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MeridianComplete (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MeridianComplete (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MeridianComplete (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
MeridianComplete (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in Michigan. The overall rating for this plan is not yet available for 2025.
It's important to know that MeridianComplete (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
MeridianComplete (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MeridianComplete (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MeridianComplete (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for MeridianComplete (Medicare-Medicaid Plan)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The MeridianComplete (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. This plan has a $0 deductible, meaning you pay nothing out-of-pocket before your drug coverage begins. In the initial coverage phase, you will pay the costs for your drugs until your total drug costs reach $2,000. After this, you enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The MeridianComplete (Medicare-Medicaid Plan) offers a wide range of benefits with varying cost-sharing. Many services have no copay, including emergency services, primary care, preventive services, vision, dental, ambulance services, home health, dialysis, medical equipment, and diagnostic services. Other services, such as hearing, outpatient, and mental health, have partial coverage, while some services like inpatient hospital upgrades and worldwide emergency services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered by the MeridianComplete (Medicare-Medicaid Plan), though Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital-Psychiatric are not covered. Prior authorization is required for both Acute and Psychiatric services.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services, are covered, but outpatient substance abuse services are partially covered. Outpatient blood services have an enhanced benefit with a three-pint deductible waived, and all services require prior authorization. Individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the MeridianComplete (Medicare-Medicaid Plan) and requires prior authorization. There is no cost for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the MeridianComplete (Medicare-Medicaid Plan), with no copay or coinsurance for all ambulance services. Transportation Services - Any Health-related Location are covered, but Ground Ambulance Services, Air Ambulance Services, and Transportation Services - Plan Approved Health-related Location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, are covered by the MeridianComplete (Medicare-Medicaid Plan) with no copay and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The MeridianComplete (Medicare-Medicaid Plan) covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, with no copay or coinsurance for Occupational Therapy and Physical Therapy, Speech-Language Pathology Services. Chiropractic Services and Mental Health Specialty Services are partially covered, but Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, and Group Sessions for Mental Health Specialty Services are not covered, as well as Individual Sessions for Psychiatric Services and Group Sessions for Psychiatric Services. Podiatry Services are not covered.
Preventive Services See details
The MeridianComplete (Medicare-Medicaid Plan) covers Medicare-covered preventive services with no copay, but does not cover annual physical exams. Additional preventive services, including Health Education, are covered, while services like In-Home Safety Assessments, Personal Emergency Response Systems, and several others are not covered. Other preventive services like Glaucoma Screening and Diabetes Self-Management Training are covered.
Hearing Services See details
Hearing services are partially covered by the MeridianComplete (Medicare-Medicaid Plan), with hearing exams and fitting/evaluation for hearing aids covered, but routine hearing exams, prescription hearing aids - inner ear, prescription hearing aids - outer ear, prescription hearing aids - over the ear, and OTC hearing aids are not covered. Fitting/evaluation for hearing aids are limited to 2 visits every year, and prescription hearing aids (all types) are covered once every 5 years.
Vision Services See details
The MeridianComplete (Medicare-Medicaid Plan) plan covers vision services, including routine eye exams with no copay, and eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames with no copay. Upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Orthodontic services and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Medicare Part B Insulin Drugs are covered, but Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical equipment benefits are covered under the MeridianComplete plan, including Durable Medical Equipment, with no copay or coinsurance, and Prosthetics/Medical Supplies - Non-Medicare benefit, with no copay or coinsurance. The plan does not cover Durable Medical Equipment for use outside the home, Diabetic Supplies, Diabetic Therapeutic Shoes/Inserts, Prosthetic Devices, or Medical Supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the MeridianComplete (Medicare-Medicaid Plan), but some services are not covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. There is no copay for covered services.
Home Health Services See details
Home Health Services are covered under the MeridianComplete (Medicare-Medicaid Plan) with no copay or coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services are covered, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, including additional days beyond Medicare-covered, with prior authorization required. Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for over-the-counter (OTC) items and additional services, while acupuncture, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Over-the-counter (OTC) items have a maximum plan benefit coverage amount of $20.00 every month. Private Duty Nursing Services and Other 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18, 20, 21, 22, 23, and 24 are also covered. Nursing Home Services is covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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