Directory Preamble Colorado

This directory is current as of August 12, 2022

This directory provides a list of Longevity Health Plan’s current network providers.

This directory is for Longevity Health Plan’s residents of Michigan.

To access Longevity Health Plan’s online provider directory, you can visit LongevityHealthPlan.com.  For any questions about the information contained in this directory, please call our Member Service Department at 1-888-312-8825 (TTY 711), TTY users should call 711.

Statement of Nondiscrimination

Longevity Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Section 1 – Introduction

This directory provides a list of Longevity Health Plan’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).

You will have to choose one of our network providers in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care coverage from your PCP. Your PCP works in collaboration with your Longevity Health Plan Nurse Practitioner to assure you receive seamless, patient-centered care.

The network providers listed in this directory have agreed to provide you with health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. To obtain a referral, please contact your PCP or Nurse Practitioner.

For a complete listing of services that require prior authorization, or a referral, please refer to the Member Resources section of the Longevity Health Plan website at LongevityHealthPlan.com or call our Member Services Department at 1-888-312-8825 (TTY 711).

About the Longevity Health Plan Provider Network

Our network providers are the doctors, health care professionals, medical groups, hospitals, and other health care facilities that have an agreement with Longevity Health Plan to accept our payment and your cost-sharing amount as payment in full.

We have arranged for these providers to deliver covered services to members in our plan. The providers in our network bill us directly for the care they provide to you. When you see a network provider, you pay only your share of the cost for their services. You should use network providers for all your services.

Out-of-Network Providers

Only in limited cases, may you receive covered services from out-of-network providers. These cases include:

  • A medical emergency – go to the closest available provider
  • Urgently needed services – go to any qualified provider when out of the Plan’s service area, or when network providers are unavailable
  • Renal dialysis that you receive when you are outside the Plan’s service area
  • Services that have been approved in advance by Longevity Health Plan, and
  • Any services which were covered through the appeals process

You should always see a network provider unless one of the limited cases mentioned above applies. If you choose to receive services from an out-of-network provider, they must request prior approval from Longevity Health Plan unless it is an emergency to an acute care hospital.

If you receive a bill from an out-of-network provider, you should not pay the bill, unless you have received an Explanation of Benefits (EOB) that details what the plan will pay for your service, and any remaining balance you will need to pay. If you receive a bill from an out of network provider, but have not yet received an EOB, please submit the bill to Longevity Health Plan or ask the provider to submit the bill to Longevity Health Plan for you. The out-of-network provider may also bill you for any remaining balance not paid by Longevity Health Plan.

If you have already paid for the covered services, Longevity Health Plan will reimburse you for our share of the cost (if prior approval was obtained). If you have any questions, visit our “how to file an appeal” section of our website located at https://www.longevityhealthplan.com/member-resources/ or call our Member Services Department at 1-888-312-8825 (TTY 711).

Payment for services is contingent upon:

  1. The services you received are included in Longevity Health Plan benefits as outlined in the Evidence of Coverage (EOC) that can be found on the plan website.
  2. The provider, or medical facility, you received services from is eligible for payment from Longevity Health Plan.
  3. The service(s) meet requirements for medical necessity.
  4. An authorization or referral was obtained.

Note: Temporary out-of-network dialysis services when you are out of the service area, medical emergencies, and urgently needed medical services do not require notification or preauthorization for payment.

You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers, neither Medicare nor Longevity Health Plan will be responsible for the costs.

What is the service area for Longevity Health Plan?

The counties in our service area are listed below:

  • Calhoun
  • Genesee
  • Grand Traverse
  • Ingham,
  • Kalamazoo
  • Kent
  • Livingston
  • Macomb
  • Monroe
  • Oakland
  • Ogemaw
  • Ottawa
  • Saginaw
  • St. Clair
  • Washtenaw
  • Wayne

How do you find Longevity Health Plan providers that serve your area?

The pages that follow contain several listings of providers. There are separate listings of PCPs, specialty physicians, hospitals, and other providers. The lists are organized by specialty, state, county, city, and zip code. Within each zip code, the providers are listed alphabetically. To find a provider, locate the specialty, state, county, city, and zip code you are interested in, and then view the providers in alphabetical order.

