Here you will find some common questions and answers about Access Health. This is not a complete listing of questions. Contact the Access Health office if you have questions you do not find on the site:

Does Access Health cover prescriptions?

Yes. Members and providers should refer to the Formulary. This is a listing of covered medications. There is an annual limit that Access Health will pay out per member. To offset this, members can utilize other prescription programs offered at local retailers, such as Meijer, Target or Walmart.

What if my medication is not on the Formulary?

Medications not on the formulary are not covered by Access Health. Members should first contact their physician to see if there is another medication that is on the formulary in the same classification. A copy of the Member and Provider Formulary is located in the Member Resources & Information section. If not, the member should contact the Muskegon Community Health Project at 231-672-3201 to apply for a Pharmaceutical Assistance Program.

My medication is listed on the formulary, but has a PDP or PA after the medication, is it covered by AH?

Medications with a PDP or PA, will only be covered after you apply for pharmaceutical assistance. Access Health may then cover them until you start receiving them.

I am having difficulty getting my prescription at the pharmacy, what do I do?

Contact Access Health at 231-728-5180 x101 or 102. Our staff would be happy to assist you.

Does Access Health have a pre-existing medical clause?

No, the plan does not.

Does Access Health cover pregnancy?

Yes, but only if the member has applied and does not qualify for Medicaid. To screen for this, members may contact Muskegon Community Health Project at 231-672-3201.

What is the C3 Program?

The C3 Program means "Choice, Challenge and Change" which are three components of improving personal health. Members may choose to participate with the C3 or Standard Plan if your employer offers both. Some employers only offer the C3 Program. Ask your employer what they offer.

What do I have to do to participate in the C3?

Annually, complete a Health Risk Appraisal, meet with a Health Advisor, and attend two health related classes. We offer several at no charge. Contact the office if you are already attending a health related event that might count towards C3 credit. Members that smoke must attend Smoke Free which is a Tobacco Cessation class offered at the Muskegon Health Department.

If I take the Tobacco Cessation Class, do I have to quit smoking?

The class is a requirement for the C3 Plan or by protocol. If you are taking the class for a C3 credit, you are not required to quit smoking, but it is encouraged because of the adverse health risks. Members may take the class in order to assist them quit smoking prior to a surgery or service that requires them to quit smoking.

Can anyone enroll in Access Health?

Access Health is a program that is available to employers located in Muskegon and Northern Ottawa Counties who don't offer health coverage to their employees. These employers have specific guidelines that are required. Click here to read more.