The PDL is a listing of drugs that are covered by Michigan Medicaid. Mail. Q: What medical services does Medicaid cover? Provider Search. For information on carved out drugs, please call Magellan Medicaid Administration Clinical Call Center at (877) 864-9014. . A:Apply online faster through http://healthcare4mi.comor learn about other ways to apply using the Application for Health Coverage & Help Paying Costs form (DCH-1426). These drugs are covered by MDHSS Fee-for-service (FFS) using the Magellan Pharmacy Benefit Manager. Licensing information for Adult Foster Care and Homes for the Aged, Child Day Care Facilities, Child Caring Institutions, Children's Foster Care Homes, Child Placing Agencies, Juvenile Court Operated Facilities and Children's or Adult Foster Care Camps. There are no co-pays for viral hepatitis treatments for Healthy Michigan Plan. The help desk offers assistance with: Preferred product selection and exceptions 2-1-1. Heres how you know. Or contact the CSHCS office in yourlocal health departmentfor information on how to apply. Pharmacies Fill prescriptions at more than 2,000 pharmacies in Michigan under Medicare Advantage Part D Our network includes pharmacies that offer standard cost-sharing and pharmacies that offer preferred cost-sharing. Members: 888-437-0606 (TTY 711) Providers: 888-773-2647 (TTY 711) Healthy Michigan Plan's regular business hours are Mon - Friday 8am-6:30pm EST. Aetna Better Health also covers diabetic supplies. Medicaid BIN# 019595 PCN 06180000 Medicare BIN# 019587 PCN 06190000. The formulary flags these drugs with the letters QLL The QLLs are established based on FDA-approved dosing levels and nationally- established, recognized guidelines pertaining to the treatment and management of the condition being treated. Members: 1-855-580-1689 (TTY 711) Monday-Friday, 8am to 8pm CST. Members previously enrolled in Sacramento County's LIHP program can call Sacramento County Department of Human Assistance at 916-874-9238 for any assistance. Quality, Safety & Oversight - General Information. Information about injury and violence prevention programs in Michigan. Michigan Assistance and Referral Service (MARS): Q: What is Medicaid? The Quick Reference Guides, the complete Positive Lists are available by contacting MHP at (888) 327-0671 or clicking on the link below. Aetna Better Health of Michigan may consider making medical necessity accommodations for members who need a non-MDRP participating NDC when all formulary NDCs are unavailable. Can more than 4 weeks of therapy be prescribed at a single time (e.g., 8 weeks of therapy, or less frequently 12 weeks of therapy, as opposed to 4 weeks with refill(s))? Q. 800-555-CLIN (800-555-2546) Open 8 a.m. to 8 p.m. Eastern time, Monday through Friday Pharmacy medication intake team For preauthorization of medication supplied and administered in a physician's office and billed as a medical claim (Part B for Medicare) 866-461-7273 Open 8 a.m. to 8 p.m. Eastern time, Monday through Friday Customer Service 1-800-228-8554 TTY: 1-888-987-5832 24 hours a day, seven days a week . Under the Common Formulary, Medicaid Health Plan formulary coverage is limited to products with a National Drug Code from manufacturers who participate in the Medicaid Drug Rebate Program. Information about the Michigan law that requires certain information be made available to a woman who is seeking an abortion at least 24 hours prior to the abortion procedure. A:Call yourHealth plan. Common Formulary MDHHS Link McLaren Health Plan Medicaid & Healthy Michigan Drug Formulary Denied a covered Medicaid(CSHCS) benefit. PROVIDER. A:Click here for more information on Healthy Kids. Labelers listed for termination are removed from coverage according to the effective date presented on the Terminated Labelers table. You might be eligible depending on your household income, family size, age, disability, and other factors. More information may be found here in MDHHS BulletinBPB 2013-007. The Pharmacy Prior Authorization form is available on our website. The links below may include unofficial information for use in Program Development. Fax: 877-355-8070. TheCenters for Medicare & Medicaid Services (CMS)administers thisprogram. For members enrolled in the Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise managed . State Medicaid agencies handle the enrollment of their own providers and to be a covered provider, you need to work directly with the states Medicaid Agency. transferred to our after-hours help desk. Itwill list theHealth Plan choices in your county. Prior Authorization guidelines can be found below. Q: Do Healthy Kids beneficiariesget ahealth ID card? A: Medicare is a Federal Health Insurance Program. Please click here to see information on the new grants program offered by the Maryland Medicaid Pharmacy Program for Maryland's small rural pharmacies. Aetna Better Health Specialty Drug Program is managed through CVS Health Specialty Pharmacy. A:Contact your local Health Department. Call our enrollment specialists toll-free at 833.489.5443. HAP Empowered has a unique set of BIN/PCN numbers for processing Medicaid pharmacy claims. A variety of reports & statistics for programs and services. The Prior Authorization criteria for drugs indicated on the Medicaid Health Plan Common Formulary as requiring PA is below: A standard prior authorization form, FIS 2288, was created by the Michigan Department of Insurance and Financial Services (DIFS) to simplify the process of requesting prior authorization for prescription drugs. If they choose this option, their medicine comes right to their door. Click here for more information on Medicare. A manufacturers labeler code is represented in the first five digits of a products NDC. