Cholesterol management services are covered when ordered or provided by an in-network provider. Co-payments and out-of-network access vary based on each member’s coverage agreement. In-network provider co-payments are always less costly to the member.  Refer to the following for more information:

• Evidence of Coverage (EOC)
• I'm a Member
• Member Handbook
• Resources on the secure Member portal of this website
• Member Services
• Summary of Benefits

Primary Care Physician services:

• Nutritional education and counseling services up to 3 encounters per year (additional services require Mercy Health Plans’ prior approval) for individuals living with high cholesterol (hypercholesterolemia)
• Referrals to participating specialists upon primary care physician recommendation
• Lab work and other testing such as cholesterol testing or lipid profiles
• Medications (including generic, preferred brand, and non-preferred brand options) used in the treatment of high cholesterol and associated medical problems for members with Mercy Health Plans' pharmacy coverage 
• Other medical services as recommended by the attending practitioner (based upon the coverage and limitations outlined in the member’s coverage document)