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Topic: Genesee Health Plan

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rapunzel
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Eastside Business Association

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October 18, 2006

State Senator Bob Emerson will speak about the Genesee County Health Services millage on the November 7th ballot.

The Genesee Health Plan is basic health coverage for working adults.

The largest cost to local businesses in Genesee County is health care for employees. 12 million in uncompensated care at Hurley. Preventive Dr. visits can have a positive effect on our local economy and our college students.

Genesee Health Plan

Genesee Health Plan Information - Plan B
Genesee Health Plan (GHP) is a community-sponsored health coverage program implemented in Genesee County on November 1, 2001. The program is funded by local, state and federal funds and replaces the State Medical Program (SMP) in Genesee County. GHP is a 501 (C) 3 organization and has a Board of Directors from the local health systems and public health organizations. GHP has contracted with HealthPlus of Michigan, to provide member servicing, claims payment and Please delete me! management. GHP has also contracted with Genesee County Health Department (GCHD) to provide outreach and community education services and to provide enrollment sites.


How does a person become eligible for GHP?
Eligibility Requirements:
Must be a US Citizen and Genesee County Resident
Beteween the ages of 19 - 64
Family of 1 - Under $1396 of monthy income
Family of 2 - Under $1871 of monthy income
Family of 3 - Under $2346 of monthy income
Family of 4 - Under $2822 of monthy income
How to enroll?
For those who meet the eligibility requirements listed above for Plan B, apply in person at a participating enrollment site*. Walk-ins will be accepted but appointments are recommended. A picture identification and proof of wages are needed. Enrollment site locations are:

Health Access
1428 W. Court Street
Flint, Michigan 48503
To schedule an appointment, call (810) 232-4200.

Health and Allied Services
G3169 Beecher Rd, Flint, MI
Phone: (810) 232-7789

Genesee County Health Department
630 S. Saginaw Street
Flint, Michigan 48502
For general information, or to set an appointment to enroll, call (810) 257-3612 or (810) 767-2229. Ask for the Health Care Outreach and Enrollment Department.

What is the role of Health Access and the Genesee County Health Department?
Health Access or Genesee County Health Department staff will help you complete the application and tell you if you qualify for the program. They will provide education to you about the program, assist with selection of a doctor, and identify special needs for case management.

What is the role of HealthPlus?
HealthPlus will -- at GHP’s direction -- pay claims, process referrals, educate you about the program and provide customer service. HealthPlus will also answer any questions providers have about the program.

What are the benefits?
Coverage is limited. This is not an insurance product. Plan B benefits are subject to change.
Benefit Summary Plan B
Office visits with both primary care and specialist physicians Covered - $3 co payment
Outpatient lab and radiology services Covered $5 copayment for x-rays
Outpatient hospital services Not covered
Please delete me! (Generics will be provided when available. Your doctor will prescribe what is appropriate for you from a limited list of medications). Covered.
$1 Copayment for generic drugs
$3 Copayment for name brand drugs
Emergency ambulance transportation Not covered
Limited medical supplies Covered $5 copayment


The following benefits are NOT Covered:Inpatient hospital care, Maternity or obstetrical care, Dental and vision services, Durable Medical Equipment.

Who are the providers and how do you choose a provider?
Providers are affiliated with Hurley, Genesys and McLaren health systems. You will be asked to choose a Primary Care Physician (PCP) from the list of GHP participating physicians. You can choose your PCP at the time of application, by calling GHP at (810) 720-7785, or by talking with a health department representative. You may change providers one time each year. If you do not choose a doctor within 15 days of enrollment, one will be assigned. You will be notified of the choice and will have an opportunity to make a change.

How long will you be a member of GHP?
GHP and FIA will do a redetermination of eligibility at least every 24 months. However, you may not stay enrolled in GHP if you become eligible for other insurance. If you are found eligible for Medicaid you will no longer have GHP coverage.

What happens if you need inpatient care?
Inpatient care is not a benefit of GHP. If inpatient care is needed, you should seek care at a local hospital. The hospital will determine if you are eligible for a special program or payment plan. You may also be asked to apply for Medicaid.

How does my doctor know if I am eligible for services?
You will receive an enrollment card. If it is necessary for you to see a doctor or get medicine before you get your enrollment card, call Genesee Health Plan at (810) 720-7785. Providers can access the Integrated Voice Response (IVR) system at 1-800-675-2965 to confirm eligibility, PCP assignment and coverage. Customer Service is available through HealthPlus at 1-800-332-9161.

*Applicants with income below $500 per month should go to Family Independence Agency to apply for State Medical Plan enrollment (SMP). FIA determines eligibility.


The website should be up next month
http://www.GeneseecountyHealthPlans.org
Post Mon Oct 16, 2006 11:37 pm 
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