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. If you receive a denial, reduction or termination in medical benefits or if you disagree with an adverse benefit determination made by an MDHHSmanaged care entity (health or dental plan, CMHSP/PIHP, MHL or waiver program), you have the right to ask for an appeal with that managed care entity. STAR Pharmacy Help Desk, call 1-855-457-0405. Call 866-775-2192 to get the help you need. MIChildis not a Medicaid program. Toll-Free: 877-267-2323. TTY Toll-Free: 800-877-8339. Your doctor may make a request by telephone at 1-866-316-3784, via fax 1-855-799-2551, or through CoverMyMeds.com. Fee-for-Service pharmacy claims are processed by ODM's contracted pharmacy benefits administrator (PBA) in an online, real-time environment which allows the dispensing pharmacist access to the terms of coverage. A:Click here for more information on Medicare. Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. Email. It may also provide for labor and delivery services (including all professional and inpatient hospital services). TTY Toll-Free:800-877-8339 If the rules for that drug are met, we will cover the drug. Choose ways to enroll: PharmacyPrior Authorization Faxnumbers:1-855-799-2551, Disease-specific education and counseling by the CareTeam, Delivery of Specialty drugs to your patients home and/or your office in temperature-controlled packaging with the required supplies, i.e. Low-income Households Water Assistance Program (LIHWAP). MHP welcomes your comments about the current formularies. Children's Special Health Care Services information and FAQ's. Home to an array of public health programs, initiatives and interventions aimed at improving the health and well-being of women, infants, families and communities. information about the Department's public safety programs. Select 2021 WellCare plans will participate in the Senior Savings Model (SSM) capping insulin medication costs at $35 per 30-day supply throughout the plan year. For more information about MDHSS Fee-for-service carve outs please click here. Extending Medicaid Post-Partum Benefits; Enterprise Case Management (ECM) Facebook Twitter YouTube. Click here for MDHHS office phone numbers. We're available Monday through Friday 9 a.m. - 4 p.m Employer Small Business Sales 800.471.2504, option 4 or through an independent licensed Priority Health agent Medicare 888.230.0372 (TTY 711) 8 a.m. to 8 p.m., 7 days a week Medicaid MIChild 888.988.6300 (TTY 711 ) Information is collected to monitor the general health and well-being of Michigan citizens. This form or a prior authorization used by a health plan may be used. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. For confirmation of carved out agents use the FFS drug search tool. A variety of reports & statistics for programs and services. APPLY THROUGH THE MARKETPLACEAPPLY THROUGH YOUR STATE MEDICAID AGENCY. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Industry Events 2022; . For Medicaid, co-pay for MAVYRET is $1, and co-pay for non-preferred DAAs are $3. A:It provides pregnancy related services during the pregnancy and through 60 days after the pregnancy ends. If you receive bills you feel Medicaid should have paid. Apply on-line or print, complete and mail the DCH-1426 form You can call or go to your local Department of Health and Human Services (MDHHS) to get an application. Provider Portal. Providers: 1-855-580-1689 (TTY 711) Monday-Friday, 8am to 8pm CST. Universal caseload, or task-based processing, is a different way of handling public assistance cases. General Medicare Coverage Information. The preferred Glucose meters and Test Strips are J&J One Touch products. Pharmacy Effective January 1, 2020 Page 1 of 4 . CHIP Pharmacy Help Desk, call 1-855-457-0403. I think my child qualifies for CSHCS, how do Iapply? Please contact individual health plans to verify their most current BIN, PCN and Group Information. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. If you receive a denial, reduction or termination in medical benefits. