Provider Search – MI Health Link

To locate a network provider nearest to you, select the type of provider you would like to see.

  1. Provider Search – Search for Primary Care Providers and Specialists in your area.
  2. Hospital Search – Search for Hospitals in your area.
  3. Facility Search – Search for ancillary providers in your area, including Audiology, Dialysis, Durable Medical Equipment, Physical Therapy, and more.
  4. Long Term Support Services – Search for long term support services providers in your area.
  5. Pharmacy Search– Search for pharmacies that participate with the plan. If you need to locate a pharmacy outside of Michigan’s Upper Peninsula please click here.
    (Scroll down for additional Pharmacy information.)
  6. Dentist Search – Search for dentists that participate with the plan.
    (clicking on this link will take you away from the Upper Peninsula Health Plan’s website.)
  • Upper Peninsula Health Plan (UPHP) MI Health Link (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees.
  • The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you.
  • Benefits may change on January 1 of each year.
  • This searchable Directory lists health care professionals (such as doctors, nurse practitioners, and psychologists), facilities (such as hospitals or clinics), and support providers (such as Adult Day Health and Home Health providers) that you may see as a UPHP MI Health Link member. We also list the pharmacies that you may use to get your prescription drugs.
  • We will refer to these groups as “network providers” in this Directory. These providers signed a contract with us to provide you services. This is a list of UPHP MI Health Link’s network providers for the Upper Peninsula of Michigan, including Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon, and Schoolcraft counties.
  • You can get this information in print for free in other languages. Call UPHP MI Health Link Customer Service 1-877-349-9324 (TTY 711) 7 days a week from 8:00 a.m. to 9:00 p.m. Eastern time. The call is free.
  • Puede obtener esta información de forma gratuita en otros idiomas. Llame a Servicio al cliente de Upper Peninsula Health Plan (UPHP) MI Health Link (Plan Medicare-Medicaid) al número
    1-877-349-9324 (TTY 711) los 7 días de la semana, de 8 a. m. a 9 p. m., hora del este. La llamada es gratis.
    يمكنك الحصول على هذه المعلومات بلغات أخرى مجانًا. اتصل بخدمة العملاء الخاصة ببرنامج UPHP MI Health Link برنامج التابع للبرنامج الصحي لشبه الجزيرة العليا على الرقم (TTY 711) 1-877-349-9324 والذي يعمل أيام في الأسبوع من 8 ص إلى 9 م بالتوقيت الشرقي. المكالمة مجانية.
  • You can also get this information for free in other formats, such as large print, Braille, or audio. Call 1-877-349-9324 (TTY 711) 7days a week, 8 a.m. to 9 p.m. Eastern Time to request alternate formats. You can also make a standing request for materials. The call is free.

This searchable directory is updated daily, but you need to know that some UPHP MI Health Link providers in our network may no longer be accepting new members. If you are having trouble finding a provider who will accept new members, call UPHP Customer Service at 1-877-349-9324 (TTY 711) 7 days a week from 8:00 a.m. to 9:00 p.m. Eastern time and we will help you.  The call is free.

Getting started in UPHP MI Health Link
Some key terms you may see in the UPHP MI Health Link Provider and Pharmacy Directory:

  • Providers are health care professionals and support providers such as doctors, nurses, pharmacists, therapists, and other people who provide care and services. Services include medical care, long-term supports and services, supplies, prescription drugs, equipment and other services.
    • The term providers also includes facilities such as hospitals, clinics, and other places that provide medical services, medical equipment, and long-term supports and services.
    • Providers that are a part of our plan’s network are called network providers.
  • Network providers are the providers that have contracted with us to provide services to members in our plan. The providers in our network generally bill us directly for care they give you. When you see a network provider, you usually pay nothing or pay only your share of the cost for covered services.
  • A Primary Care Provider (PCP) is a physician, physician assistant or nurse practitioner who gives you routine health care. Your PCP will keep your medical records and get to know your health needs over time. Your PCP will also give you a referral if you need to see a specialist or other provider.
  • Specialists are doctors who provide health care services for a specific disease or part of the body. There are many kinds of specialists. Here are a few examples:
    • Oncologists care for patients with cancer.
    • Cardiologists care for patients with heart conditions.
    • Orthopedists care for patients with certain bone, joint, or muscle conditions.
  • You may need a referral to see a specialist or someone that is not your PCP. A referral means that your network PCP or our plan must give you approval before you can see the other provider.
    • Referrals from your network PCP or our plan are not needed for:
      • Emergency care;
      • Urgently needed care;
      • Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are outside the plan’s service area; or
      • Services from a women’s health specialist.
    • Additionally, if you are eligible to receive services from Indian health providers, you may see these providers without a referral. We must pay the Indian health provider for those services even if they are out of our plan’s network.
    • More information on referrals is available in Chapter 3 the Member Handbook.
  • Your provider may need prior authorization or an approval from UPHP MI Health Link before you get certain services. Covered services that need prior authorization are marked in the Benefits Chart in Chapter 4 of the Member Handbook. Some drugs are covered only if you get prior authorization from us. Covered drugs that need prior authorization are marked in the List of Covered Drugs.
  • You also have access to a Care Coordinator and a Care Team that you choose.
    • A Care Coordinator helps you manage your medical providers and services.
    • Your Care Team includes you, your chosen allies or legal representative, Primary Care Provider, Care Coordinator, LTSS Coordinator and/or PIHP Supports Coordinator (as applicable), and others as needed. Everyone on the Care Team works together to make sure your care is coordinated. This means that they make sure tests and labs are done once and the results are shared with the appropriate providers. It also means that your PCP should know all medicines you take so that he or she can reduce any negative effects. Your PCP will always get your permission before sharing your medical information with other providers.

