Zing Open Choice MI (PPO)

Inpatient Hospital See details

The Zing Open Choice MI (PPO) plan covers inpatient hospital stays, including acute and psychiatric care, with a copay of $310 for days 1-6 and no copay for days 7-90. Additional days for inpatient hospital-acute are covered with no copay. Non-Medicare-covered stays and upgrades for inpatient hospital-acute and additional days for inpatient hospital psychiatric are not covered.

Outpatient Services See details

Outpatient Services include coverage for Outpatient Hospital Services with a $250 copay, Observation Services with a $75 copay, Ambulatory Surgical Center (ASC) Services with a $225 copay, and Outpatient Substance Abuse Services with no copay for both individual and group sessions. Outpatient Blood Services are covered with no copay.

Partial Hospitalization See details

Partial Hospitalization is covered under the Zing Open Choice MI (PPO) plan, but requires prior authorization. You will pay a $70 copay for this benefit.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered by the Zing Open Choice MI (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $225 copay, and air ambulance services have a 20% coinsurance, while transportation services to any health-related location are not covered.

Emergency Services See details

Emergency Services, including Urgent and Worldwide Emergency Coverage, are covered by the Zing Open Choice MI (PPO) plan. Emergency Services have a $125 copay with no coinsurance, and Urgent Care has a $0-$20 copay with no coinsurance. Worldwide Emergency Transportation is not covered, and Worldwide Emergency Services have a maximum benefit of $50,000.

Primary Care See details

The Zing Open Choice MI (PPO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a $40 copay, while physician specialist services have a $20 copay. Mental health specialty services, including both individual and group sessions, have no copay. Podiatry services and other health care professional services have a $30 copay, while psychiatric services including individual and group sessions have no copay. Physical therapy and speech-language pathology services have a $40 copay, and additional telehealth benefits have a copay between $0 and $35. Opioid Treatment Program Services have a $35 copay.

Preventive Services See details

Preventive Services are covered, including an annual physical exam with no copay. Other covered preventive services include glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit, all with no copay.

Hearing Services See details

Hearing Services include hearing exams with a $35 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a $750 maximum benefit every three years. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.

Vision Services See details

Zing Open Choice MI (PPO) covers vision services, including eye exams with a $35 copay, and eyewear with no copay. Routine eye exams are covered with no copay, and eyewear has a combined maximum plan benefit of $200 per year.

Dental Services See details

The Zing Open Choice MI (PPO) plan covers dental services with no copay, up to a maximum of $2,000 per year for both in-network and out-of-network services. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are covered with no copay, but are limited to one visit every six months, one per year, one visit every six months, and one per year respectively. Maxillofacial prosthetics, implant services, and orthodontics are not covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered under the Zing Open Choice MI (PPO) plan. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. Other Medicare Part B drugs have a coinsurance between 0% and 20%.

Dialysis Services See details

Dialysis Services are covered under the Zing Open Choice MI (PPO) plan. You will pay 20% coinsurance for these services.

Medical Equipment See details

Medical Equipment benefits are covered by the Zing Open Choice MI (PPO) plan, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. The plan does not cover Durable Medical Equipment for use outside the home. Diabetic Supplies have between 0% and 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, lab services, and all radiological services. Diagnostic Procedures/Tests have a maximum copay of $85, while Lab Services have no copay, and Diagnostic Radiological Services have a copay between $50 and $150.

Therapeutic Radiological Services have a coinsurance of 20%, and Outpatient X-Ray Services have a copay of $15.

Home Health Services See details

Home Health Services are covered by the Zing Open Choice MI (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are not covered by the Zing Open Choice MI (PPO) plan. The plan also does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered by the Zing Open Choice MI (PPO) plan, with prior authorization required. There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond what Medicare covers, and non-Medicare-covered stays, are not covered.

Other Services See details

The Zing Open Choice MI (PPO) plan covers Over-the-Counter (OTC) Items with no copay and a maximum plan benefit coverage amount of $174 every three months. The plan also covers Meal Benefit with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing 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, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.