Expanded Benefits - Medical Services
Acupuncture – Available to all members if medically necessary with prior authorization. Members may receive up to forty-eight (48) units (fifteen (15) minutes per unit) per year of service provided by a professional certified in Acupuncture.
Chiropractic – Available to all members if medically necessary with prior authorization. Members may receive up to twenty-eight (28) visits in addition to the basic MMA benefit of twenty-four (24) visits for a total of fifty-two (52) visits per year.
Hearing - Available to all members if medically necessary with prior authorization. The following services are provided once (1) every two (2) years: assessment for hearing aids, hearing aid fitting/checking, hearing aid monaural in ear, behind ear hearing aid, hearing aid dispensing fee, in ear binaural hearing aid, behind ear binaural hearing aid, dispensing fee, behind ear cros hearing aid, cros hearing aid dispensing fee, behind ear bicros hearing aid, dispensing fee bicros, and hearing evaluation.
Medication Assisted Treatment - Available to all members if medically necessary with prior authorization. Members may receive unlimited (as necessary on plan of care) alcohol and/or drug services, methadone administration and/or service (provision of the drug by a licensed program.
Outpatient Hospital - Available to all members if medically necessary with prior authorization. Services are unlimited as authorized the plan of care.
Prenatal Services - Available to all members if medically necessary with prior authorization. Services include rental of a hospital grade breast pump, once (1) per year; rental of a breast pump, once (1) every two (2) years; fourteen (14) antepartum visits for low-risk pregnancies; eighteen (18) antepartum visits for high-risk pregnancies, and three (3) postpartum visits within ninety (90) days following delivery.
Primary Care Services – Members may access unlimited outpatient visits as authorized by their plan of care.
Vision Services – Available to all members as authorized by their plan of care. Members may receive one (1) pair of frames per year and one (1) eye exam per year. Contact lenses are dispensed in a six (6)-month supply per lens with a prescription.
