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What are the Different Type of Benefits?

The following are the different type of benefits that MiCare offers to members:

1. Medical Care  Benefits includes out-patient consultations, diagnostic procedures and tests, maternity care, routine physical examination, hospital in-patient care, doctor’s fee, short term physical therapy and others specified under Part 6.2.a of MiCare Regulations.

1. Prescription Drug Benefits– The Plan covers prescription drug as set forth under Part 7.8 of MiCare Regulations. Member pays $2 deductible and 10% co-payment per prescription.  For Chronic refill program enrollees, one year membership will be $200.

2. Vision Care Benefits– member is entitled for one pair of eyeglasses, every two years not to exceed $150 in cost.

3. Dental Care Benefits— covers dental consultation, cleaning, simple dental extraction, temporary and permanent fillings. A Basic Plan member is covered up to a maximum of $300 per fiscal year and $500 for Supplemental Plan members.

4. Prosthetic Appliances Benefits– The Plan covers 50% of the  total cost of corrective appliances and artificial aids such as implants, pacemaker, braces and hearing aids.

5. Emergency Benefits– This benefits is offered to Basic Plan members traveling abroad for a period not to exceed 30 days with a maximum benefit of $2,500. Emergency care applies also to Supplemental Resident member who needs emergency care abroad where there is no approved off-island healthcare facility.