| Health Alliance Plan
We've Got You Covered! |
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| When you're away on business or vacation or the kids are away at school, we've got you covered for emergency care. Anywhere, Anytime.* |
(313) 872-8100 | |
| Outpatient Services: | Health Alliance Plan Coverage: | |
| Outpatient Physician/ Professional Visits (which may include) Periodic Physical Exams OB/GYN Exams Newborn Exams Pediatric Exams Allergy Testing Eye Exams Hearing Exams |
Covered | |
| Services Provided During Outpatient Visits: | ||
| Allergy Injections Other Injections and Immunizations All Outpatient Diagnostic, X-ray, Laboratory Tests, Pap Smears and Therapeutic Procedures |
Covered | |
| Services Provided as a Result of Outpatient Visits: | ||
| Outpatient Surgery Wellness Services Family Planning and Infertility Services Physical, Speech, and Occupational Therapy |
Covered Covered Covered 60 visits per condition lifetime |
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| Inpatient Hospital Services: | ||
| Days of Care Semi-Private Room (Specialty Care Units when Medically Necessary) Surgery and Related Services Anesthesia Laboratory Tests, EKGs, EEGs, and similar tests Physical Therapy Physician Services Diagnostic & Therapeutic X-ray Services |
Unlimited Covered Covered Covered Covered Covered Covered Covered |
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| Home Health Care: | ||
| Home Health Care (by RN or LPN) Hospice Care |
Covered Covered 210 days lifetime |
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| Emergency Care: | ||
| Emergency Room Services Emergency Ambulance |
Covered in any hospital when unable to reach a Health Alliance Plan facility Usually billed by hospital to Health Alliance Plan directly Covered/$25 copay |
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| Substance Use Disorders: | ||
| Inpatient Substance Use Disorder Treatment Outpatient Substance Use Disorder Treatment |
45 days, renewable after 60 days or state mandated annual aggregate dollar amount. whichever is greater. A 35 visit limit per member per calendar year or state mandated annual aggregate dollar amount, whichever is greater. |
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| Mental Health: | ||
| Inpatient Mental Health Hospital Services Outpatient Professional Mental Health |
45 days, renewable after 60 days. Covered. 20 visits per member per calendar year |
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| Maternity Services: | ||
| Outpatient Prenatal and Postnatal Care Delivery in Hospital Newborn Care in Hospital |
Covered Covered Covered |
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| Additional Benefits: | ||
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Prescription Drugs Skilled Nursing Care in Convalescent Facility Durable Medical Equipment (Wheelchairs. Special Beds, etc.) Prosthetic Appliances (including artificial limbs) Orthotic Devices (Special back braces, etc) Hearing Aids |
See
MEBS/Caremark Up to 730 days Covered for authorized equipment Covered for authorized equipment Covered for authorized equipment Covered with prescription change. Limited to conventional hearing aids |
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