Benefits at a Glance

Utah Molina Medicaid Integrated Care (UMIC)

For a full list of benefits information, please read your Member Handbook or call Member Services at (888) 483-0760.

Covered Services are marked with "X."

Services that need approval in advance (prior authorization) are marked "+."

Services You May Need	Traditional Utah Medicaid
Abortion	X +
Diabetes education	X
Medical supplies/equipment	X
Durable Medical Equipment (DME)	X +
End state renal disease - dialysis	X
Eye Exam	X - limited to one exam every 12 months
Eye Glasses	X - covered only for those eligible for EPSDT services
Home health services	X +
Hospice services (up to 30 days)	X +
Skilled nursing facility, intermediate care facility, long-term acute care (up to 30 days)	X +
Family planning	X
Lab/x-ray	X
Inpatient hospital services	X
Outpatient hospital services	X
Emergency and Urgent Care	X - must use a network provider for urgent care
Physician services	X
Podiatry services	X - limited benefits for adults
Preventative services (mammograms, Pap smears, prostate exams)	X
Physical therapy (PT)/occupational therapy (OT)	X – approval is needed after 12 combined visits per calendar year
Private duty nursing	X +
Speech and hearing Services	EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC)
Hearing aids and batteries	EPSDT or Early Periodic Screening, Diagnosis and Treatment (previously called CHEC)
Speech augmentativecommunication devices (SACDs)	X +
Sterilizations	X +
Substance use treatment	X
Outpatient Behavioral Health Care (mental health)	X
Personal Services	X+
Organ transplant	X

Carved Out Services (not covered by Molina Medicaid Integrated Care)
Dental	Contact State Medicaid	Contact State Medicaid
Ambulance transportation	Contact State Medicaid	Contact State Medicaid
Nursing facility, Long Term Care (longer than 30 days)	Contact State Medicaid	Contact State Medicaid
Non-Emergent Medical Transportation Services	Contact State Medicaid	Contact State Medicaid
Chiropractic services	Contact State Medicaid	Contact State Medicaid
Apnea monitors	Contact State Medicaid	Contact State Medicaid