Michigan Medicaid Eligibility For Seniors


How Do You Know If I Qualify For Medicaid

Medicare-Medicaid Assistance Program from the Area Agency on Aging

You can see if you qualify for Medicaid 2 ways: Visit your states Medicaid website. Use the drop-down menu at the top of this page to pick your state. Fill out an application in the Health Insurance Marketplace. When you finish the application, well tell you which programs you and your family qualify for.

What Medicaid Covers For Medicare Enrollees

Medicare has four basic forms of coverage:

  • Part A: Pays for hospitalization costs
  • Part B: Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services
  • Part C: Medicare Advantage Plan offered by private companies approved by Medicare
  • Part D: Assists with the cost of prescription drugs

Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid . Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state’s payment limit.

The Pace Philosophy: Complete Health Care

The focus of PACE Southeast Michigan is to help you live in the community and stay in your own residence for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people who enroll in PACE are eligible for nursing home care, only 7 percent nationally live in nursing homes.

PACE services are designed to meet your individual needs:

  • PACE Southeast Michigan provides care and services in the home, the community and our day health center.

  • Many PACE Southeast Michigan participants receive most of their care from our expert staff at our center.

  • To make sure you can attend our day health center, we provide all medically necessary transportation to our center for activities and medical appointments.

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Michigan Medicaid Expansion Update

Michigan expanded Medicaid as of April 2014. The expanded Medicaid program is called Healthy Michigan.

Nearly 750,000 Michiganders are enrolled in expanded Medicaid as of mid-2020, up from about 650,000 before the COVID-19 pandemic began.

In addition, work requirement for Medicaid took effect as of January 2020, but a judge overturned it in March 2020.

University of Michigan researchers reported that the expansion of Medicaid in Michigan resulted in about 30,000 new jobs.

Furthermore, it resulted in a $2.3 billion increase in personal income in the state in 2016.

How To Apply / Learn More

Income Guideline For Medicaid 2020

The MI Choice Waiver program is operated by the Michigan Department of Community Healths Medical Services Administration and is available statewide across Michigan. There is room in this program to accommodate approximately 18,000 participants. However, there is a waiting list to receive services via this waiver. New applicants can expect approximately a six to twelve month waiting list to begin services.

To apply for the program, one should contact their local Michigan Area Agency on Aging. Some limited information about this program is available on the Michigan Department of Health & Human Services webpage.

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Is Medicare Free For Seniors

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

How Do I Apply For The Healthy Kids Program

There are three ways to apply for the Healthy Kids program:

You can apply online faster through http://healthcare4mi.com.

PO Box 30763Lansing, MI 48909

If you have questions about appeals, call the Michigan Office of Administrative Hearings and Rules for the Department of Health and Human Services at 1-800-648-3397.

Michigan Medicaid Eligibility Summary

We hope this post on Michigan Medicaid Eligibility was helpful to you.

If you have any questions about Medicaid in the state of Michigan, you can ask us in the comments section below.

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Be sure to check out our other articles about Medicaid.

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Michigan Home Help Program

Seniors who prefer to age-in-place and receive care services in their own home may consider the Michigan Home Help Program, which operates similarly to the MI Choice Waiver. Seniors who require assistance with their activities of daily living may participate in the Home Help Program to receive Medicaid coverage for in-home personal care and housekeeping services.

Individuals who currently reside in nursing homes may not qualify for the Home Help Program. The program is designed to help seniors remain in their private residences for as long as possible without being institutionalized, therefore a nursing home resident may not use the program to relocate from their facility into a residential setting.

The Home Help Program operates using Michigans Cash and Counseling model, allowing participants to select their caregivers. They may select anyone to provide their care, including family members or close friends. The person who is selected to provide care may be paid for their services through the Home Help Program, although they may not be paid as much as a caretaker working for a facility. However much a caretaker is paid depends on the county in which they provide service.

Additionally, an applicant must meet the asset and income requirements for Medicaid to qualify for the Home Help Program.

Michigan Choice Waiver Program

The MI Choice Waiver program

In the past, nursing homes were the only choice for seniors requiring long-term care. However, present-day seniors may prefer community-based care in their home or in an assisted living facility to receive their care. For low-income seniors who prefer community-based care to a standard nursing facility, the Michigan Choice Waiver Program may allow them to receive coverage for such services through Medicaid.

The MI Choice Waiver Program began in 1992 as the Home and Community-Based Service Waiver for the Elderly and Disabled. Individuals who meet the waivers requirements may qualify to receive Medicaid coverage for long-term care in their home or another residential setting.

Recipients of the MI Choice Waiver receive the basics benefits covered by Medicaid, in addition to benefits which allow them to receive services in their own home, including:

  • Transition services
  • Home delivered meals
  • Emergency response systems

The MI Choice Waiver Program is operated by the local Area Agencies on Aging . To learn more about the MI Choice Waiver, applicants should find their local AAA and contact them for more information.

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How To Sign Up

Note: With MIBridges, you can apply for the Food Assistance Program , the Family Independence Program , and other benefits at the same time as you apply for Medicaid.

For help with your application, visit or call your local county human services agency or call the Medicaid Beneficiary Help Line at 1-800-642-3195 or 1-866-501-5656 .

What Do I Need For Proof Of Income

In order to prove that you fall within the limit for income eligibility, you will need to provide documentation of all sources of income that you have.

Documents to include are things like pay stubs from wages, copies of social security deposits, copies of alimony checks, and award letters from any other monthly financial benefit that you may receive.

It would also be helpful to have all of your most recent income tax returns and any other tax forms that would be relevant to verifying your income.

