Member resources

We want to make sure you have the information you need at your fingertips. Below are important resources that will help you understand and use your benefits.


Online access to your HAP Empowered membership

We make it easy for you to access your health plan information with an online HAP account.

Once you register you just have to log in to:

  • Print your ID card or download it to your phone.
  • Send our Customer Service team a secure message.
  • Search our list of doctors and hospitals.
  • Check on your claims.

 

HAP OnTheGo

You can also use the HAP OnTheGo mobile app to simply:

  • Find a doctor, urgent care or hospital.
  • View your member ID card.
  • Find HAP contact information.

HAP OnTheGo is free and in the Apple and Google Play app stores.

Medicaid member information

  • Important contact information | Language assistance

    HAP Empowered Customer Service   (888) 654-2200 (TTY: 711)
    Appeals and grievances  (888) 654-2200 (TTY: 711)
    Medical Management  (888) 654-2200 (TTY: 711)
    Transportation help  (888) 654-2200 (TTY: 711)
    24-hour Nurse Advice Line  (877) 394-0665
    Dental for Healthy Michigan Plan and pregnant women  (800) 838-8957
    Hearing  (877) 484-2688
    Vision  (800) 252-2053
    Pharmacy  (800) 922-1557
    Report Fraud/Waste/Abuse  (866) 622-8980
    Smoking Cessation Program  1-800-QUIT-NOW or (800) 784-8669
    Wellness Program  (248) 663-3889

    Michigan Department of Health and Human Services contact information

    Michigan ENROLLS – Medicaid (888) 367-6557 
    MIChild  (888) 988-6300
    Women, Infants and Children (WIC)  (800) 225-5942
    mihealth card  (800) 642-3195
    Maternal Infant Health Program (MIHP)  (248) 663-3889
  • Member Handbook | Certificate of Coverage
    For policies and procedures, please refer to the Member Handbook.
  • Prior authorization

    At times, specialists may suggest services we don't feel are best for a patient. That's why we want members to check with us so we can help with their care. This is called prior authorization. If you need this approval, your doctor will get it.

    Example:

    When Mary visits the ear, nose and throat doctor for the first time, she pays an office copay. The ENT suggests a sinus surgery for her. Before the surgery, the ENT office must get prior approval from HAP Empowered to make sure the service is covered and that it's necessary.

    Here are detailed lists of related services:

    How does this work? Your doctor submits a request based on the suggested treatment. Then, you and your doctor will get a notice of approval or denial within 14 days. Your request must be approved before you get treatment or services. If you’re not approved, you may have to pay for the entire cost of your care.

    If your request is denied, you have the right to know why. It can be for many reasons. You can talk to your doctor or call Customer Service at (888) 654-220 (TTY: 711).

     

    Mental health services

    Do you need mental health services? See your primary care physician for a referral to a contracted psychiatrist or behavioral health provider.

    You may self-refer to a provider. For emergencies, go to the closest hospital that provides psychiatric services.

  • Rights and responsibilities | Fraud and abuse
  • Grievances and appeals

    How to file a grievance and appeal

    We want you to be happy with our service. We follow all applicable federal civil rights laws. We do not discriminate based on race, color, national origin, age, disability or sex.

    If you are unhappy, you can file a grievance. If you feel discriminated against, you can file a grievance.

    This applies to the following items:

    • Quality of health care services, including safety issues
    • Access and availability of care
    • Attitude and service of providers, office staff or HAP Empowered staff
    • The benefits in your plan

    In person:

    HAP Empowered
    2050 S. Linden Rd.
    Flint, MI 48532

    By mail:

    HAP Empowered
    P.O. Box 2578
    Detroit, MI 48202

    We also have an appeal and grievance analyst to help you. They can help you write a grievance. This can be done over the phone, in writing or in person. We also offer interpreter services.

    • Your doctor or an authorized person may file a grievance for you
    • A letter of receipt will be sent within five days
    • All grievances are thoroughly investigated
    • You will get a response in writing 30 days from the grievance date

    Appeals

    Pre-service/post-service appeals

    • You can file an appeal if a covered health care service has been denied, suspended, terminated or reduced.
    • You have 60 calendar days from receiving the denial to file an appeal.
    • You can do this in person, in writing, or by telephone. The appeal coordinator can help you.
    • You can choose someone to represent you. You can bring information you feel will help us make a better decision.
    • Once we receive your appeal request, a decision will be mailed within 30 days. However, we can extend this time by an additional 14 days if you ask us to or if we believe that allowing additional time will be in your best interest.
    • You can request a state fair hearing after getting notice that we have denied your pre-service or post-service appeal. It must be within 120 days of the denial of a final decision.

