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Members - Deductible FAQ
 

Questions often come up about deductible plans. The most common questions and answers are listed below. If you have additional questions about deductibles, or other Grand Valley Health Plan healthcare plan questions, please contact Customer Service at 616-949-2410.

What services are not subject to the deductible?

The following services are not subject to your deductible:

  • Services performed at a Grand Valley Health Plan Health Center
  • Services performed at the Grand Valley Health Plan Diagnostic Radiology Center
  • Services performed at the Grand Valley Health Plan Urgent Care Center
  • Preventative healthcare services

What types of services are subject to my deductible?

All other services not listed above including, but not limited to, visits to a specialist, emergency care services, hospitalizations and outpatient surgical center visits.

What out-of-pocket costs do not apply to your deductible?

The following out-of-pocket costs do not apply to your deductible:

  • Co-payments
  • Non-covered medical services
  • A deductible met on a prior insurance plan
  • Deductibles that may have been met on a previous Grand Valley Health Plan contract

Do deductibles carry over to the next contract year?

No, your deductible requirements renew every contract year.

Is the plan year and benefit year the same for deductibles?

Yes.

Does my deductible apply if my provider refers me to have an outside service?

Yes, your deductible will apply even if your provider refers you. Further, if you do not receive proper authorization for a service, you may be responsible for the charges. In that case, these charges will not apply to your deductible.