If you are interested in applying for Medicaid in Michigan, you’ve come to the right place. In this post, we will provide information about Michigan Medicaid eligibility criteria for children and family, pregnancy, the elderly, the blind, and the disabled.
We will explain in detail everything you need to know to successfully apply for Michigan Medicaid.
In addition, we will show you the various ways you can apply, including how to log in to MI Bridges portal, and how to contact Michigan Medicaid.
Finally, we will answer some of the most frequently asked questions about Michigan Medicaid Eligibility.
This article on Michigan Medicaid eligibility will cover:
- What is Michigan Medicaid?
- Who is Eligible for Medicaid in Michigan?
- Michigan Medicaid Eligibility Guidelines
- 2021 Michigan Medicaid Income Limit
- How to Apply for Medicaid in Michigan
- What does Medicaid Cover in Michigan?
- Michigan Medicaid Phone Number
- Medicaid Expansion in Michigan
- Michigan Medicaid Card
- FAQs about Medicaid in Michigan
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
Michigan Medicaid
The Massachusetts Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 2.5 million people.
This includes 1 million children as shown by the image below.
In Michigan, the Medicaid program is run by the Department of Health and Human Services (MDHHS).
Who is Eligible for Medicaid in Michigan?
In Michigan, there is traditional Medicaid (TM) and the Healthy Michigan Plan (HMP). HMP started in 2014 as part of the Affordable Care Act. Once you are enrolled, TM and HMP work just like other health insurance.
The following people may qualify for Michigan Medicaid if they meet certain financial
requirements:
- Low-income families with children
- Be between the ages of 16 and 64
- Pregnant women
- Infants and children under the age of 21
- People who are aged 65 or older
- People who are blind or expected to be disabled for at least a year
- Recipients of Supplemental Security Income (SSI)
- People who need nursing home care or home and community-based care
- People who are on Medicare
- Individuals who are medically needy
Michigan Medicaid Eligibility Guidelines
To qualify for Medicaid in Michigan, an individual must meet the eligibility requirements of the program.
There are several Medicaid programs that people in Michigan can be eligible for. Each program has its own income and asset requirements.
However, all applicants must meet the general requirements below in order to qualify for Michigan Medicaid.
Proof of Identity
Identity can be verified by a driver’s license, state identification card or another piece of identification.
Social Security Number (SSN)
A SSN must be provided for each person applying for Medicaid.
Your county Medicaid Office staff can help you apply for an SSN for anyone who does not have one.
Residency
Medicaid assistance is available to individuals who are residents of Michigan if all other eligibility requirements are met.
There is no requirement regarding the length of time that a person must live in Michigan in order to be eligible.
Citizenship
Medicaid is available to United States citizens, refugees, and certain lawfully admitted aliens. Other aliens may be eligible for limited Medical Assistance benefits if an emergency medical condition exists.
Additionally, U.S. citizens, refugees and legal aliens must submit documentation proving U.S. citizenship or legal alien status.
Household Composition
County Assistance Office staff will determine who are mandatory or optional budget group members in the Medical Assistance application based upon household relationships and individual needs for Medical Assistance.
Income limit
The income requirements for Michigan Medicaid is perhaps the most important eligibility criteria. See below for details about Medicaid income limits by group. and household size.
2021 Michigan Medicaid Income Limit
The MI 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 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 212% | 212% | 212% | 212% | |
|
Household Size
|
1 | $12,880 | $27,306 | $27,306 | $27,306 | $27,306 |
| 2 | $17,420 | $36,930 | $36,930 | $36,930 | $36,930 | |
| 3 | $21,960 | $46,555 | $46,555 | $46,555 | $46,555 | |
| 4 | $26,500 | $56,180 | $56,180 | $56,180 | $56,180 | |
| 5 | $31,040 | $65,805 | $65,805 | $65,805 | $65,805 | |
| 6 | $35,580 | $75,430 | $75,430 | $75,430 | $75,430 | |
| 7 | $40,120 | $85,054 | $85,054 | $85,054 | $85,054 | |
| 8 | $44,660 | $94,679 | $94,679 | $94,679 | $94,679 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
Michigan has expanded Medicaid to include adults without dependents.
Therefore, adults without dependents can apply for Medicaid in Michigan.
For an update on the Medicaid expansion debate and timeline in Michigan, see our Michigan Expansion update below.
