call Healthplex at 1- 800-468-9868 or please call YourCare at 1-800-683-3781 Customer Services Representatives are there to help you. Many speak your language or have a contract with Language Line Services. Show your Member ID card to access dental benefits. You will not receive a separate dental ID card. When you your dentist you should show the YourCare plan ID card. You can also go to a dental clinic that is run by an academic dental center without a referral. Call 1-800-468-9868 for a list of academic dental centers. ORTHODONTIC CARE Healthplex will cover braces for children up to age 21 who have a O severe problem with their teeth, such as: can’t chew food due to severely crooked teeth, cleft palette, or cleftlip. VISION CARE Services of an ophthalmologist, ophthalmic dispenser and optometrist, and coverage for contact lenses, polycarbonate lenses, artificial eyes, and or replacement of lost or destroyed glasses, including repairs, when medically necessary. Artificial eyes are covered as ordered by a plan provider Eye exams, generally every two years, unless medically needed more often Glasses (new pair of Medicaid approved frames two years, or more often if medically needed) low vision exam and vision aids ordered by your doctor specialist referrals for eye diseases or defects PHARMACY Prescription drugs Over-the-counter medicines Insulin and diabetic supplies Smoking cessation agents, including OTC products Hearing aid batteries Enteral formula Emergency Contraception (6 per calendar year) Medical and surgical supplies A pharmacy co-payment may be required for some people, for some medications and pharmacy items. There are no co-pays for the following consumers/services: Consumers younger than 21 years old. Consumers who are pregnant. Pregnant are exempt during pregnancy and for the two months after the month in which the pregnancy ends. Consumers in an OMH or OPWDD Home and Community o
call Healthplex at 1- 800-468-9868 or please call YourCare at 1-800-683-3781 Customer Services Representatives are there to help you. Many speak your language or have a contract with Language Line Services. Show your Member ID card to access dental benefits. You will not receive a separate dental ID card. When you your dentist you should show the YourCare plan ID card. You can also go to a dental clinic that is run by an academic dental center without a referral. Call 1-800-468-9868 for a list of academic dental centers. ORTHODONTIC CARE O Healthplex will cover braces for children up to age 21 who have a severe problem with their teeth, such as: can’t chew food due to severely crooked teeth, cleft palette, or cleftlip. VISION CARE Services of an ophthalmologist, ophthalmic dispenser and optometrist, and coverage for contact lenses, polycarbonate lenses, artificial eyes, and or replacement of lost or destroyed glasses, including repairs, when medically necessary. Artificial eyes are covered as ordered by a plan provider Eye exams, generally every two years, unless medically needed more often Glasses (new pair of Medicaid approved frames two years, or more often if medically needed) low vision exam and vision aids ordered by your doctor specialist referrals for eye diseases or defects PHARMACY Prescription drugs Over-the-counter medicines Insulin and diabetic supplies Smoking cessation agents, including OTC products Hearing aid batteries Enteral formula Emergency Contraception (6 per calendar year) Medical and surgical supplies A pharmacy co-payment may be required for some people, for some medications and pharmacy items. There are no co-pays for the following consumers/services: Consumers younger than 21 years old. Consumers who are pregnant. Pregnant are exempt during pregnancy and for the two months after the month in which the pregnancy ends. o Consumers in an OMH or OPWDD Home and Community
2019%20YourCare%20Option%20(Medicaid%20Managed%20Care)%20Handbook.docx