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. P.O. . Evidence-Based Care. The Specialty pharmacies fill prescriptions and ship drugs for complex medical conditions, multiple sclerosis,rheumatoid arthritis and most cancer drugs. Need help with your login or our website? Email. Our goal is to provide members with wide-ranging, cost-effective medication choices. , was created by the Michigan Department of Insurance and Financial Services (DIFS) to simplify the process of requesting prior authorization for prescription drugs. Information on adoption programs, adoption resources, locating birth parents and obtaining information from adoption records. Our goal is to make sure pharmacists and their clients have access to the resources they need whenever they are needed. A:Medicaid is a health careprogram for low-income families & individuals. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. CLIENT/PROSPECT. Blue Cross Complete of Michigan 4000 Town Center Suite 1300 Southfield, MI 48075 . Welcome to the Pharmacy Services website for the Michigan Medicaid program. It will also have instructions on how toenroll ina Health Plan and choose a Primary Care Provider (Doctor). Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes and relatively few assets. Aetna Better Health of Michigan Members must have their prescriptions filled at a in network pharmacy to have their prescriptions covered at no cost to them. Network pharmacies have also been made aware of the changes to the PA status of Mavyret and should be prepared to dispense accordingly. Information on the Food Assistance Program, eligibility requirements, and other food resources. Information & resources for Community and Faith-Based partners. 1-888-417-3479. Find a Provider/Pharmacy . Mail: 1 Campus Martius, Suite 750. Q: Wherecan Iapply for Medicaid? A: Healthy Kids is a Medicaid health care program for low-income children under age 19. Information on communicable & chronic diseases. Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. Hep C treatment no longer requires a prior authorization if using the State Preferred PDL agent Mavyret. Call (405) 522-6205, option 4 or (800) 522-0114, option 4. Aetna Better Health also covers certainover-the-counter drugsif they are on our list. If you cannot afford child care, payment assistance is available. Learn more about the Community Connections Help Line (PDF). Requests for Medications requiring Prior Authorization (PA) will be reviewed based on the PA Guidelines for that medication. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Online Drug Search Links. Information on Safe Sleep for your baby, how to protect your baby's life. a care management program designed to help qualified patients that have coverage with us. Pharmacy Lookup. Home to an array of public health programs, initiatives and interventions aimed at improving the health and well-being of women, infants, families and communities. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Information on DHS Applications and Forms grouped by category. Lansing, MI 48909
It'scalled themihealth card. Customer Services Division
This linkcontains a list ofMedicaid Health Plan BIN, PCN and Group Information. You are leaving our website and going to a non Medicare-Medicaid Plan website. If you have questions about getting service coordination or service management through your health plan, call the help line phone number listed on the back of your health plan ID card. Pharmacy. Notice of Non-Discrimination. Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. Q: Do Medicaid beneficiariesget ahealth ID card? In the event a particular product is not approved, the dispensing pharmacist can notify the prescriber of possible alternatives. For questions on specialty drugs, call 1-866-796-0530. The Center for Medicaid and CHIP Services (CMCS) is committed to working in close partnership with states, as well as providers, families, and other stakeholders to support effective, innovative, and high quality health coverage programs. Formore general information on Michigan Medicaid Health Plans, visitwww.michigan.gov/managedcare. You can alsocall your localMDHHSfor more information. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. A locked padlock to get more information that will help you find out if you qualify for MIChild. Q: Do Medicaid beneficiarieshave to join a Health Plan? Contact Us. Billing and Payments. A:Yes. Low-income Households Water Assistance Program (LIHWAP). If you think you or your child qualifies for CSHCS: Healthy Kids questions and to see if you qualify, MIChild questions and to see if you qualify, Emergency Relief: Home, Utilities & Burial, Formula Updates and Shortage Information for WIC Clients, General Information For Families About CSHCS, Supplemental Nutrition Assistance Program Education, Behavioral and Physical Health and Aging Services Administration, Immunization Info for Families & Providers, Michigan Maternal Mortality Surveillance Program, Bureau of Emergency Preparedness, EMS, and Systems of Care, Division of Emergency Preparedness & Response, Infant Safe Sleep for EMS Agencies and Fire Departments, Adult Behavioral Health & Developmental Disability, Behavioral Health Information Sharing & Privacy, Integrated Treatment for Co-occurring Disorders, Cardiovascular Health, Nutrition & Physical Activity, Office of Equity and Minority Health (OEMH), Communicable Disease Information and Resources, Mother Infant Health & Equity Improvement Plan (MIHEIP), Michigan Perinatal Quality Collaborative (MI PQC), Mother Infant Health & Equity Collaborative (MIHEC) Meetings, Child Lead Exposure Elimination Commission, Coronavirus Task Force on Racial Disparities, Michigan Commission on Services to the Aging, Nursing Home Workforce Stabilization Council, Guy Thompson Parent Advisory Council (GTPAC), Strengthening Our Focus on Children & Families, Supports for Working with Youth Who Identify as LGBTQ, Civil Monetary Penalty (CMP) Grant Program, Nurse Aide Training and Testing Reimbursement Forms and Instructions, MI Kids Now Student Loan Repayment Program, Michigan Opioid Treatment Access Loan Repayment Program, Trauma Facility Verification and Designation, MI Interagency Migrant Services Committee, Students in Energy Efficiency-Related Field, Other Chronic Disease & Injury Control Data, Nondiscrimination Statement (No discriminacion), 2022-2024 Social Determinants of Health Strategy, Apply on-line or print, complete and mail the DCH-1426 form, Application for Health Coverage & Help Paying Costs, Click here for additional information on Medicaid, Click here for Request for Departmental Review (DCH-0892), Click here for Women, Infants & Children (WIC). Official Policy is maintained on the MHD site. Children's Special Health Care Services information and FAQ's. The following Medicaid Drug Rebate Program reference is reproduced from the Drug Manufacturer Contacts reference located on medicaid.gov. Box 516, Essington, PA 19029. Want to see a list of drugs covered under your patient's plan or help them find a pharmacy? Or call the medical provider. Information about the health care programs available through Medicaid and how to qualify. to get more information that will help you find out if you qualify for Healthy Kids. Who can I call to see if I qualify for MIChild? Legislation policy and planning information. Bridge Card Participation Information on Electronic Benefits for clients and businesses, lists of participating retailers and ATMs, and QUEST. The Michigan Department of Health and Human Services' (MDHHS) Division of Environmental Health (DEH) uses the best available science to reduce, eliminate, or prevent harm from environmental, chemical, and physical hazards. They will receive a permanent health ID card. For questions on medical or behavioral health authorizations, call 1-844-477-8313. We're here to help. Programs for healthy children & families, including immunization, lead poisoning prevention, prenatal smoking cessation, and many others. Medicare Acronyms Lookup Tool. The Specialty Drug Program provides care management services to your members, including: Contact CVS Specialty Pharmacy at1-800-237-2767from 7:30 a.m. (EST) to 9:00 p.m. (EST) time, Monday Friday. SSM information can be found in the plan's Evidence of Coverage. Members, log in to find information specific to your plan or start a Live Chat. HAP Choice West Michigan HMO Option 1 HAP Choice West Michigan HMO Option 1. . Information about audits conducted by the Office of Audit. Q. Birth, Death, Marriage and Divorce Records. It will also have instruction on how toenroll ina Health Plan and choose a Primary Care Provider (Doctor). For patients currently taking another Direct-Acting Antiviral (DAA) therapy (Zepatier, Epclusa, etc. Services and resources. Q. ) or https:// means youve safely connected to the .gov website. Children's Special Health Care Services information and FAQ's. Publich Health Emergencies: 517-335-9030 Medicaid Customer Help: 800-642-3195 Medicaid Provider Help: 800-292-2550: Minnesota Medicaid Phone Number Departent of Human Services-DHS: Information Desk: 651-431-2000 800-627-3529 MHCP enrolled Health care . A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. We are committed to making sure our providers receive the best possible information, and the latest technology and tools available. Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. Elixir pharmacy staff are available 24 hours a day at 1-844-222-5584 . Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. Select 2021 WellCare plans will participate in the Senior Savings Model (SSM) capping insulin medication costs at $35 per 30-day supply throughout the plan year. Can't find what you're looking for? Lansing, MI 48909-7979. Medicaid Drug Rebate Program Labeler List Reference - To help you more easily identify Medicaid rebatable NDCs, we are posting a monthly reference list here . If you want Medicare to be able to give your personal information to someone other than you, you need to fill out an "Authorization to Disclose Personal Health Information." Legislation policy and planning information. 2022 Medicare and PDP Compare Plans and Enroll Now 2023 . Please contact Customer Service at (888) 327-0671. Information on Safe Sleep for your baby, how to protect your baby's life. With Electronic Prior Authorization (ePA), you can look forward to: CVS Caremark Pharmacy Help Desk:1-855-432-6843. Secure .gov websites use HTTPS Box 30763