Michigan Medicaid Income Limit for Adults
| Michigan Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 195% | 54% | 100% | 133% | |
|
Household Size
|
1 | $12,880 | $25,116 | $6,955 | $12,880 | $17,130 |
| 2 | $17,420 | $33,969 | $9,407 | $17,420 | $23,169 | |
| 3 | $21,960 | $42,822 | $11,858 | $21,960 | $29,207 | |
| 4 | $26,500 | $51,675 | $14,310 | $26,500 | $35,245 | |
| 5 | $31,040 | $60,528 | $16,762 | $31,040 | $41,283 | |
| 6 | $35,580 | $69,381 | $19,213 | $35,580 | $47,321 | |
| 7 | $40,120 | $78,234 | $21,665 | $40,120 | $53,360 | |
| 8 | $44,660 | $87,087 | $24,116 | $44,660 | $59,398 | |
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.
How to Apply for Michigan Medicaid
There are 3 ways you can apply for Medicaid in Michigan.
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. Click here 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.
Option 2 – Apply at MDHHS Office Near You
You can apply in person at the Michigan Department of Health and Human Services (MDHHS) office near you. Click here to locate an MDHHS office.
Option 3 – Apply by Phone
Call the Michigan Health Care Helpline at 1-855-789-5610 and have an application mailed to you.
Once you complete the application, you can mail it to:
Health Insurance Affordability Program
Michigan Department of Community Health
P.O. Box 30273
Lansing, MI 48909.
Resources Limits
Medicaid eligibility for some is also determined using resource and household size in comparison to resource limits.
However, the resource limits do not apply to the following groups:
- Adults Age 19-64
- Pregnant women
- Families with children in the household – under their care and control
- Children under the age of 21
- CHIP
Examples of resources counted in determining eligibility include:
- Cash
- Checking accounts
- Savings accounts and certificates
- Christmas or vacation clubs
- Stocks and bonds
- Some trust funds
- Life insurance
- Vehicles
- Revocable burial funds
- Non-resident property
Examples of resources not counted in determining eligibility include:
- Your home
- Revocable and irrevocable burial reserves subject to specified limits
- Burial space and marker
- One motor vehicle
As mentioned above, some Medicaid eligibility groups have resource limits. This includes:
- Seniors ages 65 and above
- People with Disabilities
- SSI Recipients
For details on Michigan Medicaid resources limits for these group of applicants, check with your county Medicaid office.
Documents you need to apply
During the application process for Medicaid in Michigan, you will need to have various documents to support your application.
Here’s the list of documents you may have to provide:
- Information about household members (name, date of birth and Social Security number)
- Rent or mortgage information
- Expenses (utilities, daycare, etc.)
- Vehicle information
- Bank statements
- Income (pay stubs)
- Proof of disability or medical records showing a lasting medical condition
- Recent medical bills
- Proof of citizenship
- Additional information as requested
What happens after I apply for Medicaid in Michigan?
After you submit your Michigan Medicaid application, you may be required to attend an interview with a Department of Health and Human Services (MDHHS) caseworker.
Whether you will be required to attend an interview depends on your situation:
If you are applying for Medicaid for your child(ren) alone, then no interview will likely be required.
If you are applying for any other benefits at the same time, then an interview will likely be required.
During this interview, you will be required to bring documents that prove the information that you provided on your initial Michigan Medicaid application.
Once you complete this interview, you will receive a call or a letter in the mail that will tell you whether you were approved or denied.
If you are denied benefits, you have the right to appeal but that appeal must be filed within a certain timeframe. As your caseworker for details.
What to bring to your MDHHS appointment
Here is the list of documents you should bring to your Medicaid interview appointment:
Proof of Income
- Pay Stub(s) from the last 30 days
- Bank Statement from the last 30 days
- Social Security awards letter
- Tax Return
- Unemployment letter
Social Security Number
Identification
- Driver’s License
- State ID
Proof of Address
- ID with current address
- Utility Bill
Your DHS caseworker will give you a list of missing documents and a date by which they are due.
Additionally, if you need assistance finding the documents, your caseworker may be able to help.
What does Medicaid Cover in Michigan?
Michigan Medicaid covers a variety of medical services. However, the type and amount of services depend on the age of the beneficiary, the type of Medicaid program in which the beneficiary is enrolled.
Additionally, coverage depends on the type of services determined medically necessary by the beneficiary’s Primary Care Provider.