    Call HAP Empowered at (888) 654-2200 (TTY: 711). Or, call the state of Michigan at (800) 642-3195 to have a hearing request form (DCH-0092) sent to you. Fill out the form and return it to the address listed.

    If you are unhappy with our decision or we don’t give a decision within 30 days, you can request an external review from the Department of Insurance and Financial Services. Your request must be in writing and sent to:

    Department of Insurance and Financial Services
    Office of General Counsel – Appeals Section
    P.O. Box 30220
    Lansing, MI 48909-7720

    Expedited pre-service appeal

    If you or a doctor say that the 30-calendar-day time frame could harm your health, your pre-service appeal will be an expedited request. Expedited appeals are handled in 72 hours. 

    External review by the Department of Insurance and Financial Services (DIFS)

    You can ask for an external review if you don’t get an answer within 30 calendar days. You can also do this if you are unhappy with the decision HAP Empowered made. Write to DIFS at:

    Department of Insurance and Financial Services
    Office of General Counsel – Appeals Section
    P.O. Box 30220
    Lansing, MI 48909-7720

    You must appeal in writing to the DIFS within 60 calendar days of getting a decision. You must complete HAP Empowered Medicaid's grievance and appeal process before asking for review from the DIFS. The appeal coordinator will explain the external review process. We can also mail the external review forms to you.

    DIFS will send your appeal to an independent review organization for consideration, as necessary. A decision will be mailed to you within 14 calendar days of accepting your appeal.

    Are you unhappy with our final decision? Do you want your appeal request to be expedited? You have 10 calendar days to file an appeal to DIFS.

    • If we are going to reduce or stop a service we already approved, you can keep getting benefits during the appeal and state fair hearing process. The appeal must be filed within 12 days of the date the denial letter was mailed
    • You must ask to keep the service

    The service will stop if:

    • You withdraw your appeal
    • You do not ask for a state fair hearing within 12 days of getting the denial letter
    • A state fair hearing decision is made against you
    • The authorization ends or service limits are met

     

  • Nondiscrimination Notice
  • Protecting your health and quality care

    We want to make sure you get and stay healthy. By focusing on quality and safety, we can help you avoid prescription drug errors and getting sick or hurt.

    We help our members get the best care by:

    We also offer a safety toolkit, as well as other tips.

    Safety standards

    The My Care Compare website measures care provided by Michigan hospitals and doctors. It also gives you tools to help you get the best care.

    Other resources to learn about hospital and patient safety standards:

    How we ensure quality care

    Our quality program ensures all our members get the highest quality health care. It should be safe, effective and meet your needs. We constantly check to see what’s working well and where we can improve. Learn more about this work and get our annual report.

  • Newsletters

    Our Make Health Happen newsletter is published twice a year and offers information about your health care benefits and ways to get and stay healthy.

  • Maternal Infant Health Program (MIHP)

    This program is for pregnant women and their baby up to one year of age. It provides proper food, support and a ride for health services. It’ll also help you know the value of getting prenatal care, well childcare and scheduled shots. If you need help, call (248) 663-3889.

    Services are:

    • Prenatal teaching
    • Nutritional support and education
    • Help with personal problems
    • Newborn baby assessments
    • Referrals to community resources
    • Help with a ride
    • Support to stop smoking

    Preventive health reminders

    Sent to members who may be due for these:

    • Child vaccines
    • Adolescent vaccines
    • Human Papillomavirus Vaccine (HPV)
    • Lead testing
    • Well Child Visits/Well Adolescent Visits
    • Diabetes care
    • Mammogram and cervical cancer screening
    • Colorectal cancer screening
    • Yearly physical exams
    • Flu vaccine
    • Pneumonia vaccine

    For additional information, please visit the Maternal Infant Health Program (MIHP) website.

HAP Midwest Health Plan, Inc. is a wholly owned subsidiary of Health Alliance Plan (HAP). It is a Michigan nonprofit, taxable corporation.

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Customer Service

  • HAP Empowered Medicaid

    Call (888) 654-2200 (TTY: 711)

    Seven days a week,
    24 hours per day