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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