Paul Sanchez
Medicaid is a health care program that provides comprehensive health care services to low-income adults and children in Michigan. The program is also available to certain low-income individuals aged 65 or older, as well as those who are disabled or blind, although there are asset and income limits in these cases. To apply for Medicaid in Michigan, you can apply online using MI Bridges, regardless of your age. If you are under 65 and don't have Medicare, you can also begin the process through Healthcare.gov, which will direct you to Michigan Medicaid. You can also fill out a paper application (form DCH-1426) and submit it by mail, fax, or in person at a local office.
| Characteristics | Values |
|---|---|
| How to apply | Apply online using MI Bridges, or begin the process through Healthcare.gov (only if you are under 65 and don't have Medicare) |
| Fill out form DCH-1426 and turn it in at a local office, by fax, or by mail | |
| Call the application helpline at 1-855-276-4627 | |
| Apply online at www.michigan.gov/mibridges | |
| Apply online at www.michigan.gov/mdhhs | |
| Apply at MDHHS offices at 44777 N Gratiot, Suite A, Clinton Township, MI 48036; 586-469-7700 | |
| Eligibility | Children up to 1 year with household income up to 195% of FPL |
| Children ages 1-18 with household income up to 160% of FPL; children with household income up to 212% of FPL qualify for MICHILD | |
| Pregnant women with household income up to 195% of FPL | |
| Adults with household income up to 133% of FPL (138% with the built-in income disregard) | |
| Certain low-income people who are 65 or older, disabled, or blind |
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What You'll Learn
Online application process via MI Bridges
To apply for Medicaid health insurance in Michigan online via MI Bridges, you can follow the steps outlined below:
Firstly, navigate to the MI Bridges website at https://newmibridges.michigan.gov. Here, you will find an option to 'Find a Community Partner'. You can search for a nearby Navigator by entering your address. The Macomb County Health Department has a navigator that can assist in English or Spanish, and they can be contacted at 586-469-5520.
If you would prefer to apply independently, you can create an account on the MI Bridges website. You will be required to fill out form DCH-1426. Should you encounter any difficulties during the application process, you can call the application helpline at 1-855-276-4627. Alternatively, you can contact the MiBridges HelpDesk for application assistance at 844-799-9876. This helpline is available Monday through Friday from 8 a.m. to 5 p.m. and offers assistance in Spanish and Arabic in addition to English.
Online applications are generally processed faster than paper applications. After completing your application, you will be notified of the programs for which you and your family members are eligible.
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Paper application process
The Michigan Department of Health and Human Services (MDHHS) offers several ways to apply for health care coverage. While online applications are encouraged and will be processed faster, you can also apply via a paper application. Here is the paper application process:
- Download the paper application at www.michigan.gov/mdhhs.
- Click on 'Assistance Programs', then 'Health Care Coverage', and then 'Go to Health Care Coverage'.
- Next, click on 'Application for Health Coverage and Help Paying Costs'.
- Complete the fillable form DCH-1426 or download the printable version.
- Turn in the completed form at a local office, by fax, or by mail. The mailing address is: Michigan Department of Health and Human Services Health Insurance Affordability Program PO Box 8123 Royal Oak, MI 48068-9985.
You can also find the location or fax number for a local office. If you need help with your application, call the application helpline at 1-855-276-4627.
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Income eligibility criteria
Income eligibility is a key factor in determining whether you qualify for Medicaid health insurance in Michigan. The income limits vary depending on your age, family situation, and health status. Here is a detailed breakdown of the income eligibility criteria:
Children up to one year old are eligible for Medicaid coverage if their household income is up to 195% of the Federal Poverty Level (FPL). For children aged 1 to 18, the income limit is slightly lower, with a household income of up to 160% of FPL. However, if the child's household income is up to 212% of FPL, they may qualify for MICHILD, which provides low-cost health insurance for kids.
Pregnant women can receive Medicaid coverage if their household income is up to 195% of FPL. This ensures that they have access to essential prenatal and postnatal care. For adults without children, the income limit is lower, with a household income of up to 133% of FPL. However, this increases to 138% with the built-in income disregard, providing more flexibility for those just above the initial threshold.
For certain low-income individuals who are 65 or older, disabled, or blind, Medicaid coverage is also available. However, in addition to income limits, there are asset limits for these populations. The specific asset limits can be found on the Department of Community Health website, along with more detailed information on covered groups and eligibility guidelines.
It's important to note that Michigan's Medicaid expansion program, Healthy Michigan, offers additional coverage options. As of April 1, 2018, some Healthy Michigan enrollees with income above the poverty level (between 100% and 138%) had the option to switch to a Qualified Health Plan (QHP) subsidized with Medicaid funds or work with their doctors to meet healthy behavior requirements to remain on the Healthy Michigan Plan.
