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 (Guardian Dental PPO Plan)	$0 Preventative Care/Varies All Other Services
Behavioral Health Service (limited benefit)	$0
Sleep Studies, CPAP and CPAP Supplies	$0
Speech Therapy	Limited Benefit
Substance Use Disorder Services (limited benefit)	$5
Telehealth Visits	$5
COVID-19 Testing & Vaccine*	$0

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

COMMON SERVICES NOT COVERED BY IHP

(Summary ONLY - Not a Complete List and subject to change)

SERVICE	ADDITIONAL INFORMATION
Acupuncture
Ambulance
Cardiac and Pulmonary Rehabilitation	93797, 93798, G0424 Rev codes G0237, G0238
Chemotherapy
Chiropractic Care
Cosmetic Services	Including cosmetic reconstructive surgery
Dialysis
Emergency Department Services
Experimental or Investigational Treatment
Formulas and Feeding Tube Supplies
Hearing Aids and Related Services
Home Health Care Services	Skilled nursing, post-hospital recovery, infusion therapy and in-home PT, OT, SLP
Hospice
Infertility Treatment	Screening labs covered
Inpatient Services
Intrauterine Implants, Devices, Rings and Patches	Refer to Planned Parenthood, Ingham County Health Department or Plan First
Medical Equipment	Except: CPAP machines and supplies
Nursing Home Care
Nutrition Services	Except: Diabetes Education Program
Out of State Services
Oxygen and Supplies
Pregnancy Related Services	Refer to Medicaid MOMS
Prosthetics and Orthotics
Sterilization Services and Procedures	Refer to Plan First
Transplant Services and Procedures	Inpatient and Outpatient
Transportation
Travel Immunizations
Vision Exams, Glasses, Contacts
Weight Reduction Services	Including Medications

For questions about eligibility and covered benefits, you may also call Plan Management Services (toll free) at 866-291-8691

For More Information about IHP Covered Services:

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