If you have questions about Longevity Health Plan, or require assistance in selecting a PCP, please call our Member Service Department at 1-888-312-8825 (TTY 711), TTY users should call 711, or visit LongevityHealthPlan.com.

Section 2 – List of Network Providers

 

[Show all current contracted network providers for each type of provider (e.g., PCP, specialist, hospital, etc.).  Optional:  You may include other provider types in addition to the required types on pages 7-12.]

 

[Recommended organization:

 

Type of Provider (PCPs, Specialists (types), Hospitals, Skilled Nursing Facilities, Outpatient Mental Health Providers, and Pharmacies (types) where outpatient prescription drugs are offered by the plan.)

 

State (Include only if directory includes multiple states)

 

County (Listed alphabetically)

 

City (Listed alphabetically)

 

Neighborhood/Zip Code (Optional: For larger cities, providers may be further subdivided by zip code or neighborhood)

 

Provider Name (Listed alphabetically)

 

Provider Details]

[Note:  Plans that offer supplemental services (e.g., vision, dental) must choose to either include these network providers in a directory combined with PCPs, etc. or in a separate provider directory.]

 

[For Dual Eligible Special Needs Plans (D-SNPs) only:  Identify Medicare providers that accept Medicaid to assist dual eligible enrollees in obtaining access to providers and covered services.  Plans have the option to include a global statement at the beginning of the network provider listing section or to provide a Medicaid indicator next to each provider.  The global statement should state:  “All providers in this provider directory accept both Medicare and Medicaid.”  Inclusion of the global statement signifies a model directory without modification.  Those plans that choose not to use a global statement need to place a Medicaid indicator next to each provider (e.g., an asterisk and an accompanying footnote for all Medicare providers that participate in Medicaid also.)  Inclusion of a Medicaid indicator next to each provider signifies a non-model directory with modification.

 

[Full and partial network PFFS plans must indicate, for each type of provider, whether the plan has established higher cost sharing requirements for enrollees who obtain covered services from out-of-network providers.]

 

[Primary Care Providers (PCPs)]

 

[State]

[County]

[City]

[Zip Code]

 

[PCP Name]

[Accepting New Patients?  Yes/No]

[PCP Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for PCP(s) that support electronic prescribing]

 

[Specialists]

[Specialty Type]

 

[State]

[County]

[City]

[Zip Code]

 

[Specialist Name]

[Accepting New Patients?  Yes/No]

[Specialist Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for specialist(s) that support electronic prescribing]

 

[Hospitals]

 

[State]

[County]

[City]

[Zip Code]

 

[Hospital Name]

[Hospital Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for hospital(s) that support electronic prescribing]

 

[Skilled Nursing Facilities (SNFs)]

 

[State]

[County]

[City]

[Zip Code]

 

[SNF Name]

[SNF Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for SNF(s) that support electronic prescribing]

 

[Outpatient Mental Health Providers]

 

[State]

[County]

[City]

[Zip Code]

 

[Provider Name]

[Accepting New Patients?  Yes/No]

[Provider Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for provider(s) that support electronic prescribing]

 

[All plans have the choice to either (1) list information on both providers and pharmacies in one combined document; or (2) provide two separate documents:  a provider directory and a pharmacy directory.

In the list of pharmacies (whether appearing in a combined or single document), plans must identify or include those pharmacies that provide Part B drugs, if applicable.

Note:  Plans offering a Part D benefit, please refer to the Part D Model Pharmacy Directory for Part D requirements.]

 

[Pharmacies]

[Type of pharmacy as applicable:  Retail, Mail Order, Home Infusion, Long Term Care (LTC), Indian Health Service/Tribal/Urban Indian Health (I/T/U)]

 

[State]

[County]

[City]

[Zip Code]

 

[Pharmacy Name]

[Pharmacy Street Address, City, State, Zip Code]

[Phone number]

[Optional: website and e-mail addresses]

[Optional: Indicator for pharmacy(ies) that support electronic prescribing]