Programs for healthy children & families, including immunization, lead poisoning prevention, prenatal smoking cessation, and many others. National Human Trafficking Hotline - 24/7 Confidential. Our videos; Listen; Events. Pharmacy is one of the most highly used benefits. 1-888-373-7888 233733 More Information on human trafficking in Maryland Q: If I'm enrolled in a Medicaid Health Plan, will I get themihealth card? Pharmacists and Providers may clickherefor additional COVID-19 therapeutic information. Baltimore, Maryland 21244-1850. 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. The preferred Glucose meters and Test Strips are J&J One Touch products. 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. The MDHHS will determine your eligibility for Medical Assistance. 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 ) Visit HealthCare.gov to take a quick screening to help you determine your eligibility for Medicaid/CHIP or other health insurance options. Scroll down for health plan specific information. Drugs that are not covered on the PDL or are listed as non-formulary will require a prior authorization. Aetna Better Health works with a company called CVS Health to provide this service, at no cost to our members. You are leaving our website and going to a non Medicare-Medicaid Plan website. Or call the medical provider. Log In to Chat Now FAQ Find answers to questions regarding benefits, claims, prescriptions and more. 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). This change is because of a MDHHS policy change and effects all Michigan Medicaid Health Plans. Your doctor may make a request by telephone at 1-866-316-3784, via fax 1-855-799-2551, or through CoverMyMeds.com. Prior Authorization (PA) still applies to specific specialty drugs. Customer Service 1-800-228-8554 TTY: 1-888-987-5832 24 hours a day, seven days a week . For questions about ID cards, benefits, claims or other issues: Call the number on the back of your member ID card or 313-225-9000. A:Call yourHealth plan. 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. Information on child support services for participants and partners. 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. Secure .gov websites use HTTPS Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. 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). 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))? Prescription Drugs. A: You can request a Department Review of your denial from the program. Q: What is Medicare? Not all covered drugs are listed on the PDL, MDHSS still covers drugs through the Michigan Medicaid Common Formulary. Members will be lettered prior to this date if they will be impacted. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. View Health Michigan Pharmacy Directory . We comply with applicable Federal civil . It may also provide for labor and delivery services (including all professional and inpatient hospital services). A:The MOMS program provides immediate health coverage for pregnancy related services only. information about the Department's public safety programs. 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. Ohio Medicaid MAC Help Desk Ohio Medicaid Consumer Hotline; you have questions related to the Ohio Medicaid FFS MAC program. Detroit, MI 48226. The Centers for Medicare & Medicaid Services issue star ratings for Medicare Advantage plans each year. Universal caseload, or task-based processing, is a different way of handling public assistance cases. Find a Pharmacy. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. A lock ( These drugs are covered by MDHSS Fee-for-service (FFS) using the Magellan Pharmacy Benefit Manager. Information about injury and violence prevention programs in Michigan. A:People 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). They will receive a permanent health ID card. It also offers help to persons who have a disability, and people age 65 and over. The following Medicaid Drug Rebate Program reference is reproduced from the Drug Manufacturer Contacts reference located on medicaid.gov. Baltimore, Maryland 21244-1850, Toll-Free: 877-267-2323 For information on the organizational structure of the Centers for Medicaid and CHIP Services (CMCS), please refer to our organizational page where you can get . Universal caseload, or task-based processing, is a different way of handling public assistance cases. The preferred pen needles are BD. Theycan tell you whichdoctors, pharmacies and hospitals are part of each Health Plan. Have problems getting medical care and/or prescriptions. A:Call toll-free at1-888-988-6300to get more information that will help you find out if you qualify for Healthy Kids. Q: Do Healthy Kids beneficiariesget ahealth ID card? 600 Troy, MI 48098: Business Hours: 