Signature Benefits are only available for Group or Individual plans.
Medicare Supplement plans are excluded.
We want you to use these money saving benefits.
These are available before meeting your deductible.
All Individual plans and Employer plans* include these signature benefits.
$0 Mental Health Visit
Mental wellness is just as important as physical wellness. That’s why we’re offering your first mental health visit per year at no cost to you.
HOW TO USE
1. Choose an in-network mental health provider and make an appointment.
You may also choose a mental health provider through Doctor on Demand.
2. Go to your appointment.
After your visit, your doctor will submit your claim to the CO-OP, and our team will make sure your first mental health visit of the year is covered when we process it.
Call us with questions: 800-299-6080
Exlusions
Exclusions may apply to Standard and HDHP plans. Please check your plan documents to verify if this specific benefit applies to you. Contact our customer service team at 800-299-6080 and they would be happy to review your benefits and answer any questions you may have.
Get paid up to $210 per year to take care of yourself.
Make an appointment. See a doctor. Save money*.
$100 Dental Exam Reimbursement
** This is an annual reimbursement program so we pay you back after you send us proof of services received.
This benefit is only available for Group or Individual plans. Medicare Supplement plans are excluded.
1. Choose a dentist of your choice
There are no restrictions on who you see since this is a reimbursement program.
We pay you, not the provider, after you cover the initial costs.
You will receive up to $100 reimbursed towards the total cost of the visit.
Example
If the service costs $120, you’ll be reimbursed $100. The visit will have cost you $20.
If the service costs $85, you’ll be reimbursed $85. Your visit will essentially be $0.
2. Get Proof of Services
The document we need is not a receipt.
What we need is a superbill. This is a detailed document that outlines the medical services, including diagnosis codes, procedure codes (CDT codes), charges, and provider information.
3. Send & Receive
Reimbursement will be mailed to you within 30-45 business days of receiving your superbill.
Submit your superbill for reimbursement by uploading it in the Message Center of your Member Portal. You can attach and submit only one superbill per thread in the Message Center.
Questions? Contact Member Services by calling 800-299-6080.
$60 Eye Exam Reimbursement
** This is an annual reimbursement program so we pay you back after you send us proof of services received.
This benefit is only available for Group or Individual plans. Medicare Supplement plans are excluded.
1. Choose an optometrist of your choice
There are no restrictions on who you see since this is a reimbursement program.
We pay you, not the provider, after you cover the initial costs.
You will receive up to $60 reimbursed towards the total cost of the visit.
Example
If the service costs $80, you’ll be reimbursed $60. The visit will have cost you $20.
If the service costs $50, you’ll be reimbursed $50. Your visit will essentially be $0.
2. Get Proof of Services
The document we need is not a receipt.
What we need is a superbill. This is a detailed document that outlines the medical services, including diagnosis codes, procedure codes (CPT codes), charges, and provider information.
3. Send & Receive
Reimbursement will be mailed to you within 30-45 business days of receiving your superbill.
Submit your superbill for reimbursement by uploading it in the Message Center of your Member Portal. You can attach and submit only one superbill per thread in the Message Center.
Questions? Contact Member Services by calling 800-299-6080.
$50 In-home Health Assessment
Complete a free health assessment with our new partner Porter from home and earn $50.
This benefit is only available for Group or Individual plans. Medicare Supplement plans are excluded.
1. Request to schedule your free health assessment visit
Connect with Porter by completing this form or calling 1-800-558-9922 to set up your appointment.
2. Within 72 Hours
Your Porter Care Guide will reach out to complete scheduling your in-home** or telehealth visit. Your caller ID may identify them as “Porter & MHC” when they call.
3.You will not receive an invoice or bill for this screening.
It’s completely free! The CO-OP pays for the assessment and any in-home or mail-order testing performed.
The Nurse Practitioner shares all data and test results with your doctor.
4. Your Porter Care Guide helps you make the most of your results
by coordinating care from your primary care physician or specialists, helping you understand your benefits, and more.
5. Your $50 check is mailed
No later than 90 days after your appointment.
Get Started: 1-800-558-9922
Dental & Vision Questions
All Group and Individual members are eligible for reimbursements up of to $100 for dental exams and cleanings or $60 for a vision exam per calendar year.
Reimbursement will be mailed to you in 30-45 business days once we receive your Superbill.
To expedite your reimbursement:
Make sure your Member ID is included on your Superbill — a line item statement specifically saying what service was performed not just the cost.
No. This program is only for vision exams. We don’t reimburse purchases of eyewear or contacts.
No. This program is only for dental exams — such as routine cavity check — or dental cleanings.
