As of 2016, benefits covered under the Meridian Health Plan of Michigan include dozens of procedures, such as allergy, hearing, mammogram and cardiac stress testing, chemotherapy, bone density studies, and brain and lymph node surgeries, according to Meridian. When patients obtain prior approval, the plan covers treatment and services including pulmonary and cardiac rehabilitation, infusion therapy and hospice, and equipment including hearing aids, and orthotics and prosthetics that cost more than $1,000. Patients don't need referrals for services covered.
The Meridian plan requires that patients' doctors notify Meridian about certain tests, services or treatments before the patients receive them, explains the Meridian Health Plan of Michigan. Doctors must provide notice to Meridian before patients receive outpatient radiation therapy, dialysis, delivery and maternity care, and outpatient mental health care if the patient has more than three visits. Meridian also requires doctors to give notice before consults and office visits with specialists.
Patients must obtain plan approval prior to inpatient emergency admissions and surgeries in the plan network of providers and 23-hour observations outside the coverage network, notes Meridian Health Plan of Michigan. To obtain emergency approval, doctors or patients must notify Meridian within the first 24 hours or the following business day. Hospitals outside of network must notify Meridian once they stabilize patients, and the hospitals must request approval before providing care after stabilization.