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Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by DLP Marquette General Hospital, LLC available for enrollment in 2025 to people living in Upper Peninsula of Michigan. The overall rating for this plan is not yet available for 2025.
It's important to know that Upper Peninsula Health Plan MI Health Link (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:
Upper Peninsula Health Plan MI Health Link (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 Upper Peninsula Health Plan MI Health Link (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 Upper Peninsula Health Plan MI Health Link (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 Upper Peninsula Health Plan MI Health Link (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 Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan) has a $0 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $0 for your Part D drugs. Once you pay your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Upper Peninsula Health Plan MI Health Link plan offers a variety of benefits, including coverage for inpatient and outpatient services, emergency services, primary care, vision, and dental services. Many services have no copay, including ambulance services, emergency services, medical equipment, diagnostic and radiological services, and home health services. This plan also provides coverage for hearing services, with hearing exams, hearing aid fittings, and prescription hearing aids covered. Additional benefits include dialysis services, home infusion services, and skilled nursing facility services, though some services may require prior authorization or doctor referrals.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but non-Medicare-covered stays, additional days for inpatient psychiatric, and upgrades for inpatient acute are not covered. Additional days for inpatient acute care are covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient substance abuse services are covered, but individual and group sessions are not.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. There is no information about the cost of services.
Ambulance and Transportation Services See details
Ambulance services are covered with no copay or coinsurance, but ground and air ambulance services are not covered. Transportation services to any health-related location are covered, and there is no copay, coinsurance, or service-specific maximum.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan) with no copay and no coinsurance. However, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
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 are covered. Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are partially covered, with routine chiropractic care, individual sessions for Mental Health Specialty Services, group sessions for Mental Health Specialty Services, individual sessions for Psychiatric Services, and group sessions for Psychiatric Services not covered.
Preventive Services See details
Preventive services are covered under the Upper Peninsula Health Plan MI Health Link plan. However, annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids (all types), but routine hearing exams, prescription hearing aids (inner ear, outer ear, and over the ear), and OTC hearing aids are not covered. Fitting/evaluation for hearing aids is covered for 2 visits every year, and prescription hearing aids (all types) are covered once every 5 years.
Vision Services See details
Vision services include routine eye exams with one visit every two years, and eyewear including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, with one pair of contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames covered every year. Upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams (1 every six months), dental x-rays, other diagnostic dental services, prophylaxis (cleaning) (1 every six months), fluoride treatment (6 per lifetime), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, prosthodontics, fixed, and oral and maxillofacial surgery. However, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs. Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by the Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan) with a required doctor referral. The plan does not specify cost-sharing details like copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefit, with no copay or coinsurance. However, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for covered services.
Home Health Services See details
Home Health Services are covered, including Additional Home Health Services under "Other 1". There is no copay or coinsurance for these services, though authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan). Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, including additional days beyond Medicare coverage; however, a non-Medicare-covered stay for SNF is not covered. Prior authorization and a doctor referral are required.
Other Services See details
The Upper Peninsula Health Plan MI Health Link plan's "Other Services" benefit covers Private Duty Nursing Services, Other 1, Other 2, Other 3, Other 4, Other 5, Other 6, Other 7, Other 8, Other 9, Other 10, Other 11, Other 12, Other 13, Other 14, Other 15, Other 18, Other 20, Other 21, Other 22, Other 23, Other 24, and Nursing Home Services. Acupuncture, Over-the-Counter (OTC) Items, Meal Benefit, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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