Hospital are performed in a Services facility that is not a regular hospital Psychological Tests used to detect We cover: Testing Services or diagnose 10 hours of psychological problems with testing per year memory, IQ or other Copayment: $2.00 per areas visit Psychosocial Services to assist We cover: Rehabilitation people re-enter Up to 480 hours per year Services everyday life. They Copayment: $2.00 per include help with visit basic activities such as cooking, managing money and performing household chores Radiology and Services that Covered as medically Nuclear include imaging necessary Medicine such as x-rays, Copayment: $1.00 per Services MRIs or CAT scans. portable x-ray visit; $2.00 They also include per office visit portable x-rays Regional Services provided Covered as medically Perinatal to pregnant women necessary Intensive Care and newborns in Center Services hospitals that have special care centers to handle serious conditions Reproductive Services for women We cover family planning Services who are pregnant or services. You can get these want to become services and supplies from pregnant. They also any Medicaid provider; they include family do not have to be a part of planning services our Plan. You do not need that provide birth prior approval for these control drugs and services. These services are supplies to help you free. These services are plan the size of your voluntary and confidential, family even if you are under 18 years old. Respiratory Services that treat We cover: Services conditions, illnesses Respiratory testing or diseases of the Respiratory surgical procedures
Hospital Services are performed in a facility that is not a regular hospital Psychological Testing Services Tests used to detect or diagnose problems with memory, IQ or other areas We cover: 10 hours of psychological testing per year Copayment: $2.00 per visit Psychosocial Rehabilitation Services Services to assist people re-enter everyday life. They include help with basic activities such as cooking, managing money and performing household chores We cover: Up to 480 hours per year Copayment: $2.00 per visit Radiology and Nuclear Medicine Services Services that include imaging such as x-rays, MRIs or CAT scans. They also include portable x-rays Covered as medically necessary Copayment: $1.00 per portable x-ray visit; $2.00 per office visit Regional Perinatal Intensive Care Center Services Services provided to pregnant women and newborns in hospitals that have special care centers to handle serious conditions Covered as medically necessary Reproductive Services Services for women who are pregnant or want to become pregnant. They also include family planning services that provide birth control drugs and supplies to help you plan the size of your family We cover family planning services. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. You do not need prior approval for these services. These services are free. These services are voluntary and confidential, even if you are under 18 years old. Respiratory Services Services that treat conditions, illnesses or diseases of the We cover: Respiratory testing Respiratory surgical procedures
Enrollee_Handbook_Template_For_MMA-and-LTC.docx