Eligibility

Genesee Health Plan has the following programs available.  Eligiblity information for each program is as follows:

Plan A

Plan A is the Adult Benefit Waiver Program through Michigan Department of Community Health.  Eligibility and program open enrollment dates are determined by MDCH. Visit their website at http://www.michigan.gov/mdch/0,1607,7-132-2943-66333--,00.html or contact them by calling 1-800-642-3195.

Plan B

If you live in Genesee County, are between the ages of 19-64, have no health insurance, are a U.S. citizen, and meet the income requirements below, you may qualify for Plan B. You may have Medicaid spend down and be eligible to enroll. You must come into the office and complete an application.. Please call (810) 232-7740 if you have additional questions.

Family Size

Annual Income Limit for Plan B

Monthly Income Limit for Plan B

One

$18,953.00

$1,711.00

Two

$25,498.00

$2,302.00

Three

$32,043.00

$2,893.00

Four

$38,588.00

$3,484.00

Five

$45,133.00

$4,075.00

For each additional dependent in your family, add $5,705

When You Enroll

When you enroll, you will need proof of household income (a paystub), your social security card and a picture ID. A Michigan Identification Card or driver’s license will do.   A membership card will  be mailed to you within 10 business days.   If you do not receive a card, please call customer service at 810-720-7785. Your coverage becomes effective the first day of the second month in which you enroll in Genesee Health Plan.  For example, if you apply in February, your coverage will be effective on April 1.

You will need to show picture identification when you use your enrollment card to receive health care services.

Only the person listed on the card may use it to receive services.

Keep your identification card with you at all times. Your card has an expiration date for coverage. It is your responsibility to contact Genesee Health Plan at (810) 232-7740 before the expiration date to make sure your coverage isn’t interrupted and that you are still eligible for coverage.

Choosing a Doctor

You must see a Genesee Health Plan doctor or provider for your health services. Referrals to a specialist must be within the same health system as your primary care physician. Your doctor has a list of these providers. If you did not select a primary care physician at the time of enrollment, you should call (810) 720-7785 to choose a doctor from the provider list. If you did not choose a doctor at enrollment, or have not called to choose a doctor, Genesee Health Plan will pick a doctor for you and notify you by mail. You may choose your doctor once a year. However, we will be happy to work with you to find a doctor if there are special issues or concerns. It is recommended that after you have enrolled in Genesee Health Plan, contact your primary care physician and schedule an initial appointment.

Your doctor will arrange for your care, including referrals to a specialist, x-rays or prescriptions. If you need to see your doctor, call for an appointment. The number is on your enrollment card. Describe why you need to see the doctor. The doctor’s assistant may give you an appointment. He or she may also suggest that you try something at home or go to a specialist.

Be ready for your appointment with the doctor:

  • Write down how you are feeling.
  • Write down any questions you want to ask.
  • Write down the names of any medicines you are taking.
  • Ask questions about your doctor’s directions.

If you need to change or cancel an appointment, please call your doctor the day before. It is your
responsibility to keep all doctor appointments. You may be charged for appointments not kept. This
allows your doctor to see someone else who may need services. If you have a life-threatening emergency, you should go directly to an emergency room or call 911.

Disenrollment From Genesee Health Plan
   
 

Other Insurance

If you become eligible for any kind of insurance, you will not be eligible for enrollment in Genesee Health Plan or the State Medical Program. Please notify Genesee Health Plan at (810) 720-7785. This is a local call.

Moving out of Genesee County

You must live in Genesee County. Please notify Gemesee Health Plan at (810) 232-7740 if you move out of Genesee County.

Change of Income  

Please notify the Genesee County Health Plan at (810) 232-7740 of any change in income or circumstances. 

Fraud and Abuse

Genesee Health Plan (GHP) does not condone activities of fraud and abuse by its members.  Activities of fraud and abuse include:

*  Altering or forging a prescription by the member.

*  Drug-seeking behavior, attempting to go to multiple physicians or pharmacies to get narcotics or other addictive medicines.

*  Aggressive or threatening behavior to GHP Staff or to GHP contracted providers or their office staff.

* Misrepresentation of themselves or the information a member provides.

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