Choosing a Primary Care Provider (PCP)

You can get services from any provider who is in our network and accepting new members.

First, you will need to choose a Primary Care Provider. You may be able to have a specialist act as your PCP. This will depend on your medical needs. This could be an Obstetrician, Gynecologist or Internal Medicine doctor. Call UPHP Customer Service at 1-877-349-9324 (TTY 711), 7 days a week from 8:00 a.m. to 9:00 p.m. Eastern time before choosing a specialist as your PCP.  The call is free.
To choose a PCP, you might choose a provider in the provider network:

  • who has been recommended by someone you trust, or
  • that you use now, or
  • whose offices are easy for you to get to.

If you want help in choosing a PCP, please call UPHP Customer Service at 1-877-349-9324 (TTY 711), 7 days a week from 8 a.m. to 9 p.m. Eastern time. The call is free. You can also visit our website at www.uphp.com/medicare.

If you have questions about whether we will pay for any medical service or care that you
want or need, call Customer Service and ask before you get the service or care.

Getting long-term supports and services

As a UPHP MI Health Link member, you may be able to get long-term supports and services (LTSS), such as home health, personal care, nursing home and home and community based services (adult day program, respite, expanded community living supports, preventive nursing services, private duty nursing, and other services). Long-term supports and services supports are help for people who need assistance to do everyday tasks like taking a bath, getting dressed, making food, and taking medicine. Most of these services are provided at your home or in your community but could be provided in a nursing home or hospital.

You should discuss long-term supports and services with your Care Coordinator to determine which services you qualify for and how to access them.

Identifying Providers in UPHP MI Health Link’s Network

You may need a referral to see someone who is not a Primary Care Provider.

You must get all of your covered services from providers within our network. If you go to providers who are not in UPHP MI Health Link’s network (without prior authorization or approval from us), you will have to pay the bill.

The exceptions to this rule are when you need urgent or emergency care or dialysis and cannot get to a provider in the plan, such as when you are away from home. You can also go outside the plan for other non-emergency services if UPHP MI Health Link gives you permission first.

  • You may change providers within the network at any time. If you have been going to one network provider, you do not have to keep going to that same provider. For some providers, you may need a referral from your PCP.
  • UPHP MI Health Link works with all the providers in our network to accommodate the needs of people with disabilities. As applicable, the list of network providers in this searchable Directory includes information about the accommodations they provide. If you need to see a provider and are not sure if they offer the accommodations you need, UPHP MI Health Link can help you. Talk to your Care Coordinator for assistance.

Finding UPHP MI Health Link providers in your area

You can find a network provider nearest your home in this list, by searching by specialty, then sorted alphabetically by county, then by city, zip code and then by provider name.

You may receive services from any of the providers on this list. For some, you may need a referral from your PCP.

List of network providers
This searchable Directory of UPHP MI Health Link’s network providers contains:

  • Health care professionals including primary care providers, who may be physicians, physician assistants, or nurse practitioners; hearing, dental, or vision specialists.
  • Facilities including hospitals; urgent care centers; nursing facilities; Prepaid Inpatient Health Plan (PIHP) facilities for needs related to behavioral health, intellectual/developmental disability, and/or substance use.
  • Support providers including adult day services; assistive technology; chore services; community transition; environmental modifications; home-delivered meals; LTSS and non-LTSS home health agencies; non-medical transportation; personal care; preventive nursing; private duty nursing and/or respite care.