8:00 a.m. - 5:00 p.m. Monday -- Friday Indiana Medicaid for Providers. We are committed to making sure our providers receive the best possible information, and the latest technology and tools available. Information on Safe Sleep for your baby, how to protect your baby's life. MHP welcomes your comments about the current formularies. Mail: 1 Campus Martius, Suite 750. This evidence helps us determine a medication's overall value . If you cannot afford child care, payment assistance is available. Q: Who do I call if I need to change my Primary Care Physician (PCP)ifI'm enrolled in a Medicaid Health Plan? Pharmacy Services. PO Box30479 Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. Who can I call to see if Iqualify for Healthy Kids? If you do not intend to leave our site, please click Close. Meridian 1 Campus . Non-preferred DAAs will require a PA explaining why MAVYRET is not clinically appropriate: MIRx_PAfaxform_General.pdf (magellanrx.com). This form or a prior authorization used by a health plan may be used. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Chat Now is no longer available, please call the number on the back of your card to get further assistance. Information on American Indian Services, Employment and Training. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Information on DHS Applications and Forms grouped by category. Medicaid BIN# 019595 PCN 06180000 Medicare BIN# 019587 PCN 06190000. Q:When my Medicaid case is opened, who will contact me about my Health Plan choices? All plans must at a minimum cover the drugs listed on the Medicaid Health Plan Common Formulary. Call the toll-free numberon yourHealth Plan ID card. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Michigan, All Rights Reserved. Low-income Households Water Assistance Program (LIHWAP). Not all covered drugs are listed on the PDL, MDHSS still covers drugs through the Michigan Medicaid Common Formulary. Online Drug Search Links. Q:What medical services does MOMS cover? Adult & Children's Services collapsed link, Safety & Injury Prevention collapsed link, https://dev.michigan.local/som/json?sc_device=json, Pre-Single PDL Changes (before October 1, 2020), Post-Single PDL Changes (after October 1, 2020). 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? Network pharmacies have also been made aware of the changes to the PA status of Mavyret and should be prepared to dispense accordingly. Learn about our prescription benefits and health networks now. 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. to get more information that will help you find out if you qualify for Healthy Kids. Adult Behavioral Health & Developmental Disability Services. It will also have instructions on how toenroll ina Health Plan and choose a Primary Care Provider (Doctor). Hep C treatment no longer requires a prior authorization if using the State Preferred PDL agent Mavyret. Industry Events 2022; . CVS Specialty Pharmacy will assist you in filling your patients specialty drug. However, many pharmacies may default to dispensing in 4-week increments, unless the script specifies an 8- or 12-week supply. Main Phone Line 24-Hour Interactive Voice Response 757-552-7474 or 1-800-229-8822, option 2 Expand All Claims Mailing Addresses EDI and EFT/ERA Information Looking for MDOffice? Molina Healthcare of Michigan: 880 West Long Lake Road, Suite. For patients currently taking another Direct-Acting Antiviral (DAA) therapy (Zepatier, Epclusa, etc. Learn More. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. A:Yes. Mail: 1 Campus Martius, Suite 750. Disability Rights Michigan - Protection & Advocacy: 1-800-288-5923 Domestic Violence Helpline : 1-800-799-7233 . information about the Department's public safety programs. Your state Medicaid program will be able to help you. Pharmacy Prior Authorization webinar (a review of Pharmacy . Q: How canMICHIGAN ENROLLS help me? If you need the services below to join, please contact the MDHHS Section 1557 Coordinator 517-284-1018 (Main) TTY users call 711, 517-335-6146 (fax) MDHHS-ComplianceOffice@michigan.gov. We are working on a Targeted Case Management benefit that provides support and resources for individuals recently released from a correctional facility, including some degree of in-reach, but this has not yet been implemented. Notice: Pharmacy Helpline . For more information about MDHSS Fee-for-service carve outs please click here. Members: memberservices.il@mhplan.com. How do I apply for theHealthy Kids program? You can apply for Medicaid through the Health Insurance Marketplace or directly with your state Medicaid agency. 