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Family Planning Services
On March 1, 2006, the Centers for Medicare and Medicaid Services (CMS) approved Michigan's submission of a Section 1115 demonstration waiver to provide family planning services to Michigan citizens meeting certain eligibility requirements.
The demonstration waiver is approved for five (5) years with an implementation date of July 1, 2006. This program enables the Michigan Department of Community Health (MDCH) to provide family planning services to women who otherwise would not have medical coverage for these services.
Through this waiver, MDCH offers family planning services to women:
It is estimated that at least 200,000 women may meet this criteria. Beneficiary applications are available at local health departments, local Department of Human Services (DHS) offices and Title X clinics. For more information providers may call 1-800-292-2550.
A woman's coverage will continue for the duration of the waiver as long as the eligibility criteria are met. Program determinations will be completed annually. Family planning services are defined as any medically approved means, including diagnostic evaluation, pharmaceuticals, and supplies, for voluntarily preventing or delaying pregnancy.
There are no patient co-pays for family planning services, supplies or pharmaceuticals. Services covered under this waiver include:
The Family Planning service benefit will not include coverage of abortions or treatment of infertility.
Professional services related to family planning are available from and billed to MDCH by family planning clinics, primary care physicians (MDs and DOs) in public and private practice, and other Medicaid approved providers, i.e., Certified Nurse Midwives and Nurse Practitioners. In addition, Medicaid enrolled pharmacies, laboratories and outpatient hospitals are eligible to provide and bill for services, as appropriate. Federally Qualified Health Centers (FQHC), School-Based/Linked Health Centers, Rural Health Clinics (RHC), Tribal Health Centers and the sub-grantees of the Title X publicly funded family planning agencies (including local health departments, Planned Parenthood clinics and private non-profit family planning agencies) provide and bill for services as well. Family planning services are available statewide.
Should a beneficiary need primary care services beyond what is covered under Plan First!, the provider may either provide the services and work with a beneficiary to arrange payment options or they may refer or inform them how to access primary care services at the nearest FQHC. Click Here for a list of FQHC's in Michigan.
Note: the paper MSA-1582 form, Plan First! Application, is obsolete and is no longer an acceptable assistance application.
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