What's Covered

Below are some of the services covered by Passport Health Plan. Please call Member Services for more details.

• Alternative birthing center services.
• Ambulatory surgical center services.
• Ambulance transportation for emergencies – when you are transported in an emergency condition, usually to the hospital, resulting from an accident, serious injury, or illness that makes it impossible to use other types of transportation.
• Ambulance transportation for some nonemergencies (if needed) – when you cannot get out of bed before or after receiving medical care or you must be moved by a stretcher in order to receive care.
• Non-emergency transportation (See the Transportation Sheet in the back of the Handbook.)
• Basic dental care.
• Basic hearing care.
• Basic vision care.
• Behavioral health services (see page 13 of the Handbook).
• Case management services.
• Chiropractic services.
• Disease screenings and treatment – such as tuberculosis, HIV, AIDS, HPV and sexually transmitted diseases.
• Durable medical equipment (DME) and supplies - such as wheelchairs or crutches.
• Early and Periodic Screening, Diagnosis and Treatment (EPSDT) – health checkups, screenings, and immunizations for children,from birth to age 21. See more information about EPSDT on page 19 of the Handbook.
• End stage renal dialysis services.
• Family planning (birth control).
• Flu shots.
• Home health services.
• Hospice care.
• Hospital services – inpatient and outpatient.
• Immunizations (shots).
• Long term care (see page 13 of the Handbook)
• Meals and lodging for appropriate escort of members.
• Medical care during pregnancy.
• Medical detox.
• Organ transplant services.
• Physical, occupational, and speech therapy.
• Podiatry (foot) services.
• Prescription drugs – some may require prior authorization.
• Preventive health services.
• Provider office visits – routine, urgent, and emergency care.
• Some over-the-counter drugs prescribed by a provider.
• Specialty care – most members need a referral from a PCP to see a specialist. Members who are in out-of-home placement (foster care, etc.), Medicare or Passport Advantage, do not need a referral to see a specialist signed up with the Plan.
• X-rays and laboratory services.

Direct Access Services

As a Passport Health Plan member, you may get some services without seeing your PCP. These services are called Direct Access Services.

Here is a list of direct access services that you may get without going to see your PCP:

• Chiropractic care.
• Dental care.
• Diabetes eye test.
• Family planning (birth control).
• Maternity care.
• Immunizations (shots).
• Routine women’s care (GYN - gynecology).
• Mammogram – breast cancer screening.
• Pap smears – cervical cancer screening.
• Basic vision care.
• Sexually transmitted disease screening, evaluation and treatment.
• Tuberculosis screening, evaluation and treatment.
• Testing for Human Immunodeficiency Virus (HIV), HIV-related conditions, and other diseases passed from person to person.