Saginaw Health Plan does not cover the following services and payment will not be made for:
- Inpatient hospital services
- Case management
- Custodial or nursing home care
- Chiropractic services
- Experimental procedures, treatments or drugs
- Comfort or convenience items
- Prosthetics and orthotics, corrective shoes or wigs
- Speech, physical or occupational therapy
- Urgent care clinics–facility charges
- Private duty nurses
- Hearing aid services or materials
- Weight reduction services or programs (non surgical weight reduction services)
- Services considered to be cosmetic (those not considered a medical necessity)
- Home health services or personal care
- Hospice care
- Services or supplies related to sex or gender change
- Vision exams, eyeglasses or contact lenses (exams by referral related to chronic illness are covered)
- Podiatry services (exams by referral due to chronic illness are covered)
- Dental services
- Smoking cessation programs
- Transportation (non-ambulance)
- Emergency transportation by air
- Any condition for which an enrollee is eligible to receive health care services or benefits through a public or private benefit, program or insurance
- Lodging expenses
- Office visits, exams, treatments or tests related to documentation of health for employment, insurance, marriage license, school, sports physicals, citizenship or any legal proceeding or court-mandated activity
- Services received before the effective date of coverage or after the termination of enrollment
- Over-the-counter medicines or supplies such as first aid materials or vitamins
- Services not approved by the SHP doctor on your enrollment card or a specialist you are referred to
- Services that are not medically necessary
- Immunizations required for travel
- Maternity or obstetrical services*
*You should contact the Saginaw County Michigan Department of Human Services office (formerly known as the Saginaw County Family Independence Agency or FIA) if you become pregnant while a member of Saginaw Health Plan. Ask about Medicaid eligibility as soon as possible. Remember to avoid drugs and alcohol if you think you might be pregnant.