Michigan Plan Benefit Materials


This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete Michigan Reward (HMO) H0482- 001 Genesee, Kalamazoo, and Saginaw counties
  • Summary of Benefits, H0482-001 - English (PDF)
Ascension Complete Michigan Secure (HMO) H0482- 002 Genesee, Kalamazoo, and Saginaw counties
  • Summary of Benefits, H0482-002 - English (PDF)
Ascension Complete Michigan Reward (HMO) H0482- 003 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Summary of Benefits, H0482-003 - English (PDF)
Ascension Complete Michigan Secure (HMO) H0482- 004 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Summary of Benefits, H0482-004 - English (PDF)

For HMO D SNP Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete Michigan DSNP (HMO D-SNP) H0482- 005 Genesee, Kalamazoo, and Saginaw counties
  • Summary of Benefits, H0482-005 - English (PDF)

For PPO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete Michigan Access Plus (PPO) H7512- 001 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Summary of Benefits, H7512-001 - English (PDF)
Ascension Complete Michigan Access Plus (PPO) H7512- 002 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Summary of Benefits, H7512-002 - English (PDF)
Ascension Complete Michigan Access Plus (PPO) H7512- 003 Genesee, Iosco, Kalamazoo, Saginaw
  • Summary of Benefits, H7512-003 - English (PDF)
Ascension Complete Michigan Access (PPO) H7512- 004 Genesee, Iosco, Kalamazoo, Saginaw
  • Summary of Benefits, H7512-004 - English (PDF)

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete Michigan Reward (HMO) H0482- 003 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Evidence of Coverage, H0482-003 - English (PDF)
Ascension Complete Michigan Secure (HMO) H0482- 004 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne
  • Evidence of Coverage, H0482-004 - English (PDF)

For HMO D SNP Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete Michigan DSNP (HMO D-SNP)  H0482- 005 Genesee, Iosco, Kalamazoo, Saginaw
  • Evidence of Coverage, H0482-003 - English (PDF)

For PPO Members:

 

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete Michigan Reward (HMO) H7512- 001 Genesee, Kalamazoo, and Saginaw counties
  • Evidence of Coverage, H7512-001 - English (PDF)
Ascension Complete Michigan Secure (HMO) H7512- 002 Genesee, Kalamazoo, and Saginaw counties
  • Evidence of Coverage, H7512-002 - English (PDF)
Ascension Complete Michigan Access Plus (PPO) H7512- 003 Genesee, Iosco, Kalamazoo, Saginaw
  • Evidence of Coverage, H7512-003 - English (PDF)
Ascension Complete Michigan Access (PPO) H7512- 004 Genesee, Iosco, Kalamazoo, Saginaw
  • Evidence of Coverage, H7512-004 - English (PDF)

If you have questions please, contact Member Services.