Medallion 4.0 Basic health benefits

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Basic health benefits

All Medallion 4.0 health plans offer these benefits and services:

  • Addiction and Recovery Treatment Services (ARTS) program
  • Behavioral health services
  • Care coordination services
  • Colorectal cancer screenings
  • Community Mental Health Rehabilitative Services (CMHRS)
  • Complete assessment of medical, psychosocial, cognitive and functional status (HRA)
  • Durable medical equipment and supplies (DME)
  • Early Intervention (EI) services
  • Emergency and urgent care
  • Family planning services
  • Hearing (audiology) services
  • HIV testing and treatment counseling
  • Hospital and home health services
  • Interpreter and translation services
  • Mammograms
  • Mental health services, including inpatient, outpatient, community-based, and 24 / 7  crisis line
  • 1 eye exam for adults every 24 months
  • Organ transplants
  • Physical, occupational and speech therapies
  • Prescription drugs and some over-the-counter medications (when prescribed by doctors)
  • Preventive and regular medical care
  • Prostate specific antigen (PSA) and digital rectal exam
  • Quit smoking programs
  • Reconstructive breast surgery
  • Rides to medical appointments
  • Smartphone (see the chart in this packet  for data packages offered by each plan)
  • Telemedicine services
  • 24 /7 nurse advice line
  • Visits to the doctor when you are sick
  • Well visits, including routine checkups and annual exams
  • Women’s health services
  • X-ray, lab and imaging services

Health care for moms and children

All health plans provide:

  • Dental care by Smiles for Children
  • Early and Periodic Screening Diagnostic and Treatment (EPSDT) including private duty nursing for children under 21
  • Health care for children under 21, including routine checkups and immunizations (shots) and screenings
  • Maternity and high-risk pregnancy care
  • Nurse midwife services through a certified Nurse Midwife provider
  • Orthodontic services, including braces for children under 21
  • Post-partum services
  • Routine eye exams and glasses for children