What's Covered?

As a Member of Well Sense You Receive

A Member Handbook

This tells you how to use your plan and includes a list of Covered and Excluded Services in Chapter 4.

Member Handbook - English 
Member Handbook - Spanish
Member Handbook Addendum for February 2021

Benefits available under Medicaid:

  • Visits with a doctor for your routine healthcare
  • Visits with specialists (doctors who have extra training in an area of medicine)
  • Telehealth behavioral health support where you can talk to a counselor or psychiatrist online or through a mobile app
  • Emergency room visits in an emergency
  • Screenings for diabetes, allergies, heart disease, etc.
  • Access to mental health and substance abuse services
  • Routine eye exam every 12 months
  • Prescriptions for little or no cost
  • Substance use treatment
  • Non-emergency transportation to your medical appointments (check your Member Handbook for details and download the reimbursement form)

And Extra benefits*:

  • Healthy Rewards card to buy drugstore items
  • Extras like dental kits, bike helmets, diapers, and car seats
  • Money back for gym memberships and Weight Watchers® reimbursements
  • Mobile app to access your personal health information and mobile ID card

Some restrictions and limitations may apply. Earn up to $250 in cash and non-cash goods and services each State fiscal year which runs from July 1 to June 30.

You must visit healthcare providers that partner with Well Sense (also called in-network providers). You may need prior approval before a service will be covered. You or your doctor may confirm if the service requires a prior authorization by checking our Medical Procedure Code Lookup Tool or our Supplies and Services Code Lookup Tool.

**We're always working to improve the quality of our services for members. If you're interested in learning more, you can read our Quality Improvement Work Plan Evaluation. You can also read our EPSDT Program Plan to learn more about our early and periodic screening, diagnostic and treatment program for children under age 21. Read the Well Sense Health Plan Quality Improvement Program Executive Summary.
 

Flu Season is Here

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Flu season is here, and it's time to get your flu shot! Remember, the flu is caused by a virus so if you do get it, antibiotics won't help.

Get Flu Tips

Translation Services Available

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Do you need help interpreting something in another language? We can help! Call us at 877-957-1300.

Dental Kits, Bike Helmets and More for Members

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Check out our extra benefits for Well Sense members! Some age and frequency limitations may apply.

Get Extras

Health Texting

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Stay on top of your health with our text messaging program. Receive reminders and wellness tips straight to your phone.

If you have Medicaid, you may even be eligible for a smartphone, at no cost to you, through the Lifeline program.

Learn More