Plan B is for individuals whose incomes are 150% or less of poverty and who are not eligible for any government-sponsored healthcare program.   Eligibility Requirements:

• Age 19-64 (children and seniors who are non U.S. citizens may qualify)
• Meet the income guidelines (see below)
• Kent County resident
• Do not have any health insurance or any other health benefits (with the exception of Medicaid Spend Down)
• Not eligible for Medicaid, Medicare, MIChild or Healthy Kids
• Non U.S. citizens ARE ELIGIBLE if they meet the above requirements

Children of U.S. citizens or permanent residents may be eligible for other State of Michigan or Federal programs.  For more information on MIChild, click here.

Income Guidelines

NOTE: These amounts refer to gross income (income before deductions)

• Household of 1 = $16,245 per year (or less)
• Household of 2 = $21,855 per year (or less)
• Household of 3 = $27,465 per year (or less)
• Household of 4 = $33,075 per year (or less)
• Household of 5 = $38,685 per year (or less)
• Add $5,610 for each additional family member

Covered Services and Copays

• There is no fee for enrollment and membership. There is a small co-pay for some services.
• If you are a member of this program and have questions about your coverage, please call Kent Health Plan at (616) 726-8204. 
• If you are a provider and have questions, please call Kent Health Plan at (616) 726-8204.
• Covered services and required copayments are as follows:

• To view the list of medications covered by Kent Health Plan, Plan B, click here.  Some medications require prior authorization before being filled.  To request prescription authorization, please call Kent Health Plan at (616) 726-8204.

• Kent Health Plan has recently made some changes to the prior authorization process.  Some brand name medications will now be covered under the following:
• An application will be made to the Pharmacy Assistance Program (PAP) for that medication.
• A medication will be covered through the Community Medical

Fund (CMF) for up to 90 days until a member begins to receive their medication from the Pharmacy Assistance Program.

To view a list of medications available through the CMF and PAP, click here.

Members will need to contact their doctor’s office to complete an application for the Pharmaceutical Assistance Program.  If a doctor’s office is unable to help with this process, the member may contact Kent Health Plan (726-8204) for assistance in completing the application.

• For any other medication inquiries, please call Kent Health Plan at (616) 726-8204 or email Jan at JHronek@kenthealthplan.org.

• Services NOT COVERED by Plan B include inpatient hospitalization, outpatient hospital care, visits to an emergency room, mental health and substance abuse services, dialysis, medications not on the KHP list of covered medications, organ transplants, transfusions, chiropractic care, experimental treatment, speech or occupational therapy, hearing aids and related services, durable medical equipment, prosthetics and orthotics, weight loss programs, cosmetic surgery, home health services, services related to sex change, vision screening, eyeglasses, contact lenses, and dental care of any kind. Also not covered is any condition that can be paid for under another public or private health care program or insurance, medical services to prisoners, hospice care, any service not authorized by a KHP provider, travel shots, and sports physicals.

Enrollment

Kent Health Plan, Plan B is not currently accepting applications.   

Please ask your clinic or doctor’s office if other help is available.  For prescription assistance you can also call 1-888-477-2669.  For more resources, you can call United Way at 2-1-1 or 459-2255. 

If you have any additional questions about this program, please contact Kristi at Kent Health Plan by calling (616) 726-8204 ext. 1, or emailing her at kristighering@kenthealthplan.org.