Durable Medical Equipment, Prosthetics and Orthotics. Special services such as durable medical equipment, prosthetics and orthotics, and other medical supplies are covered when ordered by the PCP. They must be approved in advance by UnitedHealthcare Community Plan. They must be provided by a Participating Durable Medical Equipment Provider. UnitedHealthcare Michigan 31 Community Plan may require use of the least costly device. 30 Healthy Michigan Plan Certificate of Coverage (COC)
Durable Medical Equipment, Prosthetics and Orthotics. 80% after deductible Paid as in-network Behavioral Care (Includes Mental Health Care and Addictions Treatment) Inpatient/Partial Hospitalization Services 80% after deductible 60% after deductible Outpatient/Intensive Outpatient Mental Health Care Services Performed in a Physician’s Office and Billed With a Place of Service Code “11” (Physician’s Office) Paid the same as any other illness; cost-sharing provisions such as deductibles, coinsurance, or co-payments may apply depending upon the type of service rendered Paid the same as any other illness; cost-sharing provisions such as deductibles, coinsurance, or co-payments may apply depending upon the type of service rendered Outpatient/Intensive Outpatient Mental Health Care Services Performed in a Facility, Clinic, or Any Other Place of Service, including Telemedicine E-Visits Paid the same as any other illness; cost-sharing provisions such as deductibles, coinsurance, or co-payments may apply depending upon the type of service rendered Paid as in-network Outpatient/Intensive Outpatient Addictions Treatment Services, including Telemedicine E-Visits Paid the same as any other illness; cost-sharing provisions such as deductibles, coinsurance, or co-payments may apply depending upon the type of service rendered Paid as in-network Convalescent Care & Home Health Care 80% after deductible Paid as in-network Home Infusion Therapy 80% after deductible 60% after deductible Special Notes about the Home Infusion Therapy Benefit: The infusion or injection of select products will be subject to the Plan’s Certification Requirement (see above). The list of the select products can be accessed by logging on to xxx.xxxxxxxxxxxxxxxxx.xxx or by calling ASR Health Benefits at (000) 000-0000. Hospice 100%; deductible waived 100%; deductible waived Private Duty Nursing 50% after deductible Paid as in-network Special Note about Private Duty Nursing: Eligible private duty nursing charges will not accrue towards the Coinsurance or Total Maximum Out-of-Pocket and will always be paid at the benefit percentage stated above. Miscellaneous Plan Provisions
