Heres What Else Is Included In Our Medicaid Plans:
We make it easy to find a doctor near you who accepts your insurance plan. Our online Find a Doctor tool makes it easy to search for available doctors near you.
When it comes to preventive care, weve got you covered. We have a whole list of free services that are designed to help you get and stay healthy. With a Priority Health Medicaid plan, your preventive health care is covered. You never have to worry about getting the services you need to stay your healthiest.
Virtual care is a convenient way to see a doctor for non-emergency care using your smartphone, laptop or tablet for a variety of common illnesseswithout having to go to the emergency room or urgent care center. Best of all, its free for Priority Health Medicaid members.
Weve partnered with FeelSafe Wireless to connect Priority Health Medicaid members with free cell phones and free monthly service. This initiative was created to help you stay on top of your health care needs.
With a Priority Health Medicaid plan, you wont have to worry about being covered during pregnancy and after your baby arrives. We offer a variety of programs and benefits to our expecting members, including pregnancy dental benefits and the Maternal Infant Health Program .
If youre ready to quit, we have programs for no-cost smoking cessation coaching and nicotine replacement therapy through the Michigan Tobacco Quitline.
*Available for Healthy Michigan Plan members only.
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Who Is Eligible For Medicaid
Medicaid beneficiaries generally must be residents of the state in which they are receiving Medicaid. They must be either citizens of the United States or certain qualified non-citizens, such as lawful permanent residents. In addition, some eligibility groups are limited by age, or by pregnancy or parenting status.
State Medicaid Reimbursement Information
The Medicaid reimbursement chart outlines the methodologies and professional dispensing fee amounts utilized by states. Pharmacy payment requirements are outlined in Federal regulations at 42 CFR 447 Subpart F. The Code of Federal Regulations specifically covers payment requirements for estimated acquisition cost and reasonable dispensing fees. Co-payment amounts are addressed at 42 CFR 447.54. Information will be updated and posted on the web quarterly with the data provided for in the CMS approved state plans. We update the chart quarterly and archive the previous four quarters.
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Michigan Has Accepted Federal Medicaid Expansion
- 2,733,485 Number of Michiganders covered by Medicaid/CHIP as of May 2021
- 821,476 Increase in the number of Michiganders covered by Medicaid/CHIP fall 2013 to May 2021
- 53% Reduction in the uninsured rate from 2010 to 2019
- 43% Increase in total Medicaid/CHIP enrollment in Michigan since late 2013
Medicaid If You Are 19 Or Older
If you are 19 or older, you may qualify for Medicaid if:
If you have a disability, work, and earn too much for Medicaid, you may qualify for Freedom to Work instead.
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What Are The Non
Health and medical-related assistance can be gained when Medicaid eligibility requirements in MI are met by an applicant living in Michigan. Designed to make healthcare accessible to people on a low income, the Medicaid Health Care Program is made available to an applicant who is pregnant, has a dependent aged 19 or younger or has a child with a disability.
To qualify for Medicaid, applicants must be an official resident of Michigan State. Furthermore, proof of permanent residency, citizenship or a U.S. national identification card needs to be presented when figuring out who is eligible for Michigan Medicaid.
A Social Security Card proving your Social Security number will also be accepted for Medicaid benefits in Michigan. Copies of original documents will not be accepted, however.
Unitedhealthcare Dual Complete Plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
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How To Apply For Medicaid In Michigan
Learning how to apply for Medicaid in Michigan may seem like a difficult process. However, discovering where to apply for Medicaid and if you can apply for Medicaid online can make the enrollment process much simpler. Knowing how to fill out the Michigan Medicaid application will also make understanding the Medicaid program requirements a lot easier. You may need several important documents like your birth certificate, Social Security card and tax documents to complete your Medicaid application form, so you will want to gather all required documents before starting your application. You may be wondering, Where do you sign up for Medicaid in Michigan? when you first research the program. To find out how to apply for Medicaid in Michigan, read the information below.
Where do you sign up for Medicaid in Michigan?
There is only one way of applying for Michigan Medicaid available to applicants. You must apply for Medicaid benefits online through the portal created by the Michigan Department of Health and Human services. Once you have created an account with the benefits portal, you can verify your eligibility for the Medicaid program and apply for Medicaid as well as other government benefits programs like the Supplemental Nutrition Assistance Program . If you are enrolled in Medicaid, you are required to notify the program of important changes to your information such as address, employer and income. You may use this account to update your information.
Blue Cross Complete Medicaid Programs
The following Medicaid programs are administered by Blue Cross Complete.
Flint waiver provides additional Medicaid services for children up to age 21 and pregnant women who were served by the Flint water system since April 2014, and who have income levels up to 400 percent of the federal poverty level.
