Family Planning Services

Plan First!  

Plan First! was Michigan’s Section 1115 Demonstration Waiver for family planning services. Plan First! covered women of child bearing years (ages 19 through 44) who are not eligible for Medicaid and whose other insurance does not cover family planning services, and whose income level is at or below 185 percent of the Federal Poverty Level (FPL).

 


The Plan First! Waiver ended June 30, 2016.

MDHHS stopped accepting new applications for Plan First! effective April 1, 2014, as part of a planned phase-out of the waiver.  MDHHS has taken steps to review eligibility for all current Plan First! enrollees to determine whether they are eligible for any other Michigan Medicaid programs, including the Healthy Michigan Plan.  Plan First! coverage for all enrollees will end when their eligibility for other programs has been determined.

 

 

Covered Services

Services covered under the waiver included:

  • Initial physical exam and health history, including patient education and counseling relating to reproductive health and family planning options;
  • Annual physical examination for reproductive health/family planning purposes, including a pap smear and testing for sexually transmitted infections when indicated;
  • Brief and intermediate follow-up office visit related to family planning;
  • Necessary family planning/reproductive health-related laboratory procedures and diagnostic tests;
  • Contraceptive management, including drugs and supplies;
  • Insertion, implant or injection of contraceptive drugs or devices;
  • Removal of contraceptive devices;
  • Sterilization services and related laboratory services (as long as a properly completed sterilization consent form has been submitted); and
  • Medications required incidental to or as part of a procedure done for family planning purposes.
 

The Family Planning service benefit will not include coverage of abortions or treatment of infertility. Additional coverage information can be found in the Family Planning Chapter of the Medicaid Provider Manual.

Click here for a list of covered Plan First! Family Planning codes. 

 

Service Delivery System

Professional services related to family planning were available from and billed to MDHHS 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 were 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) provided and billed for services as well. Family planning services were available statewide.