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HAP CareSource MI Health Link (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HAP CareSource 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 HAP CareSource MI Health Link (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
HAP CareSource MI Health Link (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Henry Ford Health System available for enrollment in 2025 to people living in Macomb and Wayne Counties. The overall rating for this plan is not yet available for 2025.
It's important to know that HAP CareSource 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:
HAP CareSource 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 HAP CareSource 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 HAP CareSource 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 HAP CareSource 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 HAP CareSource MI Health Link (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. This plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay the costs for your drugs until your total drug costs reach $2000. Once you reach this amount, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The HAP CareSource MI Health Link (Medicare-Medicaid Plan) offers a variety of benefits with a focus on no-copay services. Many services, including primary care, emergency services, ambulance services, vision, dental, home health, and medical equipment, are covered with no copay or coinsurance. This plan also includes coverage for hearing aids, and offers additional benefits like home infusion services, dialysis, and skilled nursing facility stays. While many services are covered, it's important to note some limitations. Prior authorization is required for certain services like inpatient hospital and home infusion, and some services like certain outpatient services, and specific services like cardiac rehabilitation, and some dental and vision upgrades are not covered. Additionally, some services, such as durable medical equipment for use outside the home, and additional home health services may not be covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric care, are covered, with prior authorization required. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered, but individual and group sessions for outpatient substance abuse are not covered. Prior authorization is required for outpatient hospital services and outpatient substance abuse services, and a doctor referral is required for observation services, ambulatory surgical center services, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the HAP CareSource MI Health Link (Medicare-Medicaid Plan). Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the HAP CareSource MI Health Link plan. All 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 with no copay or coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the HAP CareSource MI Health Link (Medicare-Medicaid Plan) with no copay or coinsurance. However, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The HAP CareSource MI Health Link plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Additional Telehealth Benefits, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services with no copay and no coinsurance. Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are partially covered, with routine chiropractic care, individual sessions, and group sessions not covered. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, health education, medical nutrition therapy, enhanced disease management, remote access technologies, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following Welcome Visits. Annual physical exams, in-home safety assessments, personal emergency response systems, 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, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids, with some sub-services not covered. Fitting/evaluation for hearing aids is covered for up to two 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 once every two years, and eyewear benefits such as contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, each covered once per year; however, upgrades are not covered. This plan has no copay or coinsurance for covered services.
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, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin, but Medicare Part B Chemotherapy/Radiation Drugs are not covered. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the HAP CareSource MI Health Link (Medicare-Medicaid Plan). This plan has coverage for Dialysis Services, with no copay or coinsurance.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME) and other non-Medicare covered equipment, is covered with no copay or coinsurance, but Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit is covered with no copay or coinsurance, and requires a doctor referral. Diabetic Equipment is covered, but diabetic supplies and therapeutic shoes/inserts are not.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, 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 the covered services.
Home Health Services See details
Home Health Services are covered by the HAP CareSource MI Health Link (Medicare-Medicaid 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 generally covered, but specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. A doctor's referral is required to receive these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization and a doctor's referral required. Additional days beyond Medicare-covered SNF stays are covered, and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items, a meal benefit, Private Duty Nursing Services, Other 1 (Adaptive Medical Equipment and Supplies), Other 2 (Adult Day Program), Other 3 (Assistive Technology Devices), Other 4 (Assistive Technology Van Lifts and Tie Downs), Other 5 (Chore Services), Other 6 (Community Transition Services), Other 7 (Environmental Modifications), Other 8 (Expanded Community Living Supports), Other 9 (Fiscal Intermediary Services), Other 10 (Home Delivered Meals), Other 11 (Non-medical Transportation), Other 12 (Personal Emergency Response System), Other 13 (Preventive Nursing Services), Other 14 (Respite - Waiver Service), Other 15 (Respite - General Service), Other 18 (Stipend for Maintenance Costs of a Service Animal), Other 20 (Doula Services), Other 21 (Michigan Diabetes Prevention Program (MiDPP)), Other 22 (Targeted Case Management Services for Recently Incarcerated Beneficiaries), Other 23 (MDHHS Community Health Worker (CHW) Policy), Other 24 (Group Prenatal Care Services) and Nursing Home Services. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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, Respiratory Care Services, Family Planning Services, Home and Community Based Services, Personal Care Services, Self-Directed Personal Assistance Services, and Freestanding Birth Center Services are not covered.
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