Maximum of five hundred dollars ($500) per eligible enrollee per lifetime. Individual therapy sessions for caregivers. Therapy services, behavior management, and therapeutic support are coordinated through individualized treatment teams to help members with complex needs from requiring placement in a more intensive, restrictive behavioral health setting. Services must be medically necessary (PDF)in order for us to pay for them. Up to three screenings per calendar year. Up to seven therapy treatment units per week. Outpatient visits with a dietician for members. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. These services must be given by your Primary Care Provider or by another provider that your Primary Care Provider refers you to. As medically necessary, some service and age limits apply. You can call 1-877-659-8420 to schedule a ride. Breast pumps, depending on the type, are covered in full as a preventive service. We cover the following inpatient hospital services based on age and situation, when medically necessary: Services to diagnose or treat skin conditions, illnesses or diseases. Family Training and Counseling for Child Development*. manual breast pumps along with supplies are considered medically necessary and are a Patient Protection and Affordable Care Act Women's Preventive Health Services mandate, effective August 1, 2012. A plan may only cover in-network-network benefits. Benefits and Services | Long-Term Care | Sunshine Health Benefits Overview Comprehensive Long Term Care members receive Medicaid benefits and Long Term Care benefits. This could be on the bus, a van that can transport people with disabilities, a taxi, or other kinds of vehicles. A review of all the prescription and over- the-counter medications you are taking. Services to help get medical and behavioral health care for people with mental illnesses. Two pairs of eyeglasses for children ages 0-20. So, you may be weighing the pros and cons of direct breastfeeding vs. pumping and formula feeding. Up to two office visits per month for adults to treat illnesses or conditions. Medical care that you get while you are in the hospital. All other types of breast pumps require a prior authorization from your provider. 9 suction modes (4 simulation and 5 expression) help simulate babies' natural nursing rhythm. Unlimited units for group therapy and unlimited units for brief group medical therapy. Yes, for dental procedures not done in an office. Up to 480 hours per calendar year, as medically necessary. Download the free version of Adobe Reader. electric or manual breast pumps along with supplies are considered medically necessary and are a Patient Protection and Affordable Care Act Women's Preventive Health Services mandate, effective August 1, 2012. Print - Wisconsin Digital blood pressure cuff and weight scale, One (1) digital blood pressure cuff every three (3) years; One (1) weight scale every three (3) years. Speech therapy includes tests and treatments that help you talk or swallow. One communication evaluation per five calendar years. Massage of soft body tissues to help injuries and reduce pain. Learn about health insurance coverage for breast pumps. Hearing tests, treatments and supplies that help diagnose or treat problems with your hearing. Provided to members with behavioral health conditions in an outpatient setting. Medical supplies include things that are used and then thrown away, like bandages, gloves and other items. This service is for drugs that are prescribed to you by a doctor or other health care provider. The benefit information provided is a brief summary, not a complete description of benefits.
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