Plan Documents

Review your HAP CareSource™ MI Health Link (Medicare-Medicaid Plan) plan documents to make sure you get the most from your health plan. You can also contact us with any questions you have about your plan.

Member Handbook

Your member handbook is a guide to your health care benefits. It tells you how our plan works, the covered services you get, services that are not included and your rights and responsibilities.

Benefits at a Glance

Benefits at a Glance (Navigate 2024 | Navigate 2025 ): View your benefits and services at a glance. Use this guide and put your benefits to work for you! To learn more about how to use your benefits and services, please refer to your Navigate Member Handbook.

Annual Notice of Change

The Annual Notice of Change outlines the changes to your benefits for the next plan year.

Summary of Benefits 

The Summary of Benefits includes your covered benefits and any limitations. It is only a summary. Please read your Member Handbook for the full list of benefits.

Provider/Pharmacy Directory

The directory lists participating providers, including pharmacies, for HAP CareSource MI Health Link. You will find office hours and if a doctor is accepting new patients. You will also see if the office is on a bus route and other helpful information. 

We are always adding new providers to the HAP CareSource MI Health Link network. Please see Find a Doctor/Provider for the most current listing. Please see Find a Pharmacy for the most current listing. You may also request a directory be mailed to you by calling Member Services.

You can also call Member Services to get information about in-network providers including name, address, phone numbers, professional qualifications, specialty, medical school attended, residency completion, board certification status and more.

Forms

Visit the Forms page to find any form when you need it. 

Prior Authorization List

Some services require approval from HAP CareSource MI Health Link before you can get them. We call this prior authorization. Your provider will ask for approval from us. Then they will schedule these services for you.

This list shows which services you need approval for before you can get them.

Usually your provider will ask for prior authorization from us and then schedule these services for you. Your provider can submit a request for a prior authorization using the Navigate Prior Authorization Request Form.

If you have questions about the prior authorization process or status, please call 1-833-230-2057 (TTY: 1-833-711-4711 or 711), 8 a.m. to 8 p.m., Monday through Friday. 

Prescription Drug Benefit Documents

Below are links to documents covering your prescription drug benefits, including the latest drugs covered by the plan and more.

Comprehensive Formulary – The HAP CareSource MI Health Link formulary is a list of all drugs covered under your plan.

Notice of Formulary Changes – Throughout the year, changes may occur to drugs on our formulary. Check this list to view the updates.

Navigate Coverage Determination Request Form – If you believe you are entitled to payment or benefits on a certain drug, you can request a coverage determination by completing this form.

Navigate Coverage Redetermination Request Form – If you are unsatisfied with the outcome of a coverage determination request, you can file an appeal using the redetermination form.

Pharmacy Prior Authorization Criteria – For certain drugs, your primary care provider (PCP) will need to contact us before you can fill your prescription.

Step Therapy Criteria – For certain drugs, we require you to first try another drug to treat your medical condition before we will cover the drug your provider initially prescribed.

Drug Transition Policy – Learn about our policy for potentially covering a drug that you currently use if it is not listed in our formulary.

Need Information in Another Language? 

You can get HAP CareSource MI Health Link information for free in other languages or alternate formats such as large print, braille or audio. Call 1-833-230-2057 (TTY: 1-833-711-4711 or 711), 8 a.m. to 8 p.m., Monday through Friday. The call is free.

We can help! See our Navigate Multi-Language Interpreter Services for information to request plan documents in another language.

MIDHHS - MI Health Link LogoNon-Discrimination Notice

View the Navigate HAP CareSource MI Health Link notice of non-discrimination.