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Benefits Overview

Your Child’s Plan Benefits: Managed Medical Assistance Services

The table below lists the medical services that are covered by CMS Health Plan. Remember, you may need a referral from your child’s PCP or approval from us before your child goes to an appointment or uses a service. Services must be medically necessary in order for us to pay for them.

CMS Health Plan might not cover some services, but Medicaid might still cover them. To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055.

If your child needs a ride to any of these services, we can help. Please call MTM at 1-844-399-9469 to schedule a ride at no cost to you.

If there are changes in covered services or other changes that will affect your child, we will notify you in writing at least 30 days before the effective date of the change. If you have questions about any of the covered medical services, please call your child’s care manager or Member Services at 1-866-799-5321 (TTY 1-800-955-8770).

NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. This means they are optional services you can choose over more traditional services based on your child's individual needs.

American Indian members are not asked to pay copayments.

Your Plan Benefits: Expanded Benefits

Expanded benefits are extra goods or services we provide to you, free of charge. Call Member Services to ask about getting expanded benefits.