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Plans

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  • Medicaid
  • Lehigh
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Co-Pays*

Ambulance
Per trip $0

Dental care $0

Inpatient hospital 
Per day $3
Maximum with limits $21

Medical centers
Ambulatory surgical center $3
Federal Qualified Health Center / Regional Health Center $0
Independent medical / surgical center $3
Short procedure unit $3

Medical equipment 
Purchase $0
Rental $0

Medical visits
Certified nurse practitioner $0
Chiropractor $2
Doctor $0
Optometrist $0
Podiatrist $2

Outpatient hospital
Per visit $0

Prescriptions 
Generic $1
Brand name $3

X-rays
Per service $1

Coordination of Care

Care Coordination: Help with appointments, medicines, transportation, food/housing/utility resources, and more.

Telehealth/Televisits: Doctor/Case Manager visits by phone or video at no additional cost.

OTC Drug Benefit: We cover select over-the-counter drugs and supplements.

Care Management Programs

Care Management/Special Needs Unit: A dedicated contact to help coordinate health care and more. Education on medical conditions and connections to community resources.

Health Care Plus More: Housing coordination, utility relief fund, food boxes, employment counseling, and more!

Connection Center: Located in Harrisburg. Talk to health professionals, get resources, attend events.

Member digital tools

Member Portal and App: Chat with a team member, find doctors or pharmacies, connect to helpful programs/tools.

Cell Phone: Help getting a free phone.

Pregnancy Benefits

MOM Matters:  Home visits, help with appointments, transportation, and resources for mom/baby.

Healthy Kids Programs

Caring for Kids: Help coordinate visits for screenings, tests or shots.

Childhood Programs: Weight, asthma, and diabetes management, plus events for child wellness.

Vision Benefits

Vision:  Annual allowances toward glasses/contacts.

24 Hour Medical Help Line

24-hour Nurse Line: A nurse can assist you 24/7 at no cost.

Urgent Care Benefits

Urgent Care: Doctor’s office closed? Use a participating urgent care center for free.

Healthy Living and Health Education

Lifestyle Management: Wellness coaching and free voluntary programs for chronic conditions such as asthma, diabetes, COPD, heart issues, drug/alcohol use.

Goodness Rewards Gift Card Program: Earn gift cards for completing certain health activities.

Dental: Checkups, cleanings, additional services.

Tobacco Cessation: Services to help you quit smoking.

Other Benefits

GED Exam: We pay for GED exam.