BENEFITS

WHAT'S COVERED...

The Ingham Health Plan covers basic office and outpatient care and services. Members are assigned to a primary care provider (PCP). The PCP manages member care and makes referrals to specialty care providers.

(Summary ONLY - Not a Complete List)

COVERAGE	CO-PAY
Office Visits	$5
Specialty Services	$5
Outpatient Lab Tests	$0
Outpatient X-rays	$0
Outpatient Tests & Surgeries	$0
Prescription Medication (on approved list)	$5 Generic/$10 Brand
Physical Therapy (limited benefit)	$0
Preventive Services	$0
Walk-in/Urgent Care Visits	$5
Dental Care (Delta Dental EPO Plan)	$0 Preventative Care/Varies All Other Services
Behavioral Health Service (limited benefit) Effective Jul 1, 2021	$0
Sleep Studies, CPAP and CPAP Supplies	$0
Telehealth Visits (during COVID)	$5
COVID-19 Testing & Vaccine*	$0 *IHP members considered uninsured and costs associated with these services are eligible under FFCRA and the CARES Act. (Providers: bill HRSA first and if denied bill IHP)

Many services require an authorization in order to be covered by IHP.

COMMON SERVICES NOT COVERED BY IHP

• Conditions that have alternate eligibility such as Family Planning, Pregnancy, TB services, Breast & Cervical Cancer Control Programs
• Emergency Care or Transportation (Ambulance)
• Inpatient Hospital Services
• Alcohol or Drug Use Monitoring or Treatment
• Chemotherapy
• Chiropractic Care & Services
• Contraceptive Devices & Aides
• Dialysis Care
• Hearing Aids or Related Services
• Vision Exams
• Fertility Drugs or Sterilization
• Speech & Respiratory Therapy
• Medical Equipment, Prosthetics, Orthotics
• Medical Supplies
• Cosmetic Procedures
• Bariatric Surgery or weight-loss programs
• Services or supplies related to sexual reassignment
• Services related to injury to the extent they are covered under auto insurance, Workers Compensation, Occupational Law, etc.
• Any experimental or investigational treatment, supplies, devices or medications
• Any covered service not deemed medically necessary

Refer to the Provider Manual and Member Guidebook (June 2021) for a complete list of covered and non covered services. You many also call Plan Management Services (toll free) at 866-291-8691 for questions about eligibility and covered benefits.

For More Information about IHP Covered Services:

DENTAL BENEFITS MEDICATION PARTICIPATING URGENT CARE CLINICS (PDF) WHEN DO I NEED PRIOR APPROVAL?