Announcements

2010

Changes in Vision Benefits effective October 1, 2010

In July 2009, the State of Michigan stopped covering Vision services for Medicaid members age 21 years and older. We are pleased to announce that starting October 1, 2010, we will offer Vision services for our members age 21 and older. We will cover one eye exam per year and one pair of eyeglasses every two years.  There are no changes to benefits for members under the age of 21. 

 

MDCH Changes to Carved Out Drugs for Medicaid Members Effective April 1, 2010

The State of Michigan Department of Community Health (MDCH) is making changes to coverage of certain medications for Medicaid Members. Starting April 1, 2010, Medicaid will pay for some of your medicines instead of CareSource. Your pharmacy knows what medicines Medicaid will pay for and what medicines CareSource will pay for. These medications include:

 Antidepressants  Antianxiety 
 Sedatives/hypnotics  MAO inhibitors
 Anticonvulsants  ADHD drugs

When you go to your pharmacy to get more medicine, you will need to show both your green mihealth card and your CareSource Member ID card.

Prior to April 1, 2010, CareSource members do not have a co-pay for medications. Starting April 1, 2010, the State of Michigan requires a co-pay for Medicaid beneficiaries over 21 years of age. State of Michigan co-pays under Fee for Service are:

  • $1.00 for generic medications
  • $3.00 for brand name medications

Your pharmacy can tell you if your medicine is a generic or a brand medicine.

Your pharmacy can tell you how much your co-pay will be. You can call the First Health Beneficiary Help Line toll-free at 1-877-681-7540 to ask about co-pays.

Some medicines on the list may need to be approved by Medicaid. They will need to be approved before your pharmacy can give you the medicine. If your medicine needs to get approved by Medicaid, your doctor will get the approval.

If you have questions, you can:

  • Call CareSource Member Services at 1-800-390-7102 (TTY: 1-800-649-3777 or 711)
  • Call First Health Services Beneficiary Help Line toll-free at 1-877-681-7540
  • Call the Medicaid Beneficiary Help Line toll-free at 1-800-642-3195, or
  • Ask your pharmacy

2009

Changes to Medicaid Benefits effective July 1, 2009

The State of Michigan recently announced changes to Medicaid benefits, starting July 1, 2009.  These changes are for some benefits for people who are 21 years and older (Executive Order 2009-22).  Medicaid will no longer pay for Chiropractic, Podiatry, Hearing Aids, and Vision Services.  There are no changes to benefits for members under the age of 21. 

We value our CareSource members.  CareSource will continue to cover the services below through September 30, 2009, even though they are no longer covered by the Medicaid program:

Chiropractic (back care)
CareSource members age 21 and older – 5 visits per year

Hearing Services
CareSource members age 21 and older – 1 hearing exam per year
Hearing aids (including all supplies for hearing aids and evaluations, fittings and repairs associated with hearing aids) are not covered by Medicaid or CareSource; however, hearing exams will be covered

Podiatry (foot care)
CareSource members age 21 and older – 5 visits per year (There are no limits for members with diabetes)

Vision (eye care)
CareSource members age 21 and older – 1 eye exam a year

Glasses and contact lenses are not covered by Medicaid or CareSource.  But, we have arranged for our members to get a discount on the purchase of glasses or contacts from a company called VSP.  The discounts are:

  • 20% off frames, lenses and lens options
  • 15% off contact lens exam

Change in CareSource Service Area

As of October 1, 2009, CareSource will no longer serve Medicaid members in the counties of Arenac, Benzie, Crawford, Ionia, Kalkaska, Lake, Manistee, Missaukee, Oceana, Osceola, Oscoda, Roscommon, and Saginaw. These members will still be eligible for Medicaid even though they are no longer with CareSource. Michigan ENROLLS will send an enrollment packet in the mail to those eligible in these counties.

Members affected by this change should call Michigan ENROLLS at 1-800-975-7630 or 1-888-367-6557 before September 15, 2009, to choose a new plan with a potential effective date of November 1. 

Plan enrollment requests filed after September 15 may not be effective until December 1.

Important Information

  • CareSource will cover members who are hospitalized until they are discharged from the hospital.
  • CareSource members who are currently in a skilled nursing facility are covered by CareSource until September 30, 2009.
  • All pre-approved services for CareSource members will be covered through September 30, 2009.