Michigan Medicaid

Healthy MI plan: a model approach

Where in your state to call or visit for Medicaid.How to apply

Apply online using MI Bridges. Fill out form DCH-1426. Call the application help line at 1-855-276-4627.

Who is eligible in your state to get Medicaid?Who is eligible

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 (low-cost health insurance for kids). Pregnant women with household income up to 195% of FPL. Adults with household income up to 133% of FPL. Select other groups: see details

Gov. Rick Snyder pushed for an alternative approach to Medicaid expansion in Michigan and ultimately gained bi-partisan support for the plan, which is called Healthy Michigan. Sign up for the program began April 1, 2014, and enrollment already exceeds both the first-year and total enrollment expectations.

Michigan’s eligibility guidelines

You qualify for Medicaid in Michigan if your household income is below the following limits:

  • 195 percent of the federal poverty level for infants under 1 year old
  • 160 percent of FPL for children 1-18 years old; children with slightly higher household income — up to 212 percent of FPL, qualify for the Children’s Health Insurance Program, which is called MICHILD in Michigan
  • 195 percent of FPL for pregnant women
  • 133 percent of FPL for parents and other adults

While these are the main groups covered by Medicaid, other people — such as those who are blind or disabled — may also qualify. See the Department of Community Health website for more information on covered groups and eligibility guidelines.

Use the annual income chart from Medicaid.gov to see FPL shown as dollar amounts.

Enrolling in Medicaid

Here is how you can apply for Medicaid:

  • Apply online using MI Bridges.
  • 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 Health Insurance Affordability Program; Michigan Department of Community Health; P.O. Box 30273; Lansing, MI 48909. Find the location or fax number for a local office.
  • Get help with your application by calling the application help line at 1-855-276-4627.

Michigan expands, reforms Medicaid

At the end of 2013, Michigan received federal approval to expand and reform its Medicaid program. Within the state, the expansion program is known as Healthy Michigan.

The state needed special approval — a federal waiver — for new cost-sharing requirements. Enrollees with incomes between 100 to 133 percent of the federal poverty level must contribute up to 2 percent of their income to health savings accounts that will be administered by the state.

Enrollment for the Healthy Michigan expansion started April 1, 2014, with estimates that 320,000 people would sign up in the first year and up to 470,000 ultimately. As of Jan. 5, 2015, nearly 497,000 people had enrolled in Healthy Michigan.

The Centers for Medicare and Medicaid (CMS) shows total Medicaid enrollment in Michigan as 2,151,130 (as of October 2014). That figure is a 12.5 percent increase since just before the first ACA open enrollment period.

The path to Medicaid expansion

It took nearly eight months to authorize the Healthy Michigan plan. Republican Gov. Rick Snyder announced his support in February 2013, saying it was good move for public health and state finances. Snyder had support from numerous health care and advocacy groups, but was opposed by some Republicans in the state legislature.

Ultimately, the state Senate passed Medicaid expansion in late August 2013 after an eight-hour session. The House followed suit a few days later, and passed it in early September, and Snyder signed it into law on Sept. 16, 2013. University of Michigan Medical School researchers believe the state’s bi-partisan solution could be a model for other states that have yet to expand Medicaid.

While the Senate passed Medicaid expansion, it also prevented it from taking effect immediately and delaying the start of Healthy Michigan enrollment until April 1, 2014. The Department of Community Health said each day’s delay would cost the state $7 million in federal funding.

While the delay had a negative financial impact, it is also being credited as a factor in the successful rollout of the program. Michigan was able to the first three months of 2014 to plan and to build awareness, leading to rapid uptake of the program.