There are certain medications that MCHCP will cover at 100% when accompanied by a prescription and filled at a network pharmacy (40% coinsurance after deductible when using non-network pharmacy). Covered drugs are those described in the U.S. Preventive Services Task Force (categories A and B) and Health Resources and Services Administration (HRSA) Guidelines for women, as well as infants, children and adolescents, including the American Academy of Pediatrics Bright Futures periodicity guidelines.
Preventive services are designed to help identify potential health risks, allowing for early diagnosis and treatment. When done regularly, members not only save valuable time and money, but also experience better overall health outcomes. View Medical Benefit Details for more information.
Vaccinations recommended by the Advisory Committee for Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) are covered.
Non-network vaccinations are covered 100% for ages from birth to 72 months, 40% coinsurance after deductible for persons age 6 and older. When preventive vaccinations are obtained from a non-network provider or pharmacy, the member must submit a receipt and a Vaccine Reimbursement (Non-network) form to their medical plan to receive reimbursement up to $25.
1Preferred drug as determined by ESI
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