Medical and Dental Benefits

The information on this page only pertains to the CMSP benefit program. If you’re looking for more information on the Connect to Care program, click the button below:

Advanced Medical Management is responsible for CMSP medical and dental benefits administration. Further information on benefit administration is available at the Advanced Medical Management website at

To download the CMSP Member Guide, click here.

Find a medical or dental provider.

A wide array of inpatient and outpatient benefits are provided through the CMSP Benefit. Covered services are subject to prior authorization requirements, medical necessity and clinical guidelines, provider network requirements, and/or benefit limits may apply. Please see sections about emergency services, Share of Cost (SOC) requirements, members, and primary care benefit services.

CMSP Covered Services without a SOC (if applicable):

  • Adult Immunizations
  • Colorectal Cancer Screening
  • EKG, Osteoporosis, & DEXA Scan
  • Mental health services (mild to moderate)
  • Outpatient Substance Use Disorder Services
  • Physical Therapy Services
  • Specified Prescription Medications with a $5 Copay per Prescription ($1500 maximum benefit limit)
  • Preventative Health Screenings
  • Primary Care & Specialist Office Visits
  • Routine Screening & Laboratory Testing
  • Screenings for HIV, HPV, Hepatitis B & C, & STI Screenings
  • Specified Ultrasound of Head, Neck, Trunk, Upper & Lower Extremities
  • Specified X-rays of Head, Neck, Chest, Trunk, Upper & Lower Extremities
  • Various In-Office Minor Medical Procedures

CMSP Covered Services that May Require a SOC (if applicable):

  • Acute inpatient hospital care
  • Adult day health care services
  • Audiology services
  • Blood and blood derivatives
  • Chiropractic services
  • Chronic hemodialysis services
  • Dental services
  • Durable Medical Equipment (DME)
  • Emergency air and ground ambulance services
  • Hearing aids and cochlear implants
  • Home health agency services
  • Hospital and clinic outpatient services
  • Infusion therapy
  • Inpatient and outpatient heroin detoxification services
  • Laboratory and radiology services
  • Medical supplies
  • Non-emergency medical transportation when medically necessary
  • Occupational therapy services
  • Outpatient rehabilitation services in a rehabilitation facility
  • Pharmaceutical services provided by network pharmacies
  • Physician services
  • Podiatry services
  • Prosthetic and orthotic appliances
  • Psychiatric services (inpatient and outpatient) provided by a licensed, in-network Psychiatrist
  • Speech therapy services
  • Transplants
  • Vision services including eye exams and prescription glasses