Community Health Solutions

Overview

Our C3 Health plan is low-cost coverage with no deductibles, available to qualified workers in the Muskegon area.

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.

We also offer the Continuous Health Improvement (CHI) program, a significant driver in keeping health costs low and actively helping individuals achieve and maintain good health. CHI working in tandem with C3 makes our model 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.

To see where you can find C3 participants, please check our participating providers and pharmacies.


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
  • An annual limit on out-of-pocket costs
  • Out-of-Network Coverage: Members are covered for out-of-network services and treatment, typically at a 50% rate
  • Community health resource coordination
  • Access to health education, including chronic disease management
  • Lower premiums available to members who participate in our CHI program

What is Included in Minimum Essential Coverage?

The following benefits, while not a comprehensive list of C3 Health’s 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