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Unitedhealthcare Senior Care Options Plan
UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.
Can I Keep Medicaid If I Get A Job
However, if your new job offers healthcare, Medicaid will generally work with you to maintain your coverage until your probationary period in your new job passes and you are eligible to enroll in your employers coverage, so you wont lose Medicaid immediately, leaving you in a gap while you wait for your new insurance
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What Is Blue Cross Complete
Blue Cross Complete is a health care plan contracted with the state of Michigan. We help Medicaid members get the health care they need in 32 Michigan counties in the Lower Peninsula. View our to learn more about the programs and services available. For more information about our mission and values, visit our page.
How To Complete The Michigan Medicaid Application
The easiest way to apply for Michigan Medicaid is to complete the online application through MI Bridges. If you prefer, you can also enroll through Healthcare.gov. If you dont want to apply online, you can and either fax or hand it into your local office, or mail it to:
Health Insurance Affordability Program
Michigan Department of Community Health
P.O. Box 30273
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Learn About Michigans Second Waiver
Michigan submitted a second waiver that got approved in December 2015. Changes to the Medicaid eligibility requirements in MI were detailed in the waiver, stating that new eligibility rules were valid once an enrollee had been involved in the plan for two years.
Two Medicaid application guideline options would then be presented to the beneficiary at the end of the second year:
Nevertheless, the government aims to make it mandatory for recipients to learn the Medicaid qualifications for QHP plan enrollment by the year 2018. No changes will be made to healthcare coverage following the approval of MIs second waiver.
B Drug Pricing Program
The 340B Program requires drug manufacturers participating in Medicaid to provide outpatient drugs to covered entities at significantly reduced prices. To participate in the 340B Program, covered entities must register and be enrolled with the 340B program and comply with all 340B Program requirements administered by HRSA. State Medicaid agencies are prohibited from billing manufacturers for Medicaid rebates for drugs dispensed to Medicaid patients that have already been discounted under the 340B Program. Additional information on the 340B Program.
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How Many People Are Enrolled In Expanded Medicaid In Michigan
Sign up for the program began April 1, 2014 , and enrollment in expanded Medicaid stood at nearly 652,000 people at the start of 2020. But enrollment climbed significantly in 2020, likely due in large part to the COVID-19 pandemic and the resulting job/income losses. As of the end of June 2020, there were 749,547 Michigan residents enrolled in Healthy Michigan.
As of April 2018, some Healthy Michigan enrollees were transitioned to private plans . This includes people with income above the poverty level who had been enrolled in Healthy Michigan coverage for 12 or more consecutive months, and who did not participate in the Healthy Behaviors Incentives Program or receive a medical exemption.
By March 2020, total enrollment in Medicaid in Michigan stood at 2,317,725, which was a 21% increase over the enrollment total at the end of 2013. This total includes people who were already eligible for Medicaid based on the pre-ACA guidelines, as well as the more than 650,000 people who had enrolled as a result of Medicaid expansion . The increase in total Michigan Medicaid/CHIP enrollment from 2013 to early 2020 was only about 406,000 people, however, which is considerably less than the total number of people covered under Medicaid expansion. But that has to be considered in light of the fact that traditional Medicaid enrollment declined between 2013 and 2015 due to an improving economy.
As of May 2021, 2,733,485 people are enrolled in Medicaid/CHIP programs in Michigan.
Medicare Advantage In Michigan
Medicare Advantage plans are the other way to get your Medicare coverage. Theyre sometimes called Part C. These bundled plans must cover all Medicare parts A and B services. Often, they include Part D, too. Medicare Advantage plans may also offer many extra benefits, such as vision, dental, and hearing care.
As a Michigan resident, you have many Medicare Advantage options. As of 2021, the following insurance companies offer Medicare Advantage plans in Michigan:
- WellCare
- Zing Health
These companies offer plans in many counties in Michigan. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
For some Michiganders, theres a third way to get Medicare: MI Health Link. These managed care plans are for people who are enrolled in both Medicare and Medicaid.
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**which Health Plan Is Available In My County
Not all plans are available in all counties, here is a map of all the health plans by county. **Washtenaw County is part of Region 9 which also includes Livingston, Jackson, Washtenaw, Hillsdale, Lenawee and Monroe counties. Your choices include Aetna Better Health, Blue Cross Complete, McLaren, Meridian, Molina and UnitedHealthcare. Here is a helpful document for choosing your plan Washtenaw County or Livingston County.
Is My Child Eligible
The child, or a parent of the minor child, or court-appointed guardian must be one of the following:
In addition:
- Children must be under the age of 21.
- Those who are 21 and older with certain conditions may also qualify.
- Must live in Michigan.
- Families with any income are eligible .