Some states are able to electronically gather the resources to verify your income, which does simplify the process as well as eliminate fraud. To find out if your state has this technology for your application, click here to learn more about the application process in your state of residence.

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Michigan Medicaid Income Limit Charts

The Michigan Medicaid eligibility income limit charts are divided by groups.

For example, the first chart is focused on income limits for children who qualify for Medicaid.

Similarly, the second chart below focuses on the Medicaid income limits for adults in Michigan who qualify for Medicaid.

Michigan Medicaid Income Limit for Children

Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.

Michigan Medicaid Income Limit Children
Children Medicaid Ages 0-1

How to Read the Michigan Medicaid Income Limits Charts Above

You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.

Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.

For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 195% of the Federal Poverty Level which for a family of two is $33,969 as shown in the chart above.

Michigan’s Income Limit For Medicaid

What Are Income Qualifications For Medicaid

Michiganders who are sixty-five or older, disabled, or blind can qualify for Medicaid if they also meet income and asset limits. People who receive SSI automatically qualify to receive Medicaid in Michigan, but if you are elderly, blind, or disabled and not receiving SSI, then your monthly income must be less than 138% of the federal poverty level to qualify for Medicaid. In 2019, that is $1,436 per month for an individual.

If your income is above this limit, you still might be able to qualify for Medicaid if your medical expenses are higher than the amount of extra income you have. In Michigan, people who are sixty-five or older, blind, or disabled can use medical bills that they incur each month to “spend down” their income and qualify for Medicaid.

If you qualify for Medicaid and live in a nursing home, you will be expected to spend almost all income on your care. Michigan allows nursing home residents receiving Medicaid to keep only $60 per month as a personal needs allowance.

If you have unpaid bills for medical expenses that were incurred in the three months before you applied for Medicaid, you may be eligible for retroactive benefits that could pay those bills. You will need to submit a separate application for retroactive benefits and show proof of the bills.

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How Do I Get Medicaid At 65

You can apply for Medicaid in the following ways: Online through myDHR. By mailing the completed application to your local department of social services. In person at your local department of social services. Download the application below to mail or take in person to your local Department of Social Services.

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Let our firm resolve your crisis or question and help you regain control of your life during this time. We have nearly three decades of experience in helping Michigan families apply for and obtain Medicaid benefits under a variety of circumstances, and we can help you, too.


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Direct Care Programs To Help Seniors Stay Living At Home

Home care services can be a critical piece in helping seniors and people with disabilities continue to live safely in a home setting. These services provide assistance with those activities of daily life a senior might have trouble doing for themselvesthings like bathing, dressing, meal preparation or housekeeping.

The Area Agency on Aging 1-B has several programs that offer direct care for southeast Michigan families living in Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties. Some of our programs receive government funding, so people must meet eligibility requirements to qualify. Government-funded programs include the and the .

How Many People Are On Medicaid

2018 Waiver Program Senior Alliance

According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:

  • 78,521,263 individuals were enrolled in Medicaid and CHIP
  • 72,204,587 individuals were enrolled in Medicaid
  • 6,695,834 individuals were enrolled in CHIP

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How To Apply To Medicaid In Michigan

To apply for Medicaid in Michigan, a person must submit a paper application to their local Department of Human Services Office. Applicants may download the application online and print it off to bring or mail to the DHS Office, or they may pick up an application in person at their local DHS Office.

Home Health Care And Assisted Living

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    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.

    Medicare Vs Medicaid Qualification

    Healthy Michigan Medicaid Work Requirement Bill ...

    Medicare Eligibility is a health-care benefit provided by the federal government to individuals over age 65, or under age 65 and disabled. Medicare covers doctor visits, tests, and care provided in a hospital and limited benefits in a nursing home . Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you will be automatically enrolled in Medicare Parts A and B effective the month you turn 65.

    Medicaid is the health care program for individuals who do not have another form of insurance or whose insurance does not cover what they need, such as long-term care. Many people rely on Medicaid for assistance in paying for care at home or in nursing homes. To qualify, you must meet certain income and asset limits. If your income or assets exceed the qualifying limits, you will not be eligible. To be eligible for Medicaid benefits, a person must need assistance that requires nursing home level care. There is no age restriction to qualify.

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    Michigan’s Resource Limit For Medicaid

    To qualify for Medicaid in Michigan, you must have no more than $2,000 in resources. Resources are assets like money and property. Some property does not count toward the resource limit. In Michigan, one car is exempt, and household goods are exempt. Your primary residence and any attached acreage is an exempt resource. However, if you need Medicaid for long-term care, then you cannot have more than $585,000 in equity in your home in 2019. Retirement accounts are counted as assets to the extent you can withdraw money from them.

    Stay In The Home You Love See Us For The Care You Need

    Our goal is to provide our frail senior community members with the care, medical treatment and support they need to achieve the highest quality of life while staying independent as long as possible. Our elder care experts offer an alternative to nursing home placement that features comprehensive, coordinated care for a seniors medical, social and physical needs, while also providing peace of mind for family caregivers.

    For more information about PACE Southeast Michigan or to speak to one of our elder care representatives, please call 445-4554 or submit our contact form.

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    Option 1 Apply Online

    You can apply online through the MI Bridges Portal as shown in the image below.

    If you have an account, you can log in or create your MI Bridges Account. to be taken to the website.

    The video below, by the Michigan HHS does a great job of explaining how to apply online for benefits with MI Bridges.

    We highly recommend you watch it if you are applying online for Michigan Medicaid.

    Which Medicaid Plan Would Be Best In Michigan

    Do I Qualify For Medicaid?

    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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