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Wayne County Four Star Health

posted on: Jan 9, 2015

Wayne County Four Star Health

 

Address: 2850 W. Grand Blvd.

City: Detroit

State: Michigan

Zip Code: 48202

Email: info@waynecountyfourstar.org

Phone: 866-780-6655

 

We’ve all joined together to provide Wayne County health coverage like no other.

“Smart employers, health plans, and medical providers are experimenting with ways to save people’s health dollars or use them more effectively. Their goal is to make it easier, even in a recession, for families to receive the care they need.”

The Wayne County Four Star Health program is a non-profit Michigan corporation organized to provide health coverage for the working uninsured in Wayne County. It is known as a “three-share” program because your employees and you share two-thirds of the monthly premium cost – and the non-profit fund covers one-third. And with the local hospitals charging heavily reduced fees the coverage limits go farther and the premiums stay even lower. Everyone worries less.

Wayne County Four Star is available exclusively to Wayne County small businesses with 2 – 100 employees. It’s managed by a board of directors from the DMC, Oakwood, Henry Ford, St. John and Wayne County. Your business must have over 50% of the qualifying employees residing here and have employees who have not participated in an employer sponsored health plan in the last 12 months. At least half of the employees of the group must earn $16.00 or less per hour.

Employer and employees pay only ea. Per mo. $62.00

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Four Star Health is a community based not-for-profit organization developed to provide affordable health coverage.

Four Star is an employer sponsored program for low and moderate income uninsured employees in Wayne County.

Wayne County Four Star is a 3-share model in which the premium cost is shared between the employer, the employee, and the county, each paying $62.00 per month.
Who is eligible?

* Wayne County Four Star Health coverage is available to Wayne County businesses with 2 to 100 employees and with 50% of their employees residing here
* Eligible employees must not have participated in an employer sponsored health plan in the last 12 months and half of the group must earn $16.00 or less per hour
* The company must have been in business for a minimum of 6 months
* Because of the nature of the WCFS Program and the support provided  to the program from Federal and State funds, the WCFS Program is not considered insurance for purposes of Federal and State insurance regulations.  For this reason, the WCFS program, at this time  does not offer coverage for dependents up to 26 years old as some more traditional insurance products have offered.

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Benefits and Co-pays
Inpatient Care
Hospitalization* $100.00
Psychiatric treatment* $100.00
Maternity – delivery* $100.00

Emergency Care
Emergency room visit* $50.00

Outpatient Care
Physician office visits $15.00
Pre & post-natal maternity $15.00
Urgent care center visit $25.00
Ambulance service 10% coinsurance
Surgery facility* No Co-pay
Lab test & radiology No Co-pay
Durable medical equipment* $50.00
Medical supplies* $50.00
Psychiatric care $15.00
Physician surgical care* No Co-pay
Anesthesia services* No Co-pay
Physician consultations $15.00
Sub abuse care 10% coinsurance
Home health agency visit* No Co-pay

Pharmaceuticals
Generic formulary drugs $5.00
Brand name drugs* 50% coinsurance

* Benefits with certain annual or lifetime maximum limits.

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What benefits are covered by Four Star?

Primary Care
The Four Star benefit includes primary care from within any of the health system physician networks. More than 850 doctors participate in Four Star.

Hospitalization
Hospitalization care is covered up to 20 days or $25,000 per year. This includes coverage for semi-private room and board, Intensive Care Unit, and ancillary services.

Emergency Care
Emergency room care is covered up to a maximum of $1,000 per visit to any of the four partner health system ERs.

Outpatient Care
Four Star provides coverage for many outpatient care services, including: Urgent Care, ambulance, lab and x-ray, outpatient surgery, and maternity care.

Pharmaceuticals
The Four Star drug benefit covers up to $2,500 annually and promotes the use of generic drugs with low co-pays.

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Health Coverage Benefits that fit your budget.

Primary care office visits
Maternity care
Prescription drugs
Specialist office visits
Outpatient behavioral visits
Outpatient services
Inpatient hospitalization
Urgent care center visits
Emergency room visits
Home care visits
Lab and x-ray services

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Wayne County Four Star Health is affordable at all four of the area’s major health systems.

Partners in Wayne County Four Star include:

St. John Providence Health System
• St. John Hospital & Medical Ctr.

Detroit Medical Center
• Detroit Receiving Hospital
• Harper University Hospital
• Hutzel Women’s Hospital
• Rehabilitation Institute of MI
• Sinai-Grace Hospital

Henry Ford Health System
• Henry Ford Hospital

Oakwood Healthcare System
• Oakwood Anapolis Hospital
• Oakwood Heritage Hospital
• Oakwood Hospital & Medical Ctr.
• Oakwood Southshore Medical Ctr.