Yes. The reimbursement is not dependent on location or network. You may visit any licensed dental or vision provider.
You’re allowed 365 days from the date of service to claim your reimbursement.
Call your dentist or optometrist to provide “Superbill” and submit it by uploading it in your Member Portal.
Questions? Contact Member Services by calling 800-299-6080.
You’re allowed one vision exam (up to $60) reimbursement and one dental exam or cleaning (up to $100) reimbursement per plan year.
Check your Summary of Benefits and Coverage to view exact coverage dates.
Fine print
* All Signature Benefits are only available for individual and group plans. Exclusions apply to Medicare Supplement plans.
** Vision and dental benefits are reimbursement programs. You pay the cost directly, we pay you back up to the allocated amount. Available in Idaho, Wyoming, and Montana for members with Group of Individual plans only. These benefits do not apply to Medicare Supplement Insurance Plans.
100% coverage for many preventive care services and prescriptions.
Our plans offer 100% coverage for preventive services when completed through an in-network provider.
Catch health changes before they become complications without paying a copayment or coinsurance, even if you haven’t met your yearly deductible.
Many insulins, select medications for depression, asthma, and more are available for $0 out-of-pocket.
What counts as preventive?
Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
Alcohol misuse screening and counseling
Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk
Cholesterol screening for adults of certain ages or at higher risk. Statin medications.
Colorectal cancer screening for adults 45 to 75
Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese
Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.
Hepatitis C screening for adults age 18 to 79 years
HIV screening for everyone age 15 to 65, and other ages at increased risk
PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adults at high risk for getting HIV through sex or injection drug use
Lung cancer screening for adults 50 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
Obesity screening and counseling
Sexually transmitted infection (STI) prevention counseling for adults at higher risk
Syphilis screening for adults at higher risk
Tobacco use screening for all adults and cessation interventions for tobacco users
Tuberculosis screening for certain adults without symptoms at high risk
Bone density screening for all women over age 65 or women age 64 and younger that have gone through menopause
Breast cancer genetic test counseling (BRCA) for women at higher risk
Breast cancer mammography screenings
Every 2 years for women 50 and over
As recommended by a provider for women 40 to 49 or women at higher risk for breast cancer
Breast cancer chemoprevention counseling for women at higher risk
Pap test (also called a Pap smear) for women age 21 to 65
Chlamydia infection screening for younger women and other women at higher risk
Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
Domestic and interpersonal violence screening and counseling for all women
Gonorrhea screening for all women at higher risk
HIV screening and counseling for everyone age 15 to 65, and other ages at increased risk
PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative women at high risk for getting HIV through sex or injection drug use
Sexually transmitted infections counseling for sexually active women
Tobacco use screening and interventions
Urinary incontinence screening for women yearly
Well-woman visits to get recommended services for all women
Pregnancy & Planning
Breastfeeding support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
Birth control: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.
Folic acid supplements for women who may become pregnant
Gestational diabetes screening for women 24 weeks pregnant (or later) and those at high risk of developing gestational diabetes
Gonorrhea screening for all women at higher risk
Hepatitis B screening for pregnant women at their first prenatal visit
Maternal depression screening for mothers at well-baby visits (PDF, 1.5 MB)
Preeclampsia prevention and screening for pregnant women with high blood pressure
Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
Expanded tobacco intervention and counseling for pregnant tobacco users
Alcohol, tobacco, and drug use assessments for adolescents
Autism screening for children at 18 and 24 months
Behavioral assessments for children: Age 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
Bilirubin concentration screening (PDF, 609 KB) for newborns
Blood pressure screening for children: Age 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years
Blood screening for newborns
Depression screening for adolescents routinely, beginning at age 12
Developmental screening for children under age 3
Dyslipidemia screening (PDF, 609 MB) for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders
Fluoride supplements for children without fluoride in their water source
Fluoride varnish for all infants and children as soon as teeth are present
Gonorrhea preventive medication for the eyes of all newborns
Hearing screening for all newborns; and regular screenings (PDF, 609 KB) for children and adolescents as recommended by their provider
Height, weight and body mass index (BMI) measurements (PDF, 609 KB) taken regularly for all children
Hematocrit or hemoglobin screening for all children
Hemoglobinopathies or sickle cell screening for newborns
Hepatitis B screening for adolescents at higher risk
HIV screening for adolescents at higher risk
Hypothyroidism screening for newborns
PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adolescents at high risk for getting HIV through sex or injection drug use
Immunizations for adults — doses, recommended ages, and recommended populations vary:
For Children
Immunizations for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
Mental Health & Lifestyle Counseling
24/7 access to Behavioral Healthcare
All mental health services are available via a virtual doctor at anytime.
