Saginaw Health Plan does not cover the following services and payment will not be made for:
- Inpatient hospital care
- Services needed as a result of a motor vehicle accident
- Services for illness that is covered under no fault law, worker’s compensation, occupational disease law or other legislation
- Custodial or nursing home care
- Chiropractic services
- Infertility or sterilization services
- Experimental procedures, treatments or drugs
- Comfort or convenience items
- Durable medical equipment, prosthetics and orthotics, corrective shoes or wigs
- Speech, physical or occupational therapy
- Hearing aid services or materials
- Weight reduction services or programs
- Services considered to be cosmetic
- Home health services
- Hospice care
- Services or supplies related to sex or gender change
- Vision exams, eyeglasses or contact lenses (exams related to chronic illness are covered with a referral)
- Dialysis services
- Podiatry services (exams for services because of chronic illness are covered with a referral)
- Outpatient services for TB screening or treatment
- Dental services, including oral surgery
- Substance abuse screening and treatment
- Mental health clinic services
- Organ transplants
- Maternity or obstetrical services**
- Medical services to anyone incarcerated
- Diagnosis or treatment of an injury or illness which occurs from an act of war, commission of a felony or illegal business
- Contraceptive methods or fertility drugs
- 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
- Emergency transportation by air
- 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 Saginaw Health Plan doctor on your enrollment card or a specialist you are referred to
- Services that are not medically necessary
- Emergency services outside of Michigan
**If you become pregnant while a member of Saginaw Health Plan, you should contact the local Department of Human Services and ask about Medicaid eligibility as soon as possible. Remember to avoid drugs and alcohol if you suspect you may be pregnant.