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A coverage determination is the initial decision we make about your coverage or payment for a prescription drug request. An organization determination is the initial decision we make about your coverage or payment for medical services.
With these decisions, we inform you whether we’ll provide the care or services you request (a pre-service decision), or pay for a service you’ve already received.
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Last updated 10/1/2020
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2020 Health Alliance Plan of Michigan
Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts. HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.
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