-888-987-5832.
You must have a relationship with a specialist, primary care provider, or other covered provider prior to enrolling with Blue Cross Complete to establish continuity of care. When requesting continuity of care, we'll need to know:
Care coordination
Blue Cross Complete’s care coordination program connects services for new and existing members with short-term or emerging needs. Our care connectors help to:
Care managers perform assessments and address needs through an individualized action plan. Our care managers, care connectors and community health navigators aim to help teach members that you have control over your health and well-being.
While Blue Cross Complete doesn't require referrals, we recommend you talk with your primary care doctor to coordinate care. We can help you find a doctor.
If you need help coordinating your care, call Customer Service at 1-800-228-8554 (TTY: 1-888-987-5832). You can also talk with your doctor about care management services.
The following provides an overview of your benefits.
Preventive and medical care
We cover the following preventive and routine medical care:
When you need extra care or have an emergency, we cover:
Sometimes, you may need long-term care. To help you get the care you need, we may cover:
Some medical conditions need special equipment. We cover:
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.
Vision and hearing
Eye care is an important part of your overall health. To make sure your eyes are healthy and help you see the best you can, we cover:
Note: One year is defined as 365 days from the date the first pair of glasses (initial or
subsequent) was ordered
The services must be from a network vision center. For a list of network eye doctors and vision centers, call Customer Service at 1-800-228-8554. TTY users should call 1-888-987-5832.
How well you hear affects your quality of life. We offer hearing benefits for members of all ages. Here’s what we cover:
Hearing exams and hearing aid evaluations are available from a network provider. Go to Find a Doctor, then search for “hearing aid.” If you have questions about this benefit, contact Customer Service at 1-800-228-8554. TTY users should call 1-888-987-5832.
Mental health
We want you to have the best mental health. To help you, we cover medically necessary outpatient mental health services. This applies to members with mild to moderate mental health needs. If you have chronic mental health needs, you will get these services through the Prepaid Inpatient Health Plan operating in your county.
Michigan Behavioral Health Standard Consent Form
Sharing behavioral health information helps your doctors coordinate your care. It also helps make sure your treatments and medicines are safe and all your health needs have been addressed. You can give your doctor permission to share your behavioral health records with other providers. Fill out the Michigan Behavioral Health Standard Consent Form at michigan.gov/bhconsent and take it to your health care provider. Make sure you keep a copy.
Customer Service can help you find a network mental health provider in your area. Call 1-800-228-8554. TTY users should call 1-888-987-5832.
If you need emergency care for a life-threatening condition, or if you’re having thoughts of suicide or death, go to the nearest emergency room or call 911.
Other benefits and services
Our free 24-hour Nurse Help Line can help you get answers to your health questions right away. It's a confidential service just for you. The nurse line can help you make informed health care choices when your doctor is not available. Our 24-hour Nurse Help Line can be reached at 1-888-288-1724. TTY users should call 1-888-987-5832.
We can get an interpreter to help you speak with us or your doctor in any language. We also offer our materials in other languages. Interpreter services and translated materials are free of charge. Call Customer Service at 1-800-228-8554 (TTY: 1-888-987-5832) 24 hours a day, seven days a week for help getting an interpreter or to ask for our materials in another language or format to meet your needs. Blue Cross Complete complies with all applicable federal and state laws with this matter.
¿Habla español? Por favor contacte a al Servicios al Miembro.
Comparta sus comentarios sobre los servicios de idiomas. Realice la encuesta.
Women have special health needs. To help you get the care you need, we cover:
The health care children and teens get shapes their adult health habits. To help someone younger than age 21 to be as healthy as he or she can be, we also cover:
We understand there may be times when you need a ride to your doctor’s office, to pick up a prescription or for other covered medical services. We can help you get there.
For more information about transportation or to schedule a ride, visit our transportation page.
Blue Cross Complete members are eligible for pharmacy benefits. Pharmacy benefits can be used to fill select prescription and over-the-counter medicines at a participating network pharmacy. Visit the pharmacy page for an in-depth look at your pharmacy benefits.
