Plan Details

All of the health plans have special programs to help members with chronic illness such as asthma, congestive heart failure, diabetes, hepatitis C, HIV, obesity and sickle cell anemia. If they do not have a program in place that fits your needs, they will work with you to create one. They also have programs for pregnant women with a high risk of problems during pregnancy and delivery.

Eye exam (No co-pay) 
Glasses covered in full* (once a year)

Dental exams and cleanings (twice a year)
Fillings and extractions
X-rays (once a year)

Members who have gone to the Emergency room 5+ times for pain can work with a case manager to find ways to manage pain. 

All Health Plans offer sponsorships and/or mini-grants for community organizations and members in need.*

Boys & Girls Club membership for eligible members.*

All of the Health Plans offer rewards for healthy behaviors. Unless otherwise noted rewards are: available once a year per member; in the form of a reward debit card or gift card.

$20 for all well visits from birth to 15 months*
$20 for annual well visits (ages 2 - 9)
$25 for annual well visits (ages 10+)
Booster seat for all well visits from birth to 6 years

$15 for annual well visits

$10 for STI Screening, members 16+

$10 for all: dilated eye exam, kidney screening and A1C blood test for all members*

$5 for a flu shot

Taking Care of Baby and Me®

$25 for prenatal visit in the first 6 weeks of pregnancy
Portable crib or an Infant car seat for 7 prenatal visits

$50 for a postpartum visit

Family planning kit to help you have a healthy pregnancy when you’re ready. Kit includes condoms, pregnancy test, prenatal vitamins and more.

In-home postpartum visit 

All health plans cover newborn male circumcision.  Check with the individual plan to find out more about their rules for getting this service. 

Inhaler sensor to help control asthma for members diagnosed with asthma*

All health plans cover coaching and medications (with a prescription) to help members stop smoking.* 

Respite Services for Caregivers - Up to 8 hours each month for caregivers of children up to age 20

Weight Watchers® meetings for eligible members age 18 and older

Healthy Families - a program to help families get fit and healthy

There are no copays for children, pregnant women, family planning supplies, members in the hospital, members of a home and community based waiver, women who have Medicaid due to breast or cervical cancer, members getting hospice services, Native American or Alaska Native members.  For others, if the medicine is: 
$10 or less = $0.50 copay
$10.01 - $25 = $1 copay
$25.01 - $50 = $2 copay
Over $50 = $3 copay

All health plans will set up a ride for members who don’t have a way to get to medical appointments. Stop at the pharmacy after your appointment to get medications.

Available with a prescription, see copays above.

All health plans cover all recommended vaccinations, including: for HPV (human papilloma virus), pneumonia, the flu (influenza), chicken pox, shingles, meningitis, DTAP (diphtheria, tetanus and pertussis), MMR (measles, mumps and rubella) and hepatitis A and B.

Up to 500 MB of data or 500 minutes of talk time.

Text4Baby, Text4Kids, Text4Health, My Advocate

www.livehealthonline.com

Video chat with a doctor through LiveHealth Online. It's an easy way to see the doctor when you can't make it to the doctor's office. Great for getting help with colds, flu, fevers, rashes, infections and allergies.

Free download for members in the Apple App Store and on Google Play.

Search for Healthy Blue Mobile

• View your ID card
• Email or fax your card to your doctor, pharmacy or other service provider
• Interactive symptom checker
• Health A to Z Encyclopedia

Healthy Blue Community Resource Link, a site with an easy to search tool that can help you find free or low-cost services and resources in your area.

• Back-to-school supply drives
• Diaper drives
• Health educators
• Health fairs

*Please contact the Health Plan for eligibility requirements and details for this benefit.