However, in general Medicaid and MIChild cover medically necessary services such as:
- ambulance
- chiropractic
- dental
- doctor visits
- emergency services
- family planning
- hearing and speech services
- home health care
- hospice care
- inpatient and outpatient hospital care
- lab
- medical supplies
- medicine prescribed by a doctor
- mental health services
- non-emergency medical transportation
- nursing home care
- personal care services
- physical and occupational therapy
- podiatry (foot care)
- pregnancy care (prenatal, delivery, and post-partum)
- private duty nursing
- immunizations (shots)
- substance use disorder treatment services
- surgery
- vision
- x-ray
Also, a yearly health exam is covered.
However, Some of the services listed above are limited and may not be covered for beneficiaries age 21 and older.
Furthermore, some of these services may require prior approval.
Check with your Medicaid provider for more details on what is covered.
Michigan Medicaid Phone Number
Here’s how to contact the Michigan Medicaid Agency:
MI ENROLLS: 1-800-975-7630
Beneficiary Help Line: 1-800-642-3195
mihealth cards: 1-800-642-3195
MIChild: 1-888-988-6300
Speech / Hearing impaired TTY
1-888-263-5897
Call center hours
Monday — Friday
8:00 am — 7:00 pm (ET)
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.
Michigan Medicaid Card
The Michigan Medicaid Card, also known as mihealth card is a permanent plastic health ID card. All Michigan Medicaid beneficiaries, including the following, are issued the mihealth card:
- Emergency Medicaid
- Children Special Health Care Service (CSHCS)
- MIChild
- Healthy Michigan Plan (HMP)
- Plan First coverage
The mihealth card is mailed to new beneficiaries when their Medicaid benefits are approved.
Furthermore, if you already have a mihealth card, you will not receive a new card.
If you need a replacement mihealth card, call the Michigan Medicaid Beneficiary Help Line at 1-800-642-3195.
Additionally, you can request a replacement card using the myHealthPortal.
FAQs about Medicaid in Michigan
Here are the most frequently asked questions about Medicaid in Michigan:
What is the Healthy Kids program?
Healthy Kids is a Medicaid health care program for low-income children under age 19 and pregnant women of any age.
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.
Also, you can learn about other ways to apply using the Application for Health Coverage & Help Paying Costs form.
Lastly, you can also call your local MDHHS for more information. Click here for the nearest MDHHS office.
What is the MIChild program?
MIChild is a health coverage program for uninsured children of Michigan’s working families. MIChild is not a Medicaid program.
What is the MOMS program?
The MOMS program provides immediate health coverage for pregnancy-related services only. The MOMS program is available only for pregnant women while a Medicaid application is pending.
What is Modified Adjusted Gross Income (MAGI) and why is it important for Medicaid?
When determining eligibility for certain Medicaid programs, the MDHHS will look at your household’s size and its Modified Adjusted Gross Income (MAGI).
MAGI is often the same amount as the Internal Revenue Service’s number for Adjusted Gross Income.
Here’s how MAGI is used in Medical Assistance applications:
MAGI is used to determine eligibility for tax credits for people who get their insurance through the insurance marketplace for the Healthy Michigan Plan.
Additionally, the MDHHS also uses MAGI when determining eligibility for certain traditional Medicaid categories.
Some examples of groups of people MAGI applies to are:
- Childless adults between 19 and 64
- Pregnant women
- People who are parents or are a caretaker of a dependent child (caretaker relatives)
Some examples of groups of people that MAGI does not apply to are:
- People 65 or older, blind, or disabled
- Those getting long-term care (LTC) services
- People eligible for or who get Medicare
How do I Appeal a Medicaid Decision in Michigan?
If your application for Medicaid is denied in Michigan, you can file an appeal.
Additionally, you can appeal a reduction of benefits or denial of service or other negative action such
as Medicaid or MIChild not paying a bill or not approving a service.
However, you are required to file your hearing request within 90 days from the date you were notified of the negative action.
Your appeals request must explain the problem in writing. Here’s what you need to know:
You have the right to represent yourself, use legal counsel, a relative, a friend, or another spokesperson.
Mail your request for a hearing to:
Michigan Office of Administrative
Hearings and Rules
Michigan Department of
Health and Human Services
PO Box 30763
Lansing, 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.
Difference between Medicare and Medicaid Programs
How to Apply for Coverage by State
Medicaid Income Limits by State
Medicaid Phone Number for Florida