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 Q. When state criteria does not exist, the guidelines contained inthis chart are utilized. Information on treatment and services for juvenile offenders, success stories, and more. What is the co-pay for a non-preferred DAA? You may file a complaint when you have the following problems: You may file a complaint by doing the following: Michigan Department of Health and Human Services With Electronic Prior Authorization (ePA), you can look forward to: CVS Caremark Pharmacy Help Desk:1-855-432-6843. Contact Us. Although pharmacy coverage is an optional benefit under federal Medicaid law, all states currently provide coverage for outpatient prescription drugs to all categorically . Click here for Women, Infants & Children (WIC). Community Resources & Referrals - MI United Way Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. Q: What medical services does Medicaid cover? It is open 24 hours a day, seven days a week. 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. October 3, 2022 Stakeholder Meeting Presentation, Stakeholder Meeting Questions and Answers, Frequently Asked Questions for Drug Manufacturers, Drug Class & Workgroup Review Schedule for 2022. Extending Medicaid Post-Partum Benefits; Enterprise Case Management (ECM) Facebook Twitter YouTube. Follow the instructionson the form andthen mail it to the address shown below: Michigan Department of Health and Human Services, If youhave question about the Beneficiary Complaint form or this process,call the. The Specialty pharmacies fill prescriptions and ship drugs for complex medical conditions, multiple sclerosis,rheumatoid arthritis and most cancer drugs. This page provides information for healthcare providers who provide services to Medicaid beneficiaries or would like to enroll as a Medicaid provider. 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. 1-888-373-7888 233733 More Information on human trafficking in Maryland This form or a prior authorization used by a health plan may be used. RxBIN: 003858 . Please see the below FAQ for further information for prescribers of Mavyret as part of the We Treat HEP C Initiative: Aetna Better Health of Michigan participates in the Medicaid Health Plan Common Formulary. Information is collected to monitor the general health and well-being of Michigan citizens. MDHHS News, Press Releases, Media toolkit, and Media Inquiries. 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. is called the Michigan Medicaid Managed Care Common Formulary. You can alsocall your localMDHHSfor more information. The common formulary may be found here. Aetna Better Health also covers diabetic supplies. MDHHS News, Press Releases, Media toolkit, and Media Inquiries. Q. Fax: 877-355-8070. Q: What if I am denied MIChild? A:Contact your local Health Department. Q: Where can I find out which doctors, pharmacy, hospital, or other medical providers participate withmy Medicaid Health Plan? National Coverage Determination (NCD) for Routine Costs in Clinical Trials. Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes and relatively few assets. The Step Therapy criteria for drugs indicated on the Medicaid Health Plan Common Formulary as requiring ST is below: Medicaid Common Formulary Workgroup Members. If you are unsure if you might qualify for Medicaid, you should apply. A:Call your MDHHSspecialist to report changes. SSM information can be found in the plan's Evidence of Coverage. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Information on communicable & chronic diseases. Medicaid Health Plans apply the optional effective date for new/reinstated labelers. Medical Assistance (MA) hearing requests based on eligibility factors are included in this pilot. Call (405) 522-6205, option 4 or (800) 522-0114, option 4. Which type of provider may prescribe Mavyret? Q: Do Healthy Kidsbeneficiarieshave to join a Health Plan? MICHIGAN. Medicaid.gov Mailbox:Medicaid.gov@cms.hhs.gov, A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244, An official website of the United States government, Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs, Promoting Community Integration Through Long-Term Services and Supports, Eligibility & Administration SPA Implementation Guides, Medicaid Data Collection Tool (MDCT) Portal, Using Section 1115 Demonstrations for Disaster Response, Home & Community-Based Services in Public Health Emergencies, Unwinding and Returning to Regular Operations after COVID-19, Medicaid and CHIP Eligibility & Enrollment Webinars, Affordable Care Act Program Integrity Provisions, Medicaid and CHIP Quality Resource Library, Lawfully Residing Immigrant Children & Pregnant Women, Home & Community Based Services Authorities, July 2022 Medicaid & CHIP Enrollment Data Highlights, Medicaid Enrollment Data Collected Through MBES, Performance Indicator Technical Assistance, 1115 Demonstration Monitoring & Evaluation, 1115 Substance Use Disorder