MEDICAL SERVICES

Here is a list of some of the medical services and benefits that are covered by Harmony Health Plan.  You can also look in your Certificate of Coverage for a complete list. You can find a copy on our Web site at www.harmonyhpi.com if you do not have one. You can also have a copy sent to you.  Just call Member Services at 1-800-608-8158.

Covered

• Hospital inpatient services

• Home health care services

• Physical therapy

• Speech and language therapy

• Laboratory and X-ray services

• Transportation

• Emergency services

• Transplant services (non-experimental)

• Family planning services (also at non-affiliated providers covered by the Illinois Medical Assistance program)

• Contraceptive devices

• Durable and non-durable medical equipment and supplies

• Whole blood and blood products

• Physician services

• Hospital outpatient services

• Mental health and substance abuse services

• Preventive services

• Alcohol and substance abuse treatment services

• Early periodic screenings and diagnostic testing services

• Maternity care services

• Well-child care services

• Health education

• Skilled nursing care (first 90 days)

• Immunizations

• Hospice

• Chiropractic services

• Podiatric services

• Orthotic/prosthetic devices, including prosthetic devices or reconstructive surgery incident to mastectomy

• Nurse midwife services

• Medical procedures performed by a dentist

• Ophthalmologist (eye specialist)

Not Covered

• Elective cosmetic surgery

• Custodial care services

• Elective abortions

Covered by HFS Medical Card

• Optical / Vision

• Dental services

• Pharmacy

Harmony Additional Benefits

• HFS pharmacy co-pays covered*

• No co-pays for doctor visits

• Dental care for adults (21 years and older)*

- One Periodic Oral evaluation every 12 months

- One Adult Prophylaxis (cleaning) every 12 months

• Harmony Hugs—Harmony Hugs is our special program for pregnant women. You’ll work with a case manger who will make sure you stay healthy and get all your needed exams. These exams are important for you and your baby.

• Harmony Healthy Kids Club

• Harmony +10 Personal Care items can be ordered online.

• Additional transportation to WIC offices, pharmacies, unlimited DME visits, including siblings, and visits to hospitalized family members.

• NurseLink toll-free 24-hour access for routine medical advice.

• Hospital to Home—complete aftercare visits after seven days and then again within 30 days of your behavioral health hospital stay. We’ll send you a $10 gift card after each visit.

At participating providers.

Service, service, service! You can call Member Services any time you have a question. Just call 1-800-608-8158 (TTY 1-877-650-0952).