For further information, click here. The Michigan Department of Health and Human Services' (MDHHS) Division of Environmental Health (DEH) uses the best available science to reduce, eliminate, or prevent harm from environmental, chemical, and physical hazards. Q: If I'm enrolled in a Medicaid Health Plan, will I get themihealth card? They can: CVS Health Mail Order Service FormEnglish / Spanish. Michigan Medicaid Phone Number Michigan Department of Health and Human Services - MDHHS . Get all your pharmacy needs covered here. mihealth card questions,andif you need a card replacement: Click here for Health Plan phone numbers. Medicaid Help Desk 1-866-935-8874 Medicare Help Desk 1-866-935-6681. Information about the health care programs available through Medicaid and how to qualify. Information on the grant awarded for the State Innovation Model Proposal, Offers resources for agencies who operate the Weatherization Assistance Program in the state of Michigan. On October 1, 2020, The Michigan Department of Health and Human Services (MDHHS) implemented a Single Pharmacy Drug List (PDL). RxBIN: 003858 . Official websites use .gov Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Resources and information to assist in assuring firearm safety for families in the state of Michigan. Q: Where can I find out which doctors, pharmacy, hospital, or other medical providers participate withmy Medicaid Health Plan? Pharmacy Benefits. Universal caseload, or task-based processing, is a different way of handling public assistance cases. Licensing information for Adult Foster Care and Homes for the Aged, Child Day Care Facilities, Child Caring Institutions, Children's Foster Care Homes, Child Placing Agencies, Juvenile Court Operated Facilities and Children's or Adult Foster Care Camps. The Michigan Department of Health and Human Services' (MDHHS) Division of Environmental Health (DEH) uses the best available science to reduce, eliminate, or prevent harm from environmental, chemical, and physical hazards. More information about your pharmacy benefits can be found in your handbook (PDF). Baltimore, Maryland 21244-1850. MDHHS News, Press Releases, Media toolkit, and Media Inquiries. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. MDHSS carves out specific classes of drugs. Detroit, MI 48226. Which type of provider may prescribe Mavyret? Health Care Coverage information and resources. Our migrant program works with a number of organizations to provide services for Michigans migrant and seasonal farmworkers. They can also enroll you by phone in the Health Plan you choose. Headquarters Multi-Agency State Office Building 195 North 1950 West Salt Lake City, Ut 84116. Michigan Health Insurance Individual and Family Plans Dental Plans Medicare If you cannot afford child care, payment assistance is available. Q: If I'm enrolled in a Health Plan, will I get the mihealth card? ), will they be able to complete their course of therapy (i.e., refills)? Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. Member Services Network Educators Pre-Authorizations Provider Connection Support Provider Relations Quality Improvement Join Our Network Prescribers must submit a prior authorization request through the CoverMyMeds website or find the prior authorization forms here. It also offers help to persons who have a disability, and people age 65 and over. The step therapy program requires that you prescribe certain first-line drugs, either generic drugs or formulary brand drugs, before you can prescribe specific, second-line drugs. Provider Relations Help Desk Info: 866-254-1669 Other versions supported: VERSION 5.1 UNTIL 01/01/2012 " SUBJECT TO CHANGE* . Q: Where can I find more information on Healthy Kids program? Fax: 877-355-8070. The Helpdesk phone number is 1-800-424-5725 and the fax number is 1-800-424-5881. Information on treatment and services for juvenile offenders, success stories, and more. Q: Where can I find more information on other health care programs available for pregnant women? They will receive a permanent health ID card. Information about injury and violence prevention programs in Michigan. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Q: If I am notenrolled in a Medicaid Health Plan, where can I find out which doctors, pharmacy, hospital, or other medical providersthat participatestraight Medicaid? Q:What is the Healthy Kids program? Increase access to health care. In addition, certain drugs on the formulary have quantity limits. Can patients fill their MAVYRET prescription at any Specialty or Retail Pharmacy? Pharmacists and Providers may clickherefor additional COVID-19 therapeutic information. This change is because of a MDHHS policy change and effects all Michigan Medicaid Health Plans. Healthcare done well. Current beneficiaries can find out which health plan theyareenrolled in bycalling the Beneficiary Help Line at 800-642-3195 (TTY 866-501-5656) or bylogging in to theirmyHealth Portal account online atwww.michigan.gov/myhealthportal. Michigan Department of Health and Human Services
Resources and information to assist in assuring firearm safety for families in the state of Michigan.
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