You may receive services from any of the providers on this list. For some services, you may need a referral from your PCP.

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Pharmacy

This Directory provides a list of pharmacies in UPHP MI Health Link’s (Medicare-Medicaid Plan)’s network. These network pharmacies are pharmacies that have agreed to provide prescription drugs to you as a member of the plan.

  • UPHP MI Health Link’s (Medicare-Medicaid Plan) members must use network pharmacies to get prescription drugs.
  • You must use network pharmacies except in emergency or urgent care situations.
    If you go to an out-of-network pharmacy for prescriptions when it is not an emergency, you
    will have to pay out of pocket for the service. Read the UPHP MI Health Link’s (Medicare-Medicaid Plan) Member Handbook for more information.
  • Some network pharmacies may not be listed in this Directory.
  • Some network pharmacies may have been added or removed from our plan after
    this Directory was published.

The pharmacy network may change at any time. You will receive notice when necessary.

For up-to-date information about UPHP MI Health Link’s (Medicare-Medicaid Plan) network pharmacies in your area, please visit this web site or call Customer Services at 1-877-349-9324, TTY 711, 7 days a week, 8 a.m. to 9 p.m. Eastern Time. The call is free.

To get a complete description of your prescription coverage, including how to fill your prescriptions, please read the Member Handbook.

Upper Peninsula Health Plan MI Health Link has contracts with pharmacies that equal or exceed requirements of the Centers for Medicare and Medicaid Services (CMS) and Michigan Department of Health and Human Services (MDHHS) for pharmacy access in your area.  Upper Peninsula Health Plan MI Health Link has contracts with many pharmacies in the service area.

We generally cover drugs filled at an out-of-network pharmacy only when you are not able to use a network pharmacy.  Here are the circumstances when we would cover prescriptions filled at an out-of-network pharmacy.

Plan drugs may be covered for up to a 30-day supply in special circumstances—for instance, illness while traveling outside of the plan’s service area where there is no network pharmacy.  You may have to pay more than your normal cost-sharing amount if you get your drugs at an out-of-network pharmacy.  In addition, you will likely have to pay the pharmacy’s full charge for the drug and submit documentation to receive the reimbursement from Upper Peninsula Health Plan MI Health Link.  Depending on your income and institutional status, you will be reimbursed by Upper Peninsula Health Plan MI Health Link up to the full cost of the drug, minus the co-payment.

In these situations, please check first with Customer Service to see if there is a network pharmacy nearby.

To find a pharmacy that participates with Upper Peninsula Health Plan MI Health Link, you can use the search tool below.

Our Pharmacy Search Tool allows you to search for pharmacies in your area.

To locate a network pharmacy, please follow the steps below:

  1. Identify the “Pharmacy Type” you are looking for (Retail, Home Infusion, Long Term Care, I/T/U); And/or
  1. Search and locate the “Pharmacy Type” section within this Directory; Or
  1. Search and locate the “County” you are looking for (counties are listed in alphabetical order); Or
  1. Search and locate the “City” you are looking for (cities are listed in alphabetical order); Or
  1. Search and locate a pharmacy by “Pharmacy Name” (pharmacies are listed in alphabetical order.

Please call UPHP MI Health Link at 1-877-349-9324, TTY 711. 7 days a week, 8 a.m. to 9 p.m. Eastern Time, if you would like assistance locating a network pharmacy.

Identifying pharmacies in our network

Along with retail and chain pharmacies, your plan’s network of pharmacies includes:

  • Home infusion pharmacies
  • Long-term care (LTC) pharmacies
  • Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies
  • You are not required to continue going to the same pharmacy to fill your prescriptions.
    You can go to any of the pharmacies in our network.

Long-term supplies of prescriptions

UPHP MI Health Link’s (Medicare-Medicaid Plan) does not offer a long term supply of drugs.

Home Infusion Pharmacies

Search the list of UPHP MI Health Link Network pharmacies to find a home infusion pharmacy provider in your area. For more information, contact Member Services, as listed above.

Long-Term Care Pharmacies

Residents of a long-term care facility, such as a nursing home, may access their prescription drugs covered under UPHP MI Health Link (Medicare-Medicaid Plan) through the facility’s pharmacy or another network pharmacy.

Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies

Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through UPHP MI Health Link’s (Medicare-Medicaid Plan)’s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to go to these pharmacies under limited circumstances (e.g., emergencies). Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies are not accessible to all members.


If you would like to request that a hard copy of the entire Provider and Pharmacy Directory be mailed to you, please click here.

 

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Page Last Updated: 06/7/2017