- Theres a fee to join CSHCS. This fee is waived if the child has Medicaid, MIChild, a court-appointed guardian or lives in a foster home.
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What Is Straight Medicaid In Michigan
Medicaid is the federal health insurance program that provides coverage to low-income individuals who meet the eligibility criteria. If you are a Michigan resident who meets the citizenship, income and asset requirements, you may be eligible for straight Medicaid, which is Medicaid coverage without an HMO plan.
Tips For Enrolling In Medicare In Michigan
Choosing a Medicare plan in Michigan is a big decision. Here are some things you may want to think about as you shop around:
- Provider network. If you choose to enroll in a Medicare Advantage plan, you generally need to get your care from in-network providers. Before you sign up, find out if the doctors, hospitals, and facilities you visit are part of the plans network.
- Service area. Original Medicare is available nationwide, but Medicare Advantage plans serve smaller service areas. Find out what each plans service area is, as well as what coverage you have if you go outside of the service area.
- Out-of-pocket costs. You may need to pay premiums, deductibles, or copayments for your Medicare coverage. Medicare Advantage plans have an annual maximum out-of-pocket cost. Make sure the plan you choose will fit into your budget.
- Benefits. Medicare Advantage plans need to cover the same services as original Medicare, but they may offer extra benefits, such as dental or vision care. They may also offer perks such as wellness programs and over-the-counter drugs.
- Your other coverage. Sometimes, signing up for a Medicare Advantage plan means losing your union or employer coverage. If you already have coverage, find out how itll be affected by Medicare before you make any decisions.
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Michild And Healthy Kids
MiChild is for uninsured kids who belong to households with low income. Your kids may qualify for MiChild even if you do not qualify yourself for Michigan Medicaid. No matter how many kids are in your household, Michigan MiChild only costs $10 per month for your family. The Healthy Kids program is free. Both MiChild and Healthy Kids offer comprehensive medical benefits. The best way to find out which program you qualify for is to go ahead and apply for all Michigan health benefits through MI Bridges. You will receive notice of which program your family is qualified for.
Which Medicaid Plan Would Be Best In Michigan
Michigan has 11 total health plan providers that you can choose from and each one will have varying packages that you may wish to look before you decide just which plan you want to choose for you and your family.
The plans are:
2. Blue Cross Complete of Michigan
3. Hap- Midwest Health Plan
4. Harbor Health Plan
10. United Health Care community plan
11. UPHP- Upper Peninsula Health Plan
All of the links to each of these providers sites and what they have to offer can be found on Michigans government webpage for you to view, so that you can get a better understanding of what they all have to offer and compare them so that you can find what is right for you and your family.
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What Are The Financial Medicaid Requirements In Michigan
States are required by federal law to set out particular Medicaid qualifications pertaining to income. Since eligibility for Medicaid benefits is mainly dependent on the recipients income and resources, it is essential that accurate information is provided to meet the financial Medicaid eligibility criteria.
For anyone who is wondering, What are the income requirements for Medicaid? the annual household income limits are as follows:
- One-person household $15,800
- Seven-person household $48,851
- Eight-person household $54,384
Annual income charts can be utilized by potential recipients who are interested in finding out how to qualify for Medicaid. Considering the Medicaid benefits eligibility guidelines include an asset test, it is imperative that the applicant meets the following income eligibility for Medicaid benefits:
- Infants below one-year-old 195 percent of FPL
- Children aged 1-18 years old 160 percent of FPL
- Pregnant women 195 percent of FPL
- Adults and parents/guardians 138 percent of FPL
The asset test and Medicaid eligibility requirements apply to individuals with all health conditions, as well as foster children and SSI/SSDI beneficiaries. Explore the different Medicaid requirements by .
When To Apply For Medicaid
The best time to apply depends on your medical situation, your marital status and the complexity of your finances. If your finances are straightforward, the state may be able to process your application faster. If you find that you need long-term care, you should apply as soon as possible because it may take some time for the state to process your application and make an eligibility determination. For the most part, the date you become eligible is based on the date you apply, assuming you meet all of the eligibility requirements when you apply. The longer you wait to apply, the later your date of eligibility will be.
The Medicaid agency usually has 45 days to process your application. If the application requires a disability determination, the agency can take up to 90 days. But, it may take longer for the state to determine your eligibility if you do not provide the required documents on time. If Medicaid thinks that you are not cooperating, it can deny your application for failing to cooperate. If this happens, you may have to start your application over again once you have your documents in hand. This will delay the date you become eligible for Medicaid even longer.
Michigan Medicaid Attorneys at The Elder Law Firm PC& Associates provide assistance in protecting your assets and protecting your family through Medicaid planning. Contact us by calling 877.960.5233 or completing our free online Medicaid planning form here.
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