MetroHealth Care Plus
Frequently Asked Questions
About MetroHealth Care Plus
For Patients With Existing Coverage at MetroHealth
Coverage & Services
Do I qualify for this program?
If you received the welcome package and letter, we have determined ahead of time that you do qualify for the program. If you have not applied, view a list of requirements.
I have my card. What do I do now?
If you haven’t seen your primary care physician in the past 12 months, you should make an appointment. If you don’t have a primary care physician, you should call and ask for an appointment with one. You need to do this because you will need referrals from your primary care physician to see specialists. To make an appointment, call 800-362-4934 or request one online.
If you are a woman, have you seen an OB/GYN in the past 12 months? If not, you should also make an appointment with your OB/GYN. If you don’t have an OBGYN, you should call and ask for an appointment with one.
What is my co-pay?
There is no co-pay for medical services, devices and prescriptions which are covered under this program.
I am already on Plan 100, Plan 200, the Community Discount Program, or another assistance program. Why should I apply for MetroHealth Care Plus?
This coverage expands what you were getting under another MetroHealth financial help plan. You will have no co-pays with MetroHealth Care Plus. To see if you are eligible, call the MetroHealth Eligibility Call Center at 216-957-2325, Monday – Friday, 8 a.m. – 5 p.m.
How do I find out what specific prescription drugs are covered?
You can find out what is covered by calling the prescription number listed on your benefit card.
Where can I get my prescriptions filled and what is my co-pay?
You will have no co-pay for prescriptions that are written by a network provider and filled at a MetroHealth pharmacy.
What kind of dental care will I have?
You’ll be allowed one dental exam and cleaning every 12 months.
Fillings, extractions, anterior crowns and root canals will be covered when approved by a MetroHealth dentist.
Braces, implants and other services are not covered.
Which specific medical devices are covered?
Covered medical devices include:
- Canes, crutches and walkers
- Oxygen supplies, including CPAPs
- Wheelchairs are covered, but require physician referral
Other medical equipment requires authorization, so check with your doctor.
I’m a diabetic. What supplies are covered and how often?
All diabetic supplies are covered. All supplies must be approved by your primary care physician.
So anytime I go to the emergency room, I’ll have full coverage, right?
You must be experiencing a true emergency to have coverage for emergency room visits.
What is a true emergency?
This would include:
- Bleeding that does not stop
- Chest pain
- Drug or other poisoning
- Major burns
- Loss of consciousness
- Difficulty breathing
- Sudden loss of vision or blurred vision
- Symptoms of stroke