Visit our Community Resources page to learn more about community resources, discounts, health information, programs and services to help you live a healthier life.
Michigan Medicaid and Blue Cross Complete are offering food services to improve your health. You may qualify for one of these services at no cost to you:
It’s up to you whether you use a food service if you qualify. Your Medicaid coverage and access to other medical services will stay the same if you use a food service or choose not to.
Read the Food Services Guide (PDF) to learn more about your food service options and if you may qualify for a food service. If you have questions, call Customer Service for more information.
You can file a grievance or appeal about the food service, for example, if you are not approved for a food service. Information on how to file a grievance or appeal can be found in your member handbook.
Now that the Covid-19 public health emergency has ended, regular Medicaid redetermination has resumed.
When it’s your turn to renew, you may receive a benefit renewal packet from the Michigan Department of Health and Human Services. Fill out and return your form as soon as you can. If you don’t return your form on time, you and your family may lose your Medicaid benefits.
Wondering when it’s your time to renew? You can look up your renewal date in MI Bridges in the View Benefits module.
Renew your Medicaid benefits
Checklist to renew your Medicaid benefits:
If you told the state that you prefer mailed information, you may receive your benefit renewal packet by mail. You’ll have about 60 days to complete your form and mail it to the address provided on your form. You also have the option to complete the form and upload your documents online in MI Bridges.
If you told the state that you prefer to receive electronic communication, you’ll receive a text message with a link to MI Bridges. There, you can complete your renewal form and upload paystubs, tax forms or W-2s.
You can also submit your renewal packet by faxing it to 1-517-346-9888.
If you don’t speak English, language assistance services are available at no cost to you. Call 1-800-228-8554 (TTY: 1-888-987-5832).
Update your contact information in MI Bridges
Make sure MDHHS can reach you when it’s your time to renew. Check that your phone number, address and email address are correct.
Find coverage if you no longer qualify for Medicaid
If you don’t qualify for Medicaid coverage anymore, Blue Cross Complete will no longer be your health insurance plan. However, you and your family may be eligible for another health plan offered through the Health Insurance Marketplace. The Marketplace has many health plan options that you can choose from.
If you’re interested in a Blue Cross Blue Shield of Michigan plan offered through the Marketplace, here’s what you can do:
Questions?
Blue Cross Complete cares about your well-being. Did you receive your redetermination form and need help with the renewal process? Call Customer Services at 1-800-228-8554 (TTY: 1-888-987-5832). You can also contact your MDHHS case worker or local MDHHS office with questions.
We want you to be happy with the services you get from Blue Cross Complete and our providers. If you are not satisfied, you can file a grievance or appeal.
Grievances are complaints that you may have if you are unhappy with our plan or if you are unhappy with the way a staff person or provider treated you. Appeals are complaints related to your medical coverage, such as a treatment decision or a service that is not covered or denied. If you have a problem related to your care, talk to your provider. Your provider can often handle the problem. If you have questions or need help with the appeal process, call Blue Cross Complete at 1-800-228-8554 (TTY: 1-888-987-5832). To learn more about the grievance and appeals process, view the Grievance and Appeals Fact Sheet (PDF).
Advance Directives
Advance Directives are documents that state how you want medical decisions made if you lose the ability to make them for yourself.
Authorization for Disclosure of Health Information form
The Authorization for Disclosure of Health Information form (PDF) allows Blue Cross Complete to share your health information with the people or organizations that you choose.
Emergency Care Expenses Claim Reimbursement
Use the Emergency Care Expenses Claim Reimbursement form (PDF) to get reimbursed for out-of-pocket medical expenses from an emergency visit outside of our service area.
Personal Representative Request Form
The Personal Representative Request Form (PDF) allows you to appoint an individual to act on your behalf and make decisions regarding your health.
Request to Access or Inspect Protected Health Information in a Designated Record Set
The Request to Access or Inspect Protected Health Information in a Designated Record Set form (PDF) allows you to request access to records Blue Cross Complete uses to assist you with your medical coverage.