The County Health Plan (CHP), Plan B, is a community sponsored program for people living
in the servicing county(s) without medical coverage. The CHP requires a periodic enrollment renewal. Members will
get a renewal notice in the mail about two months before their enrollment ends. Members must complete and return
this paperwork by the date stated in the notice to remain eligible.
Members should inform the CHP of any address changes
during their enrollment. Failure to provide the CHP with address changes could
prevent a member from receiving their renewal notice.
The CHP will review the paperwork and make sure the member
still meets eligibility requirements to participate. If a member qualifies for the plan, their coverage will be renewed.
Eligibility requirements for the health plan can vary plan
to plan but generally require the member to:
- Live in a county the plan services,
- Not be eligible for any type of comprehensive private or public
health insurance (i.e., Medicare A/B, Medicaid, Adults Benefit Waiver),
- Have a yearly gross household income below a certain percentage of the federal poverty level.
The below renewal form can be completed online and mailed to PO Box 30125,
Lansing, MI 48909, faxed to 517-394-4549, or emailed to email@example.com.
To email the form to us, save the completed form to your computer and attach the
document to an email. In order for your information to be saved directly on the form,
you must have Adobe Acrobat."
IHP B MEMBER RENEWAL
If you require assistance in completing this form, help is available
at one of the below outreach sites. Please contact them for hours and directions.
|Allen Neighborhood Center
|Capital Area Community Services
|Greater Lansing African American
|Southside Community Coalition