Covered Services
Covered Services - Medicaid/MIChild/Healthy Michigan Plan/CSHCS Members
You can call Customer Service at 888-327‑0671 (TTY: 711) if you have any questions about covered services. If you do not understand the limits or if you are told something is not covered, please call Customer Service for more information.
- Ambulance and other emergency transportation when Necessary
- Blood Lead Tests and Follow-Up
- Breast Pumps
- Certified Nurse Midwife
- Certified Pediatric & Family Nurse Practitioner Services
- Chiropractic Services (up to 18 visits per calendar year, additional visits require preauthorization)
- Community Health Worker (CHW)/Community Health Representative (CHR) services
- Dental Services
- Diagnostic Services (lab, X-ray, other imaging)
- Doula (supportive pregnancy) Services
- Durable Medical Equipment and Supplies
- Emergency Services, Including Transportation
- End Stage Renal Disease Services
- Family Planning (e.g., examination, sterilization procedures, limited infertility screening, and diagnosis)
- Habilitative services (HMP members only)
- Health Education
- Hearing and Speech
- Hearing Aids
- Home Health Services
- Hospice Services
- Immunizations (shots)
- Inpatient and Outpatient Hospital Services
- Intermittent or short-term restorative or rehabilitative services (in a nursing facility) up to 45 days
- Long Term Acute Hospital Services (LTACH)
- Maternal Infant Health Program Services (MIHP)
- Medically Necessary Weight Reduction
- Mental Health Care
- Non-Emergency Medical Transportation (NEMT) to medically necessary covered services and Medicaid services covered outside of the health plan
- Out of State Services, When Authorized
- Parenting and Birthing Classes
- Pharmacy Services
- Podiatry Services
- Practitioners’ Services
- Preventive Services
- Prosthetic and Orthotics
- Restorative and rehabilitative services in a place of service other than a nursing facility
- Sexually Transmitted Infection (STI) Treatment
- Intermittent or Short-Term Restorative or Rehabilitative Services (in a Nursing Facility), up to 45 days; Restorative or Rehabilitative Services (in a place other than a nursing facility)
- Specialist Visits with Referrals
- Therapies (speech, language, physical and occupational and therapies to support activities of daily living)
- Tobacco Cessation Treatment, including pharmaceutical and behavioral support
- Transplant Services
- Vision Services
- Well Child/EPSDT for persons under age 21
You can call Customer Service at 888-327-0671 or TTY: 711 if you have questions about these or other services. Please call Customer Service for more information if you do not understand the limits or if you are told something is not covered.
Children's Special Health Care Services Members
- We have staff dedicated to help our CSHCS members! Please feel free to call our dedicated CSHCS staff at any time if you need more information at 888-327‑0671 (TTY: 711).
- If you need transportation to medical care, please call Customer Service at 888-327‑0671 (TTY: 711).
- To see your Primary Care Physician (PCP), please just call their office and make an appointment.
- If you receive care from a PCP or specialist who is not contracted with McLaren Health Plan, we will work with you to make sure you get the care you need.
- Your PCP should decide if you need to see a specialist. Call your PCP if you would like to see a specialist.
- Your PCP and McLaren Health Plan will work together to make sure that you are able to continue care with all of your doctors.
- If you would like to know which local health department is close to you, or you need to know which Children’s Multispecialty Clinic is in your area, please call us at 888-327‑0671 (TTY: 711).
- Pharmacy: If you have problems getting your medications, please call your PCP or call us at 888-327‑0671 (TTY: 711).
Important CSHCS Information
Glossary of Health Coverage and Medical Terms
This glossary defines many commonly used terms, but isn’t a full list. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan or health insurance policy. Some of these terms also might not have exactly the same meaning when used in your policy or plan, and in any case, the policy or plan governs. (See your Summary of Benefits and Coverage for information on how to get a copy of your policy or plan document.)
Launch Glossary
Transportation Services
Your McLaren Health Plan benefits provide transportation. We provide transportation free of charge for doctor’s visits, lab visits, non-emergency hospital services, prescription pick-up, dental services, and other services covered by your Medicaid Health Plan or the State of Michigan. These services are available 24 hours a day, 7 days a week, 365 days a year. Please call Customer Service at 888-327-0671 (TTY: 711) for more information and to schedule a ride. Learn more about this benefit here: Transportation Services.
Urgent and Emergency Care - Community
When Urgent or Emergency care is needed and you seek services from a McLaren Health Plan contracted provider, you will have the lowest out-of-pocket costs.
If the services provided are rendered by a Secondary network provider, you are protected from balance billing.
If the provider of care is Out-of-Network, benefits provided by Out-of-Network providers have higher out-of-pocket expenses and may result in balance billing.
Please call Customer Service at 888-327‑0671 during normal business hours, Monday through Friday, 8 a.m. - 6 p.m. if you have questions about Urgent or Emergency care services.
Helpful tip! If you are going to be traveling, call Customer Service prior to leaving — we can help you locate Urgent and Emergency care providers in our Secondary network in the areas that you may be traveling to. This will help protect you from balance billing.