Benefits


Access Health’s C3 Health plan is low cost coverage with no deductibles, available to qualified workers in the Muskegon area. The organization crafts proven, innovative health solutions to meet its triple goals of better health care, better health quality, and lower health care costs. As a result of receiving Minimum Essential Coverage designation in 2014, the C3 Health plan ensures that participating members have coverage meeting the federal mandate for individuals. Members will not be subject to the IRS penalty for failure to comply with the mandate for the duration they are covered by C3 Health.

Access Health also offers the Continuous Health Improvement (CHI) program which is a significant driver in keeping health costs low and actively helping individuals achieve and maintain good health. This makes C3 Health unique in its ability to provide excellent coverage at a very low cost to members. Even as the plan keeps costs in check, it reimburses providers at rates comparable to commercial plans.

The C3 Health Plan Basics

Members can refer to their C3 Health handbook for a full description of their covered benefits, pharmaceutical formulary, and a list of in-network providers. Following are some of the basic aspects of the plan:

  • No deductibles
  • No co-pays for preventive services
  • No annual or lifetime maximum: There is no annual or lifetime limit on the benefits that you can receive
  • An annual limit on out-of-pocket costs: There is a limit on the out-of-pocket health care expenses (co-pays and coinsurance) that members pay every year
  • Out-of-Network Coverage: Members are covered for out-of-network services and treatment, typically at a 50% rate
  • In addition to the essential health benefits required by law, the C3 Plan helps coordinate many community health resources that help improve a member’s health

Health Services: Eligible members have access to numerous community health services such as health and nutrition classes, classes in chronic health conditions, smoking cessation programs, and many others.

Continuous Health Improvement (CHI) program: Eligible members will receive lower premiums for taking part in the CHI program. This health improvement wellness program actively helps individuals achieve and maintain their optimal health. This program favorably impacts cost through health risk management for participants.

What is Included in Minimum Essential Coverage?

The following benefits, while not a comprehensive list of C3 Health's robust benefit design, are the essential health benefits required by the Affordable Care Act:

  • Ambulatory patient services (outpatient care you get without being admitted to the hospital)
  • Emergency services
  • Hospitalization (such as surgery)
  • Maternity and newborn care (care before and after your baby is born)
  • Prescription drugs
  • Rehabilitation and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental or physical skills)
  • Laboratory services
  • Preventive and wellness services
  • Chronic disease management
  • Pediatric services