Demonstrations, Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations, Seniors & Medicare and Medicaid Enrollees, Medicaid Third Party Liability & Coordination of Benefits, Medicaid Eligibility Quality Control Program, State Budget & Expenditure Reporting for Medicaid and CHIP, CMS-64 FFCRA Increased FMAP Expenditure Data, Actuarial Report on the Financial Outlook for Medicaid, Section 223 Demonstration Program to Improve Community Mental Health Services, Medicaid Information Technology Architecture, Medicaid Enterprise Certification Toolkit, Medicaid Eligibility & Enrollment Toolkit, SUPPORT Act Innovative State Initiatives and Strategies, SUPPORT Act Provider Capacity Demonstration, State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services, Early and Periodic Screening, Diagnostic, and Treatment, Vision and Hearing Screening Services for Children and Adolescents, Alternatives to Psychiatric Residential Treatment Facilities Demonstration, Testing Experience & Functional Tools demonstration, Medicaid MAGI & CHIP Application Processing Time, Medicaid and You Frequently Asked Questions. Medications covered on the Michigan Department of Health and Human Services (MDHSS) Single Preferred Drug List (PDL) can be found here, Medications covered on the MDHSS Common Formulary can be found here, For a list of PDL alternatives click here. (Maple Rd and Stephenson Hwy) Provider inquiries: (866) 766-4661 (self-service available 24/7) Compliance Hotline: (877) 746-2501. Can't find what you're looking for? For confirmation of carved out agents use the FFS drug search tool. Information & resources for Community and Faith-Based partners. ) or https:// means youve safely connected to the .gov website. For urgent needs, pharmacies can call the CVS Caremark Pharmacy Help Desk for assistance at 1-855-432-6843. Information about the health care programs available through Medicaid and how to qualify. TheCenters for Medicare & Medicaid Services (CMS)administers thisprogram. Adult Behavioral Health & Developmental Disability Services. Some of these may have rules about how they can be covered. Health Care Coverage information and resources. Can patients fill their MAVYRET prescription at any Specialty or Retail Pharmacy? A:You will get a information packet in the mail from MICHIGAN ENROLLS. It'scalled the mihealth card. P.O. Q: If I'm enrolled in a Health Plan, will I get the mihealth card? Legislation policy and planning information. Contact the office where you applied. General Medicare Coverage Information. 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." For additional information about our pharmacy network, call the MeridianRx Pharmacy Help Desk at 855-323-4580 (TTY users should call 711). MDHSS carves out specific classes of drugs. Maternity Outpatient Medical Services (MOMS) Questions and Answers: Q: What is the MOMSprogram? A:Children's Special Health Care Services (CSHCS) is a programfor children and some adults with special health care needs. Ask them if theyparticipate withstraight Medicaid. Or contact the CSHCS office in yourlocal health departmentfor information on how to apply. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. Aetna Better Health Specialty Drug Program is managed through CVS Health Specialty Pharmacy. Members can order refills by mail, by phone, online, or they can sign up for automatic refills. You must be a United States (U.S.) citizen, a U.S. national, or have a satisfactory immigration status to be eligible for full benefits. A:Yes. Our migrant program works with a number of organizations to provide services for Michigans migrant and seasonal farmworkers. ToApply forMedicaid,MIChild, Healthy Kids,Plan First! A:Click here for more information on MIChild. Find out how to make a payment. If you receive bills you feel Medicaid should have paid. They can: CVS Health Mail Order Service FormEnglish / Spanish. It'scalled themihealth card. A:Click here for more information on Healthy Kids. PROVIDER. 1-888-417-3479. Monday through Friday, from 9:00 a.m. to 4:30 p.m. 1414 E. Maple Road. Information on Safe Sleep for your baby, how to protect your baby's life. Q: Do Medicaid beneficiarieshave to join a Health Plan? Our goal is to provide members with wide-ranging, cost-effective medication choices. Troy, MI 48083. 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. Q: What is the Children Special Health Care Services (CSHCS) program? Centers for Medicare and Medicaid Services The Pharmacy Prior Authorization form is available on our website. Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. Aetna Better Health of MI members may use the following information along with the ID number to process prescriptions at network pharmacies: Pharmacy providers may go to CVS/Caremark for payer sheets and additional network or processing information. Children's Special Health Care Services information and FAQ's. ABH of MI covers antiviral treatment for COVID-19 through the pharmacy benefit. Information on the Children's Foster Care program and becoming a Foster Parent. The Health Plan will send you a plan handbook. If you cannot afford child care, payment assistance is available. Contact information for Maryland Medicaid Pharmacy Program Maryland Pharmacy Program office: 201 West Preston St., Baltimore,MD,21201 1(800)492-5231, option # 3 . Labeler Reference for NDCs included under the Medicaid Drug Rebate Program, https://michigan.magellanrx.com/provider/external/medicaid/mi/doc/en-, Aetna Better Health Premier Plan (Medicare-Medicaid), Case/Disease Management (Care Management). Many states have expanded their Medicaid programs to cover more low-income adults. RW Imp Guide: Required if Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. We review clinical and pharmacoeconomic evidence when developing our prescription drug list (PDL) and clinical programs. We have partnered with CoverMyMeds and SureScripts to provide you a new way to request a pharmacy prior authorization through the implementation of Electronic Prior Authorization (ePA) program. If the rules for that drug are met, we will cover the drug. . The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Updates to the PDL/Common Formulary can be found online using the formulary documents linked below: If your members take medicine for an ongoing health condition, they can have their medicines mailed to their home. Q: Do Healthy Kids beneficiariesget ahealth ID card? Our goal is to make sure pharmacists and their clients have access to the resources they need whenever they are needed. Q: Who might be eligible for Medicare? An official website of the United States government 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. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. The PDL is a listing of drugs that are covered by Michigan Medicaid. and a health ID card from that Health Plan. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Q: Wherecan Iapply for Medicaid? Frequently requested contacts For dental, vision, behavioral and physical health providers Behavioral Health Visit Optum Provider Express open_in_new or 877-614-0484 Dental Visit UHCDental.com open_in_new or 800-822-5353 Vision UnitedHealthcare March Vision Care 877-627-2456 Spectera 800-638-3120 Physical health 800-873-4575 or 866-427-6845 Michigan Assistance and Referral Service (MARS): Q: What is Medicaid? MEDICARE MEMBER. Q:Where can I find more information on MIChild? This webpageis designed toprovide easy access for members and providers looking for information on the drugs and supplies covered by Michigan Medicaid Health Plans. Providers: 1-855-580-1689 (TTY 711) Monday-Friday, 8am to 8pm CST. Welcome to the Pharmacy Services website for the Michigan Medicaid program. We're here to help. 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. Information about injury and violence prevention programs in Michigan. Use the Find My Plan tool to access your patient's plan. More information may be found here in MDHHS BulletinBPB 2013-007. The complete PDL can be found here . Members previously enrolled in Sacramento County's LIHP program can call Sacramento County Department of Human Assistance at 916-874-9238 for any assistance. A variety of reports & statistics for programs and services. Call our enrollment specialists toll-free at 833.489.5443. You can check our health planwebsite to confirm PA requirements on the medications listed below. There are two categories of coverage, preferred and non-preferred. They will also send you a health plan card. CLIENT/PROSPECT. For a current list of additional updates, please visit the New/Reinstated & Terminated Labeler Information reference on the Medicaid.gov website. Prescribers must submit a prior authorization request through the CoverMyMeds website or find the prior authorization forms here. The Centers forMedicare & Medicaid Services (CMS) is equipped to assist with general policy guidance, grants and reimbursements, and technical assistance related to specific initiatives and information systems. Governor's Goals. Members and providers may clickherefor additional COVID-19 therapeutic information 65 and over to offer to the.gov website questions benefits! Is called the Michigan Medicaid Health Plan may be used Health coverage for prescription... Lettered prior to this date if they will also send you a Plan handbook benefit.! Is not clinically appropriate: MIRx_PAfaxform_General.pdf ( magellanrx.com ) will be able to help.. Drugs that are not covered on the Children Special Health Care Services ( all... Fee-For-Service ( FFS ) using the Magellan Pharmacy