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Health behaviour requirements
To apply for Medicaid in Michigan, there are specific health behaviour requirements that individuals must meet to be eligible for health insurance. These requirements are essential to ensure that individuals can access the care and support they need to maintain and improve their health. Here is an outline of the key health behaviour requirements:
Maintaining Good Health: Individuals are expected to take responsibility for their health and well-being. This includes adopting healthy behaviours such as a balanced diet, regular exercise, and abstaining from harmful substances. Michigan's Medicaid program may offer resources and educational programs to help individuals make positive health choices.
Preventative Care: Preventative care measures are important to maintain good health and reduce the risk of developing more serious health conditions. This includes regular check-ups, screenings, and immunizations as recommended by healthcare professionals. For example, Medicaid beneficiaries may be required to undergo annual physical examinations, dental check-ups, and age-appropriate cancer screenings.
Chronic Condition Management: For individuals living with chronic illnesses or conditions, active management of their health is crucial. This entails diligently following treatment plans and medication regimens prescribed by healthcare providers and attending regular medical appointments to monitor and manage their condition effectively. Medicaid may offer specialized programs or care coordination services to support individuals in this regard.
Substance Use and Mental Health: Addressing substance use disorders and mental health issues is an integral part of the health behaviour requirements. Individuals struggling with substance use may be required to participate in treatment programs, counselling, or support groups as part of their recovery journey. Additionally, maintaining mental health wellness through therapy, psychiatric care, or other recommended treatments is important for overall well-being. Michigan's Medicaid program likely offers a range of services in this domain.
Compliance with Medical Advice: Adhering to the recommendations of healthcare professionals is a key aspect of the health behaviour requirements. This includes following through with prescribed treatments, attending specialist appointments, and implementing suggested lifestyle changes. By complying with medical advice, individuals demonstrate their commitment to improving and maintaining their health.
Health Education and Self-Management: Empowering individuals to take an active role in their health care is essential. This includes encouraging individuals to seek health education, learn about their health conditions, and develop self-management skills. Through knowledge and understanding, individuals can make informed decisions and actively participate in their health management.
Meeting these health behaviour requirements underscores an individual's dedication to their health and well-being. Medicaid beneficiaries in Michigan have access to comprehensive health services and resources designed to support and enhance their journey towards a healthier life. These requirements serve as a framework to ensure individuals can fully benefit from the health insurance coverage provided by Medicaid.
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Medicaid health plans
Medicaid is a health care program that provides comprehensive health care services to low-income adults and children. Services covered by Medicaid are offered through what is called fee-for-service or through Medicaid Health Plans. Most people must join a health plan. The health plan pays for most of the services.
You can apply for Medicaid coverage in Michigan in the following ways:
- Apply online using MI Bridges (if you are any age), or begin the process through Healthcare.gov, and you’ll be directed to Michigan Medicaid (use this option only if you are under 65 and don’t have Medicare).
- Fill out a paper application (the form is DCH-1426) and turn it in at a local office, by fax, or by mail. The mailing address is: Michigan Department of Health and Human Services Health Insurance Affordability Program PO Box 8123 Royal Oak, MI 48068-9985.
- Apply with the paper application which you can download at www.michigan.gov/mdhhs. Click on Assistance Programs, click Health Care Coverage, click Go to Health Care Coverage, click Application for Health Coverage and Help Paying costs. Complete the fillable form DCH-1426 or download the printable version.
- Apply online at the MDHHS offices at their kiosks: 44777 N Gratiot, Suite A, Clinton Township, MI 48036; 586-469-7700.
After enrollment with a health plan, both the mihealth card and the health plan card are needed to access services. Enrollees do not have to pay the full cost of covered services; however, a small amount called a co-pay may be required. People age 21 and older may have a co-pay for the services listed in the co-pay chart.
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Frequently asked questions
You can apply for Medicaid coverage in Michigan by filling out form DCH-1426 online using MI Bridges or by beginning the process through Healthcare.gov. If you are 65 or older and have Medicare, you must use the MI Bridges option.
Medicaid in Michigan is available for low-income adults and children. There are also provisions for certain low-income people who are 65 or older, disabled, or blind, but there are asset limits in these cases.
Children up to 1 year old are eligible if the household income is up to 195% of the FPL. Children aged 1-18 are eligible with a household income of up to 160% of the FPL, and children with a household income up to 212% of the FPL qualify for MICHILD, a low-cost health insurance plan.
Pregnant women with a household income of up to 195% of the FPL are eligible for Medicaid.
Adults with a household income of up to 133% of the FPL (138% with the built-in income disregard) are eligible for Medicaid in Michigan.
