Per trip $0
Dental care $0
Per day $3
Maximum with limits $21
Ambulatory surgical center $3
Federal Qualified Health Center/Regional Health Center $0
Independent medical/surgical center $3
Short procedure unit $3
Certified nurse practitioner $0
Per visit $1
Brand name $3
Per service $1
Telemonitoring/Telehealth: Care without a trip to the doctor's office.
We meet members wherever they are or by phone to help with health care goals. Programs include diabetes prevention and Food is Medicine (home-delivered meals and food counseling for certain members).
Substance Use: We work with community behavioral health partners to help with substance abuse.
Member Portals and Tools: Find a doctor, check covered medicines, get a new ID card and text care managers.
Baby Partners: The support and care needed to have a healthy baby and earn rewards.
Breastfeeding Helpline: 24/7 phone access to licensed professionals for help with breastfeeding.
Education and coordination to help kids hit developmental milestones and control asthma, diabetes and lead poisoning and earn rewards.
Routine exams covered yearly. Select members also get one pair of eyeglasses or contact lenses. Children under 21 can get two pairs of glasses or contacts.
24/7 Medical Help Line: Non-emergency help by phone or video.
Urgent care visits covered when you can’t access your PCP.
Member services, health and wellness classes and assistance to find no- or low-cost local food resources.
Resource Central: Help finding food, housing and other resources.
Rewards Program: Earn rewards for completing certain health-related activities.
New Enhanced Adult Dental Benefits: Routine care and coverage for medically necessary braces. Annual benefit allowance for some procedures; limits apply.
Professional Development: Education and employment assistance through getting your GED, college courses and job readiness.
No-cost Smartphone: Help to enroll in free cell phone program.
Acupuncture: Pain management treatment.
Gym memberships at participating locations.
*Co-pays do not apply to the following: members who are pregnant, members under age 18, members age 18 through 20 who are in foster care, emergency services, or certain drugs for specific diseases. The information about the benefits from each plan was current at the time of printing. Please call the plan directly for the most up-to-date information.