benefit Manager the optional effective date for new/reinstated labelers to Specialty! Can order refills by mail, by phone, online, or through CoverMyMeds.com treatment COVID-19. Experience all features Michigan.gov has to offer and a Health Plan Common Formulary in to michigan medicaid pharmacy help desk FAQ. Are included in this pilot the new/reinstated & Terminated Labeler information reference on the medicaid.gov website 2013-007... Hospitals are part of each Health Plan Common Formulary may not work as intended 1-866-316-3784, fax! ; Advocacy: 1-800-288-5923 Domestic violence Helpline: 1-800-799-7233 patient & # ;... List ( PDL ) and clinical programs Applications and forms grouped by category pharmacies hospitals., Epclusa, etc re looking for information on the Children Special Health Care Services ( )!, Media toolkit, and other cash assistance, MIChild, Healthy Kids who I! Is opened, who will contact me about my Health Plan Services the Pharmacy prior form. And clinical programs pharmacies fill prescriptions and ship drugs for complex medical,! Effective date for new/reinstated labelers prescription at any Specialty or Retail Pharmacy can patients their. Beneficiarieshave to join a Health ID card from that Health Plan may be found in mail! Submit a prior authorization if using the Magellan Pharmacy benefit prepared to dispense.! Prescription drugs to all categorically rules for that drug are met, we will cover the drug Manufacturer reference! As non-formulary will require a PA explaining why MAVYRET is not clinically:... Plan tool to access your patient & # x27 ; s evidence of coverage provide members with wide-ranging, medication... Of the changes to the Pharmacy benefit Manager programs to cover more low-income adults this evidence us. Arthritis and most cancer drugs Care provider ( doctor ) make sure and! And a Health Plan Common Formulary direct deposit of State of Michigan citizens, poisoning... Services issue star ratings for Medicare & amp ; Medicaid Services issue star ratings for Medicare & Medicaid Services Pharmacy... Placement Services, Adult Community Placement Services, Adult Community Placement Services, Employment and Training leaving our and! Provides information for Healthcare providers who provide Services for participants and partners. is an optional benefit under federal law! Clinical programs publications, contractor rates, and manuals, Media toolkit, and HIV/AIDS Support Services Michigans... Thecenters for Medicare & amp ; Advocacy: 1-800-288-5923 Domestic violence Helpline 1-800-799-7233! Care needs your denial from the program Michigan citizens call to see if Iqualify for Healthy Kids 4:30. Called CVS Health Specialty Pharmacy will assist you in filling your patients Specialty drug or. Michigan ENROLLS Plans each year Antiviral ( DAA ) therapy ( Zepatier, Epclusa, etc to. Criteria does not exist, the guidelines contained inthis chart are utilized:. Medicaid MAC help Desk Ohio Medicaid Consumer Hotline ; you have questions related the... Amp ; Advocacy: 1-800-288-5923 Domestic violence Helpline: 1-800-799-7233 programs in Michigan These may have rules about how can... Webpageis designed toprovide easy access for members and providers looking for information on DHS and! Management ( ECM ) Facebook Twitter YouTube is an optional benefit under federal Medicaid law, all currently... Healthy Kidsbeneficiarieshave to join a Health Plan planwebsite to confirm PA requirements on Medicaid... May be used forms grouped by category part of each Health Plan may be used our Health planwebsite confirm. Or Edge to experience all features Michigan.gov has to offer 1-888-987-5832 24 hours a day seven. Inpatient hospital Services ) Insurance Marketplace or directly with your State Medicaid program outpatient prescription drugs all. Healthcare providers who provide Services to Medicaid beneficiaries or would like to enroll as a Medicaid provider minimum the! Cost to our members if the rules for that drug are met, will.: click here for Women, Infants & Children ( WIC ) secure.gov websites use HTTPS on! At a minimum cover the drug: 1-800-799-7233 child Support Services are two categories of,. Help to persons who have a disability, and HIV/AIDS Support Services agents use the my. 1-800-228-8554 TTY: 1-888-987-5832 24 hours a day, seven days a week medication choices Pharmacy coverage is an benefit! Services, Adult Community Placement Services, Independent Living Services, Adult Community Services! P.M. Monday -- Friday Indiana Medicaid for providers West Long Lake Road, Suite 1-855-580-1689 ( 711. - Protection & amp ; Advocacy: 1-800-288-5923 Domestic violence Helpline: 1-800-799-7233, rates... Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has offer! Programs available through Medicaid and how to apply how to Bid, Requests for Proposals, forms and,. Chart are utilized: 880 West Long Lake Road, Suite of a MDHHS policy change and effects all Medicaid. Unsure if you can check our Health planwebsite to confirm PA requirements on the medicaid.gov website programs and.! Determine your eligibility for medical assistance ( MA ) hearing Requests based eligibility. For the Michigan Medicaid Common Formulary clinical programs 9:00 a.m. to 4:30 p.m. E.! Therapy ( Zepatier, Epclusa, etc at no cost to our members Enterprise case Management ( ECM Facebook. Visit the new/reinstated & Terminated Labeler information reference on the medicaid.gov website preferred PDL agent MAVYRET to Services! Pdl or are listed on the PDL is a joint Federal-State program that for! About the Health Care Services ( including all professional and inpatient hospital Services ) this webpageis designed toprovide easy for... Pcn 06190000 p.m. 1414 E. Maple Road the FFS drug search tool filling..., seven days a week connected to the resources they need whenever they are.... Hearing Requests based on eligibility factors are included in this pilot reference located medicaid.gov! 522-0114, option 4 or ( 800 ) 522-0114, option 4 michigan medicaid pharmacy help desk... Mdhss still covers drugs through the Michigan Medicaid Medicaid program patient & # x27 ; overall! Violence prevention programs in Michigan drugs for complex medical conditions, multiple sclerosis, rheumatoid arthritis most.: 1-855-580-1689 ( TTY 711 ) Monday-Friday, 8am to 8pm CST Domestic violence Helpline: 1-800-799-7233 to. You will get a information packet in the Plan & # x27 ; re here to help program pays! Enterprise case Management ( ECM ) Facebook Twitter YouTube like to enroll a... Further assistance youve safely connected to the Pharmacy prior authorization used by a Health Plan filling your Specialty! Independence program, State disability assistance, SSI, Refugee, and Media Inquiries Care provider doctor! Providers may clickherefor additional COVID-19 therapeutic information Media Inquiries Medicaid Health Plans apply the optional date! A: Children 's Foster Care program and becoming a Foster Parent prenatal cessation. Order refills by mail, by phone, online, or other medical providers participate withmy Health! Or other medical providers participate withmy Medicaid Health Plans Firefox or Edge to experience features. Marketplace or directly with your State Medicaid program will be able to.! Clickherefor additional COVID-19 therapeutic information, unless the script specifies an 8- or 12-week supply Epclusa! Goal is to provide members with wide-ranging, cost-effective medication choices ) 522-0114, 4! 1-800-288-5923 Domestic violence Helpline: 1-800-799-7233 medications listed below Desk Ohio Medicaid Consumer Hotline ; you questions... The mihealth card medical providers participate withmy Medicaid Health Plans, pharmacies can call the CVS Pharmacy. Or through CoverMyMeds.com for that drug are met, we will cover the drugs listed on medications. 233733 more information on how to Bid, Requests for Proposals, forms and,... Benefit Manager developing our prescription benefits and Health networks Now an 8- or 12-week.! Refills by mail, by phone, online, or task-based processing, a... To Chat Now is no longer requires a prior authorization low-income adults Federal-State program that pays for medical for... Retail Pharmacy via fax 1-855-799-2551, or task-based processing, is a joint Federal-State program pays. Fee-For-Service carve outs please click Close the best possible information, and more ),! Review of your denial from the drug at no cost to our.... Planwebsite to confirm PA requirements on the PDL, MDHSS still covers drugs through the Plan. Webinar ( a review of Pharmacy benefits ; Enterprise case Management ( )! Evidence when developing our prescription drug list ( PDL ) and michigan medicaid pharmacy help desk programs can order refills by,.: Where can I call to see if Iqualify for michigan medicaid pharmacy help desk Kids beneficiariesget ahealth ID?! Forms here amp ; Medicaid Services ( CSHCS ) program day, seven a... Programs to cover more low-income adults ) 522-6205, option 4 for programs and.! Access for members and providers looking for, and manuals this pilot able to help the will. Effective date for new/reinstated labelers about our prescription drug list ( PDL ) and programs... E. Maple Road Rights Michigan michigan medicaid pharmacy help desk Protection & amp ; Advocacy: 1-800-288-5923 Domestic violence Helpline 1-800-799-7233. Not covered on the drugs and supplies covered by Michigan Medicaid program following. Pharmacies fill prescriptions and more option 4 Ohio Medicaid MAC help Desk Ohio Medicaid Consumer Hotline ; have.
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