Benefits and Services Overview
Buckeye Health Plan provides the same benefits as Medicaid, plus more. In this section, you can learn about the health benefits, pharmacy services and value added services Buckeye Health Plan offers.
You can also view more information about Buckeye Health Plan in our Member Handbook.
Buckeye provides round trip coverage for covered services 30+ miles away. In addition, Buckeye offers up to 15 round-trip visits (30 one-way trips) per member per 12- month period to covered healthcare/dental appointments, WIC appointments, redetermination appointments with your CDJFS caseworker, as well as pharmacies following a doctor appointment. Members can call directly 48 hours (two business days) in advance at 1-866-246-4358 (TDD/TTY: 1-800-750-0750) to schedule transportation. Members with questions or problems with transportation services may call Buckeye Member Services at 1-866-246-4358 (TDD/TTY: 1-800-750-0750).
Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Buckeye Health Plan pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more.
Buckeye Health Plan is proud to be working with SafeLink Wireless to offer you this special, federal program. As a Member of our plan, you get all the same benefits of a SafeLink phone, plus unlimited inbound text messages and calls to Buckeye Health Plan member services. There is no added cost for these extras.
How to Enroll:
As a Buckeye Health Plan Member, you can choose who you see for your healthcare needs from our network of Providers. We have many for you to choose from.
For the most part, you must get care from our network of healthcare providers. If you cannot get a covered service from one of our plan providers, we can allow the use of a non-plan provider for as long as needed. There will be no additional cost to you. Call us if you need help getting services.
Buckeye’s dental services include two periodic oral exams and cleanings per year (more than what is available with fee-for-service Medicaid).
Buckeye provides annual eye exams for children AND adults. Eyeglasses are provided annually for children under the age of 21 and adults age 60 or older and every two years for adults age 21 through 59. We offer an expanded selection of eyeglass frames to choose from, a wider selection than what is available with fee-for-service Medicaid. Please check the provider directory for a list of doctors contracted with Buckeye.
Buckeye will provide $50 toward the purchase of contact lenses, per member per year (every two years for adults age 21 through 59), and $50 toward the contact lenses fitting fee your vision provider charges, per member per year (every two years for adults age 21 through 59). Contacts are not covered by fee-for-service Medicaid. Contacts and glasses may not be obtained in the same year (or in the same two years for adults age 21 through 59).
Preventative care visits are covered by Buckeye Health Plan. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.
Buckeye Health Plan covers an annual physical for adults.
Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.
- Birth or neonatal exam
- 1 week
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 months
- 20 months
- After 30 months of age until age 21: one exam per year is recommended.
Keeping children healthy and growing the way they should is important. A big part of this is seeing the doctor regularly for Healthchek screenings—even when your child is not sick—in order to make sure your child stays healthy. Healthchek screenings help find problems or possible problems early, before they become serious. If a problem is found, Healthchek includes medically necessary follow-up care and referrals. Healthchek screenings are provided from birth to under 21 years of age. These services are covered as part of your Medicaid Care Coordination Plan.
For information on the HEALTHCHEK program please contact Buckeye Health Plan at 1-866-246-4358 (TDD/TTY: 1-800-750-0750) and ask to speak with the Quality Improvement Department or get in touch with your county’s Healthchek Coordinator by contacting your county department of job and family services.
Our Nurse Advice Line is ready to answer your health questions 24-hours-a-day – every day of the year. The Nurse Advice Line is staffed with Registered Nurses. These nurses have spent lots of time caring for people. Now they are ready and eager to help you. The services listed below are available by contacting the Nurse Advice Line, Buckeye’s 24-hour nurse hotline, at 1-866-246-4358 (TDD/TTY: 1-800-750-0750).
Through our MemberConnections program, we can help you get the support you need. A MemberConnections team member can talk to you over the phone. They can also visit your home. They can talk to you about things like how to choose a doctor, plan benefits and living healthy. They can also connect you to community social service programs. These programs will help you with food, housing and clothing.
Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant and for those moms who just had a baby. We want to help you take care of yourself and your baby every step of the way. If you are pregnant, please let us know by completing a Notification of Pregnancy form. After completing this form you will be enrolled in Start Smart. You will receive information in mail and over the phone. You can also get information in the Health & Wellness section.
Tips for Pregnancy
If you are pregnant or want to become pregnant, keep these things in mind:
- Go before you show! Go to the doctor as soon as you think you are pregnant. It is important for you and your baby to see a doctor as early as possible. It will keep both of you healthy. It will also help your baby get off to a good start. It is even better to see a doctor before you are pregnant. This is so you can get your body ready for pregnancy.
- Maintain healthy lifestyle habits. This includes exercising, eating balanced and healthy meals, and resting for 8-10 hours every night.
- Do not use tobacco, alcohol or drugs now or while you’re pregnant.
Doctors and health organizations agree that breastfeeding is best. You may already know that breast milk is packed with the perfect mix of nutrients your baby needs. Did you know that it is also more than just food? Breast milk has special ingredients, like antibodies, that only you can provide. Breast pumps are helpful if you are breastfeeding and have to be away from your baby. Call us after you deliver to see if breast pumps are offered.
Are You Pregnant? Tell Us Right Away!
Call us. Or, you can login to your Buckeye Health Plan account and fill out the Notification of Pregnancy form.
Text 4 Baby
Members can enroll in the text4baby program by texting "Baby" ("Bebe" for Spanish) to 511411. For more information, call Member Services at 1-866-246-4358.
Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.
If you need something translated into a language other than English, please call Buckeye Health Plan. We can also provide things in other formats such as Braille, CD or large print.
If you need an interpreter for your medical appointment, contact Buckeye Health Plan x before your appointment. We will arrange for one to be at your appointment.
All services must be medically necessary. Your Primary Care Provider will work with you to make sure you get the services you need. These services must be given by your Primary Care Provider or by another provider that your Primary Care Provider refers you to.
Some services may:
- Have coverage limits.
- Need a doctor’s order.
- Need prior approval.