Medicaid in Michigan is a critical public health insurance program designed to provide health coverage to low-income individuals and families, including children, pregnant women, older adults, and people with disabilities. Managed by the Michigan Department of Health and Human Services, it operates with federal and state funding, offering a wide range of health services such as doctor visits, hospital stays, long-term care, and preventive care.

Michigan has also expanded Medicaid under the Affordable Care Act (ACA) through the Healthy Michigan Plan, significantly increasing the number of residents eligible for coverage. The program has made strides in improving access to healthcare services, reducing the uninsured rate, and supporting public health outcomes across the state. Eligibility for Medicaid in Michigan is determined based on income, family size, and other factors, with the program continually evolving to meet the healthcare needs of its residents.

Medicaid in Michigan covers a comprehensive range of health services to meet the diverse needs of its enrollees. Here's an overview of some of the key covered services, along with a brief description of each:

1. Doctor Visits - Regular check-ups and consultations with healthcare professionals to manage health and diagnose conditions.
2. Hospital Services - Inpatient and outpatient hospital care, including surgeries, emergency services, and other medical treatments.
3. Prescription Drugs - Medications prescribed by a doctor, covered under the plan to ensure patients have access to necessary pharmaceuticals.
4. Vision Care - Eye examinations and corrective lenses (glasses or contacts) as needed to maintain good vision.
5. Dental Services - Preventive dental care, treatment for dental conditions, and sometimes orthodontic services depending on the beneficiary's age and specific program.
6. Mental Health Services - Counseling, therapy, and psychiatric services for mental health and substance abuse disorders.
7. Long-term Care Services - Support for individuals who need ongoing care, including nursing home care and home health care services.
8. Rehabilitative Services - Therapies aimed at improving, maintaining, or preventing deterioration of skills and functioning, such as physical therapy, occupational therapy, and speech-language pathology.
9. Preventive and Wellness Services - Screenings, vaccinations, and other services intended to prevent illness and promote health.
10. Maternity and Newborn Care - Comprehensive care during pregnancy, childbirth, and for newborns, ensuring healthy outcomes for mothers and babies.
11. Emergency Services - Medical attention for emergency conditions, accessible without prior authorization.
12. Family Planning Services - Services and supplies related to birth control, pregnancy tests, and counseling for family planning.
13. Pediatric Services - Includes care for children and adolescents, covering regular check-ups, immunizations, and specialist care as needed.

Each of these services is designed to ensure comprehensive coverage for health needs, promoting the well-being of Michigan's Medicaid enrollees.

Eligibility for Medicaid in Michigan is determined based on several factors, including income, family size, age, and specific health needs. The program uses the Federal Poverty Level (FPL) as a benchmark to determine financial eligibility. Here are some of the particular eligibility levels as a percentage of the FPL for different groups:

1. Children and Pregnant Women: Michigan offers higher income limits for children and pregnant women to ensure they receive comprehensive healthcare. For example, pregnant women and infants under one year may qualify with household incomes up to approximately 195% of the FPL, and children aged 1-18 may be eligible with household incomes up to approximately 160% of the FPL.
2. Adults under the Healthy Michigan Plan: The Healthy Michigan Plan, Michigan's Medicaid expansion under the Affordable Care Act, covers adults aged 19-64 with incomes up to 138% of the FPL. This expansion significantly increased access to Medicaid coverage for low-income adults without dependent children.
3. Parents and Caretaker Relatives: Parents and caretaker relatives living with dependent children may qualify for Medicaid with incomes up to approximately 33% of the FPL. However, this can vary and is subject to change based on state policy adjustments.
4. Seniors and Individuals with Disabilities: Eligibility for seniors (aged 65 and older) and individuals with disabilities typically focus more on asset limits in addition to income, with the income threshold often set at 100% of the FPL, but eligibility must be determined based on the specific circumstances, including whether they receive Supplemental Security Income (SSI).
5. Special Programs and Waivers: Michigan also offers various Medicaid waiver programs and special eligibility categories for individuals with specific needs, such as those requiring long-term care services, which may have different eligibility criteria, including higher income and asset limits.

These eligibility levels are subject to change due to legislative or policy updates. Additionally, the application of these percentages can vary based on household size, and some deductions and disregards can affect the calculation of countable income.

Applying for Medicaid in Michigan is a straightforward process, and there are multiple ways to apply to ensure accessibility for all residents. Here are the steps and contact information to guide you through the application process:

Online Application

The MI Bridges portal is the most convenient way to apply for Medicaid in Michigan. This website allows you to apply for healthcare coverage and other state benefits from the comfort of your home. You will need to create an account if you don't already have one, fill out the application form, and submit it online.

In Person

You can apply in person by visiting your local Michigan Department of Health and Human Services (MDHHS) office. To find the nearest office, you can use the office locator available on the MDHHS website (http://www.michigan.gov/mdhhs) or call the MDHHS helpline at 1-855-275-6424 (1-855-ASK-MICH). When applying in person, you can get assistance from a staff member, which can be particularly helpful if you have questions or need help filling out the application form.

By Mail

If you prefer to apply by mail, you can download the application form from the MI Bridges website or request a paper application by calling the MDHHS helpline at 1-855-275-6424. Once completed, mail your application to your local MDHHS office. The address can be found using the office locator on the MDHHS website.

Through a HealthCare Navigator

Michigan offers assistance through HealthCare Navigators, who can help you understand your options and complete the Medicaid application process. Navigators are trained to provide free assistance. To find a Navigator near you, visit the Michigan Health Insurance Consumer Assistance Program (MICAP) website or call 1-877-999-6442.

Once you have submitted your application, the MDHHS will review it to determine your eligibility. You will receive a notification about the decision. If approved, you will be informed about your Medicaid coverage details, including how to access services and choose a health plan if required.

For more information or assistance with the application process, contact the MDHHS helpline at 1-855-275-6424 or visit the MI Bridges portal.

Renewing Medicaid coverage in Michigan is important to ensure your healthcare benefits continue without interruption. Medicaid renewal happens once a year, and the state will notify you when it's time to renew your coverage. Here's what you need to know about the renewal process:

The Michigan Department of Health and Human Services (MDHHS) will mail you a renewal notice when it's time to renew your Medicaid coverage. This notice typically arrives a few months before your coverage is set to expire.

The renewal form you receive will include the information currently on file. Review this information carefully to ensure it's accurate. If there have been any changes to your income, household size, or other significant information, you'll need to update this information as part of the renewal process.

How to Renew

You can renew your Medicaid coverage in several ways, similar to the application process:

• Online: The easiest way to renew your Medicaid coverage is through the MI Bridges portal (https://newmibridges.michigan.gov). Log in to your account to complete and submit your renewal form electronically.
• By Mail: Complete the renewal form included with your notification and mail it back to the address provided. If you've lost your renewal form, you can request a new one by contacting your local MDHHS office or through the MI Bridges portal.
• In Person: You can also renew your coverage by visiting your local MDHHS office. Find your nearest office through the MDHHS website or by calling the MDHHS helpline.‍
• By Phone: Sometimes, you can renew your coverage over the phone by calling the MDHHS helpline at 1-855-275-6424 (1-855-ASK-MICH).

By following these steps and keeping your information current, you can ensure a smooth renewal process and maintain your Medicaid coverage in Michigan.