Depression screening for adolescents beginning routinely at age 12
Many medications for depression and mood regulation.
Diet counseling for adults at higher risk for chronic disease
Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting
$0 out-of-pocket drugs & supplies
With our plans, you won’t need to ration prescriptions or supplies.
We provide coverage for specific drugs for all Members even without meeting your deductible or annual out-of-pocket expense.
CO-OP members have zero cost-share ($0 out-of-pocket) for medications on these lists, including many insulins along with glucose monitoring supplies.
Do you take medications in one of the categories listed below? If so, these are zero cost to Members.
$0 Drug Categories:
- Anticoagulant Medications
- Antidepressant Medications
- Blood Glucose Meter
- Bone Medications
- Cardiovascular Medications
- Cholesterol Medications
- Continuous Glucose Monitor
- Diabetic Medications
- Diabetic Supplies
- Diabetic Test Strips
- Respiratory Medications
Get prescription drugs delivered to your home.
Visit Birdi to set up your profile.
Set up a profile on Birdi using the Rx information off your member benefits card.
Pharmacy Mail Order – Instructions
*NoviXus is now known as Birdi
Fine print
*Preventive Health Care services are covered at 100%, with no out of pocket costs when contracting provider networks are used. Any services performed with an Out of Network Provider will result in copayments, deductibles, and cost-sharing and may result in balance billing. Your doctor must write a prescription for preventive medication services to be covered by your plan, even if they are listed as over the counter. Frequency limitations may apply to to preventive care services such as screenings. Diagnostic tests (blood work, imaging) are not considered preventive. Networks may vary by plan. Please use the Provider Finder to find the providers for your network.
MHC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age disability, or sex.
Travel support to see specialists at our Centers of Excellence.
Not everyone lives near a major medical hub. We help cover the cost of traveling to a specialist for unique care.*
We created the Centers of Excellence** (COE), giving you access to care at high-quality facilities with provisions to reduce your out-of-pocket costs.
How to Qualify
• You must receive prior authorization by emailing [email protected]
• Services must be from Mountain Health CO-OP’s approved Centers of Excellence (COE)
• Services must be out of state or more than 120 miles from the patient’s residence.
Travel Expenses
Reimbursement
All travel-related reimbursement requires prior authorization, which can be obtained by calling 208-366-5373.
Limited to $10,000 per calendar year per member. Center of Excellence must be out of state or more than 120 miles from the patient’s residence.
Ground Transportation
Transportation provisions cover the member and one caregiver.
Travel by personal vehicle will be reimbursed at the IRS standard mileage rate, round trip, from your home zip code to the zip code of the provider location.
Air Transportation
Arranged by and billed to Mountain Health CO-OP.
Lodging
Lodging will be arranged by you, but then billed directly to us.
Member and caregiver will be given a daily per diem equal to the current federal meals and incidental daily rate for the location in which the member will receive treatment.
What’s considered unique care?
Work with a customer service representative to discover if your situation is qualified for this benefit by emailing [email protected].
Fine print
*Pre-approval required.
**LINK and Access Care Idaho plans do not have access to the Centers of Excellence Program.
Care is always available 24/7 anywhere you are using telehealth.
No long drives or waiting weeks for an appointment. No more wasted hours in waiting rooms or waiting until 9 a.m. Monday for common medical help.
Video chat with an in-network doctor in minutes — 24/7 — to treat many common conditions via the mobile app or from any web browser.
All records are shared with your primary care provider to seamlessly track your health.
Treatable Common Conditions via Telehealth
Virtual care doctors can treat most common health conditions:
- Prescription refills
- Urinary Tract Infections (UTIs)
- Yeast infections
- Birth control
- Joint Pain
- Asthma
- Bronchitis
- Skin conditions
- Hair loss
- Cold & flu
- Nausea & vomiting
- And more!
Behavioral Health
Personalized counseling in either 25 or 50 minute sessions. Our team consists of US-based therapists, rated 4.9 out of 5 stars by patients.
Your online therapy visit could be $0 depending on your plan. Register to find out your cost before your visit.
Clinical experts in a variety of different specialties, such as anxiety, depression, relationship issues, LGBTQ+, PTSD, trauma, stress, and more.
Plus, chat-based coaching:
- Healthy habits
- Trouble sleeping
- Work stress
- Motivation to change
How much will it cost?
Calculate Cost:
- Sign in online or Download the Doctor on Demand app
- Register and create your account
- Add your insurance information
- Your cost will show before your visit
Remember
Your primary care provider might offer select telehealth services during business hours such as phone appointments. Check with your provider to see what virtual options they may have.