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  Oakland Primary Healthcare Network
   
 

Description of Benefits

 
Covered Services Include:
Primary Healthcare Services
Physician Office visits, with a $5.00 Co-pay, including routine physicals and health examinations are covered
   
Pharmaceutical Coverage
Prescriptions written by your Primary Care Physician are covered
Our Primary Care Primary Physicians will NOT prescribe Narcotic, Antidepressant or Psychiatric drugs
Co-pays are as follows: $5.00 for generic drugs; $10.00 brand drugs
   
Diabetic Equipment
   
Laboratory and Radiology
If ordered by your Primary Care Physician, limited Laboratory Services are a covered benefit
Limited X-Rays , with a $5.00 co-pay, are a covered benefit
   
Urgent Care Services
Urgent Care services are provided for a $5 co-pay with prior authorization from our contracted Urgent Care Centers.
 
Non-Covered Services Include, but are not limited to:

 

NO APPLICATION FEE * NO MONTHLY PREMIUM.


Hospital Services: Inpatient, Outpatient, Emergency Room and Physician’s Fees
Ambulance Services
Vision Services
Medical Services rendered by any Medical Specialist
Dental Maintenance and Services
Therapy Services: Speech, Physical and Occupational
Eligibility Qualifications
TO QUALIFY FOR COVERAGE FOR THE OAKLAND PRIMARY HEALTH CARE NETWORK, YOU MUST:
Oakland County resident
Between the ages of 19 and 64 years.
Not eligible for Medicaid, Medicare or other commercial insurance plan.
Your household income is at 100%, or less, of the Federal Poverty Level :
(Income of no more than $800 a month for an individual or $1070 a month for a married couple - based on household income after living expenses)
Enrollment Requirements
ENROLLMENT INFORMATION REQUIREMENT INCLUDES:
A completed ‘Application’
A completed ‘Income and Expense Form’
Copy of current picture identification (Driver’s License, State Identification Card or Passport)
Copy of Social Security Card, Copy of Permanent Resident/Green Card for non-US Citizens
Medicaid rejection letter from the Department of Human Service (formerly FIA)
Proof of income, including spouse if applicable (check stub, W2, Current Income Tax Return)
Bank Statement(s)
Mortgage Statement or Lease Agreement
How To Enroll
APPLY TODAY:

Contact our office for information:
Oakland Primary Healthcare Network
18 Market Street, Suite B,
Mt. Clemens, MI, 48043
586-783-9355 Phone
586-783-6944 Fax

You may apply in person, by fax or mail
Please provide the required information to this office
You will receive an Identification Card


26711 Woodward Avenue - Suite 308 - Huntington Woods, Michigan 48070