Mandatory Passages and Language for MC+ Managed Care Health Plan Handbook, page 5
Your Health Benefits In MC+ Managed Care
Some benefits are limited based on your eligibility group or age. The benefits that may be limited have an asterisk (*) next to them. Some services need prior approval before getting them. Call your health plan for information about your health benefits.
- Adult day health care *
- Ambulance
- Ambulatory surgical center, birthing center
- Dental services related to trauma (to the teeth or mouth as a result of injury).
- Durable Medical Equipment (DME): limited to prosthetic devices (with the exception of an artificial larynx), respiratory equipment and oxygen, wheelchairs, diabetic supplies and equipment, and ostomy supplies.
- Emergency room
- Eye Exam every two years
- Family planning
- Home health care includes DME that is part of your home health plan of care, (with the exception of CPAP, BiPAP, and Nebulizers).
- Hospice, if you are in the last six months of your life
- Hospital, when an overnight stay is required
- Laboratory tests and x-rays
- Maternity benefits, including certified nurse midwife
- Mental health and substance abuse
- Outpatient hospital, when an overnight stay is not required
- Personal care
- Limited Podiatry, medical services for your feet
- Pharmacy
- Primary Care Provider (PCP) services
- Specialty care with PCP referral (some health plans do not require PCP referral to access specialty care)
- Transplant related services
- Transportation to medical appointments *
- You may get these services from your MC+ Managed Care health plan or a public health agency:
- screening, testing, and treatment for sexually transmitted diseases
- screening and testing for HIV
- screening, testing, and treatment for tuberculosis
- immunizations (shots) for children
- screening, testing, and treatment for lead poisoning
