Healthy Blue benefits

As a Healthy Blue member, you get all of your Medicaid benefits and services, including:

• Primary care provider (PCP) visits
• Immunizations and wellness visits
• EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) services for members under 21
• Maternity care
• Hospital care
• Lab and X-ray services
• Home health and personal care services
• Hospice care
• Emergency and urgent care
• Specialty care
• Behavioral health services (mental health and substance abuse services)

See your member handbook for a full list of benefits. All services must be medically necessary.

Your benefits include a wide range of prescription and over-the-counter (OTC) medicines. We can even deliver your medicines to your home. We work with CarelonRx to provide these benefits.

Visit the pharmacy page to find a pharmacy near you and check if your medicine is covered.

Go to the Pharmacy page

Your benefits include routine eye exams and eyeglasses, if needed.

Find an eye doctor

This guide can help you know when to set up doctor visits and important screenings for you and your children. Ask your doctor which exams, tests, and vaccines are right for you, when you need them, and how often.

• View Preventive Health Guidelines – English
• View Preventive Health Guidelines – Spanish

You can get no-cost rides to and from your appointments. Visit the Transportation page to learn more about setting up a ride.

Go to the Transportation page

If you have a certain health condition or disability, you may need help with day-to-day activities, like eating, bathing, or doing household chores. You can get the help you need through Long Term Services and Supports (LTSS). LTSS includes services like home health and personal care services. You may get LTSS in your home, community or in a nursing home.

If you need LTSS, you may have a care manager on your care team. A care manager is a specially trained health professional who works with you and your doctors and other providers of your choice to make sure you get the right care when and where you need it.

If you are leaving a nursing home and are worried about your living situation, we can help. Our Housing Specialist can connect you to housing options as needed. Call Member Services at 844-594-5070 to learn more.

If you have questions about using LTSS benefits, talk with your PCP, a member of your care team or call Member Services at 844-594-5070.

Managing your health care alone can be hard, especially if you are dealing with many health problems at the same time. If you need extra support to get and stay healthy, we can help. As a member of Healthy Blue, you may have a care manager on your health care team. A care manager is a specially trained health professional who works with you and your doctors to make sure you get the right care when and where you need it.

Learn more about care management

We know that health care is more than just doctor visits. As a Healthy Blue member, you have access to no-cost extras to help you live your best. Contact Member Services to learn more about these value-added services. Note: Some benefits have eligibility requirements.

Transportation

• Uber gift card
• Rides to the doctor and pharmacy

Pregnant women and new moms

• Rewards for going to doctor visits (up to $50)
• Baby Essentials Catalog (such as stroller, safe sleep kit, breastfeeding support kit, etc.)
• Community baby shower
• Doula support (in select counties

Food and housing for eligible members

• Three months of fresh fruits and vegetables (up to $120 value)
• Help with hotel after hospital stay, must meet eligibility requirements. (up to $500 value)
• Help with housing insecurity and pending homelessness, must meet eligibility requirements.
• Help with home repairs, must meet eligibility requirements (up to $1,500 value)

Invest in your future

• GED exam voucher ($160 value)
• Old Navy^® or Footlocker^® gift card for 11th-12th graders with a 3.5 GPA and up
• School supplies for students ages 6-18 (up to $50 value)
• Twenty-four hours of free virtual tutoring for eligible members ages 6-18

Active and healthy lifestyle

• WW^® (formerly Weight Watchers) vouchers (13 weeks)
• Help paying for after-school sports and activities (up to $150 value)
• Cellphone with monthly data and texts (you must qualify for the Federal Lifeline program to access minutes and data)
• Asthma and allergy relief kit for adults and children
• Healthy rewards for completing wellness visits

Behavioral health support

• Up to 12 acupuncture treatments
• Up to five extra visits to the chiropractor
• Medicine safety kit with lockbox and pill case
• Products to help you manage pain (up to $25)

Long-term services and supports

• Up to 10 rides to personal appointments
• Sensory toys (up to $100 value)
• Scale, blood pressure cuff and more
• Alzheimer’s/dementia toolkit

You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub or call Member Services at 844-594-5070 (TTY 711) to redeem.

Log in to get started today.

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Healthy Rewards is a no-cost, optional program for Healthy Blue members. The
program encourages you to get the care you need and rewards you with gift cards to
popular retailers when you complete healthy activities, such as wellness visits and
preventive screenings. You may be eligible to earn rewards for some of the activities
below:

• Well-baby visits
• Well-child visits
• Adult wellness visits
• Human papillomavirus vaccination
• Rotavirus (2 or 3 dose) and Flu (2 doses) for children under age 2 years
• Cervical cancer screening
• Diabetes A1c screening
• Asthma controller medication refills
• Follow-up appointments after behavioral health hospitalizations
• Prenatal and postpartum care visits
• Care needs screener
• Annual flu vaccine
• Tobacco cessation 

Earn rewards

To see what you're eligible to earn, enroll in Healthy Rewards by logging in to your Healthy Blue account and visiting the Benefit Reward Hub. You can also enroll in the program or learn more by calling Healthy Rewards at 888-990-8681 (TTY 711) Monday through Friday from 9 a.m. to 8 p.m. Eastern Time.

If you need help setting up your Healthy Blue online account, call Member Services at 844-594-5070 (TTY 711).
 

Access Healthy Rewards

We can help you with issues beyond your medical care. The Healthy Opportunities Pilot (HOP) program covers certain nonmedical aids for high-risk members. These services help with housing, safety, food, and transportation.

The services may be available under Healthy Blue based on where you live and other factors, such as if you have a physical or behavioral health condition.

Learn more about the HOP program

Sometimes, life leads to stress, and stress can lead to depression and anxiety. Stress can lead to marriage, family and/or parenting problems, too. It can also lead to alcohol and drug use.

If you or a family member is having these kinds of problems, we can help. Call Healthy Blue Member Services at 844-594-5070 (TTY 711).

Your benefits include medically needed services, such as:

• Inpatient behavioral health services
• Outpatient behavioral health services
• Partial hospitalization
• Substance use treatment
• Crisis services

You can also get the name of a behavioral health specialist. You don’t need a referral from your primary care provider (PCP) to get these services or to see a behavioral health specialist in your plan.

If you think a behavioral health specialist does not meet your needs, talk to your PCP. They can help you find a different kind of specialist.

There are some treatments and services your PCP or behavioral health specialist must ask Healthy Blue to approve before you can get them. Your doctor will be able to tell you what they are.

If you have questions about referrals and when you need one, contact Member Services at 844-594-5070 (TTY 711) Monday through Saturday, 7 a.m. to 6 p.m. Eastern time. If you feel like you’re in crisis, please call our Behavioral Health Crisis Line at 844-594- 5076.

Chess Health

Finding recovery support can be scary at times, especially when life is coming at you fast. If you need support, the CHESS Health Connections app is here for you at no cost. With the CHESS Health Connections app, you’ll find peer support, daily motivations, substance monitoring, sobriety tracking and virtual support meetings. To find out more, call Member Services at 844-594-5070 (TTY 711) Monday through Saturday, 7 a.m. to 6 p.m. Eastern time.