Genesee Health Plan — Plan B Services Not Covered

Genesee Health Plan Services Not Covered — Plan B

Genesee Health Plan does not cover the following services and payment will not be made for:

Services needed because of a motor vehicle accident
Services for illness that is covered under no fault law, worker’s compensation, Occupational Disease Law or other legislation
Ambulance
Brand medication
Custodial or nursing home care
Chiropractic services
Infertility or sterilization services
Experimental procedures, treatments, or drugs
Chemotherapy
IV Infusion
Sleep Studies
Nuclear Radiology
Comfort or convenience items
Durable medical equipment, prosthetics and orthotics, corrective shoes or wigs
Speech, physical, or occupational therapy
Hearing aid services or materials
Weight reduction services or programs
Services considered to be cosmetic
Home health services
Hospice care
Services or supplies related to sex or gender change
Vision exams, eyeglasses, or contact lenses (exams by referral related to chronic illness are covered)
Dialysis services
Podiatry services (exams by referral due to chronic illness are covered)
Outpatient services for TB screening or treatment
Dental services including oral surgery
Substance abuse screening and treatment
Mental health clinic services
Organ transplants
Maternity or obstetrical services^*
Inpatient hospital care
Medical services to anyone incarcerated
Diagnosis or treatment of an injury or illness which occurs from an act of war, commission of a felony, or illegal business
Contraceptive methods or fertility drugs
Any condition for which an enrollee is eligible to receive health care services or benefits through a public or private benefit, program, or insurance
Lodging expenses
Ambulance transportation
Emergency transportation by air
Non emergency transportation
Office visits, exams, treatments or tests related to documentation of health for employment, insurance, marriage license, school, sports physicals, citizenship or any legal proceeding or court-mandated activity
Services received before the effective date of coverage or after the termination of enrollment
Over-the-counter medicines or supplies such as first aid materials or vitamins
Services not approved by the GHP doctor on your enrollment card or a specialist you are referred to
Services that are not medically necessary
Medical services outside of Genesee County unless prior authorized

^*If you become pregnant while a member of Genesee Health Plan, you should contact the local Genesee County Michigan Department of Human Services (formerly known as the Genesee County FIA or Family Independence Agency) and ask about Medicaid eligibility as soon as possible. Remember to avoid drugs and alcohol if you suspect you may be pregnant.