Apple Health (Medicaid) benefits

Behavioral health includes benefits such as:

• Evaluation and assessment
• Group counseling
• Peer support
• Education about mental health, treatments, and medications
• Rehab case management

Substance use disorder treatment includes services such as:

• Withdrawal management (detox)
• Individual and group counseling
• Case management

If you need behavioral health or substance use disorder care, you can get it from:

• Your PCP.
• A plan Community Mental Health Center or substance use disorder agency.
• Another behavioral health or substance use disorder provider in your plan.

Dental benefits are paid by Apple Health (Medicaid) (using your ProviderOne services card). To learn about these benefits, consult your member handbook.

Children and youth under age 21 get:

• Eye exams every 12 months.*
• Glasses, contact lenses, and fittings (these benefits are paid by the state using your ProviderOne services card).

Adults age 21 and older get:

• Eye exams every 24 months.*
• Glasses — one pair per year for members ages 21–64 (up to a $100 value).

* Eye exams can be more frequent if medically needed.

Your benefits include a wide range of prescription and many over-the-counter (OTC) drugs. We work with CarelonRx to provide these benefits.

Review pharmacy benefits 

Your Care Plan is a tool to help you:

• Stay connected with your care coordinator.
• Get your care coordinator’s phone number and email address.
• Send secure messages about diagnoses, goals, medicines, and services. 
• View your goals and objectives.
• Check due dates and statuses of goals and objectives.

Continue to Your Care Plan 

Healthy Rewards is a program that pays you for taking control of your health. You can earn rewards for completing healthy activities like:

• Prenatal and postpartum visits for pregnant members.
• Childhood and adolescent wellness visits.
• Immunizations such as flu shots.

Then redeem your Healthy Rewards via the Benefit Reward Hub.