Waiver services are person-centered services to help you meet your daily needs. You may qualify if you are: Fully eligible for both Medicare and Medicaid. Enrolled in a MyCare Ohio...

...before you can fill your prescription. Prior Authorization Criteria (Last updated 04/01/2026) Medicare Part B Drug Prior Authorization Policies (Coming soon) Step Therapy Criteria – For certain drugs, we require...

...towards your health by taking responsibility, including appropriate and inappropriate behavior. Apply for Medicare or other insurance when you are eligible. Report changes to your local Michigan Department of Health...

...and the type of facility in which the member will reside. Assisted living facilities, retirement homes or other non-skilled group homes are not deemed by Centers for Medicare and Medicaid...

...an advocate for your goals and help you navigate the health care system. HAP CareSource MI Coordinated Health Care Coordination coordinates your Medicare and Medicaid benefits so you can have...

...services primarily covered by Medicaid or both Medicare and Medicaid. You must request a state hearing within 90 calendar days after we mail a letter to you notifying you of...

...your plan or picking a new one. If you don’t have an agent or broker, call us at 1-855-494-2667 (TTY: 711). Marketplace Changes The Centers for Medicare and Medicaid (CMS),...

...Medicaid Integrity Group at the Centers for Medicare and Medicaid Services, where he supported the development of the first national Medicaid managed care audit protocols. He also served as the...

...Link (Medicare-Medicaid Plan) has a program that can help make sure our members safely use their prescription opioid medications, or other medications with a high potential for abuse. This program...

...and Code of Conduct. Review each of our documents here: Corporate Compliance Plan Code of Conduct Centers for Medicare and Medicaid Services (CMS) Fraud, Waste and Abuse Compliance Training Module...