Michigan’s Health Care Programs
Health care coverage is available to individuals and families who meet certain eligibility requirements. The goal of these health care programs is to ensure that essential health care services are made available to those who otherwise not be able to afford them. All of the health care programs in Michigan have an income test and some of the programs also have an asset test.
If you are trying to see if you are eligible for one of these program or are trying to access health care coverage for your family, one of the best ways to start the search for healthcare is to apply for coverage through your local Department of Health and Human Services (DHHS) office or access their online enrollment process MiBridges online at https://www.mibridges.michigan.gov/access/.
If you apply at a DHS office or through the online system and are denied, you may be eligible to sign up for coverage on healthcare.gov under the “Special Enrollment Period” when normal sign up is not available.
By accessing the application process above you can determine if you or your child are eligible for any of the following 3 programs:
- Healthy Kids
Healthy Kids is a Medicaid health care program that provides a wide range of health care coverage and support services for low-income children under age 19 and for Pregnant Women of any age.
There is only an income test to qualify for Healthy Kids and there is no monthly premium. Most children who are eligible for Healthy Kids are enrolled in a Medicaid health plan. Healthy Kids provides a comprehensive package of health care benefits including mental health, medical, vision, and dental services. Healthy Kids covers Healthy Kids covers most medically necessary health care needs including: Well-child visits. Immunizations (shots, Doctor visits, Health check-ups, Hearing and speech, Dental, ambulance, Lab and x-ray tests, Medical supplies, Medicine, Mental health, Physical therapy, Substance abuse, Surgery, Vision, and many much more see the Department of Community Health’s Brochure for a complete lists of services that are covered.
Contact the local MDHS office in your county to apply for this program or you can call 1-855-275-6424, or apply online.
How Much Income Is Allowed?
Every family’s situation is different. Call toll-free 1-888-988-6300 to get more information that will help you find out if you qualify.
MIChild is a health care coverage program for low income uninsured children of Michigan’s working families. The program is administered by the Department of Community Health. MIChild has a higher income limit than Healthy Kids. There is only an income test to qualify.
MIChild is for children who are under age 19. There is a $10 per family monthly premium for MIChild. The $10 monthly premium cover’s all of the children in the family. A child must be enrolled in a MIChild health and dental plan in order to receive services.
For more information about MiChild or Healthy Kids, contact MIChild at 1-888-988-6300 or visit the MIChild information website or link to their brochure at:
- Healthy Michigan
The Healthy Michigan Plan provides health care coverage for individuals who:
Adult residents of Michigan who are aged 19-64 years who have an income at or below 133% of the federal poverty level (which is about $15,000 for a single person) who do not qualify for or are not enrolled in Medicare or other Medicaid programs.
Individuals who are eligible for services under the Healthy Michigan Plan must have access to the following 10 Essential Health Benefits: Ambulatory patient services; Emergency services; Hospitalization; Maternity and newborn care; Mental health and substance use disorder treatment services, including behavioral health treatment; Prescription drugs; Rehabilitative services and devices; Laboratory services; Preventive and wellness services and chronic disease management; Pediatric services, including oral and vision care. The Healthy Michigan Plan will cover other medically necessary services as appropriate.
Visit HealthyMichiganPlan.org for more information or click here to view Michigan Department of community Health’s Healthy Michigan Handbook
When you become eligible for Healthy Michigan you will get a packet from Enroll Michigan that will outline your health plan choices. You must join a health plan to start receiving health care services.
If you are not eligible for any of the three health care programs above you may still qualify for other health care assistance programs which are listed on the bottom of this page.
Additional Healthcare Informational Resources:
If you want to better understand the Healthy Michigan program or need help with the process of enrollment one great place to check out is Enroll Michigan.
Enroll Michigan is a statewide network of non-profit agencies providing free enrollment support services to people in Michigan seeking health insurance.
Michigan Family to Family Health Information Center (MI F2F)
Michigan Family to Family Health Information Center (MI F2F) is also a great resource when searching for information on healthcare and other disability issues related to children and youth, especially those with special healthcare needs.
MI F2F is part of a federal initiative which funds a Family Information Center in every state that is responsible to provide information and education on disability and health-related issues to families of children and youth with special health care needs and the professionals who serve them.
Michigan Family to Family works to provide families with the tools they need to make informed decisions and help build partnerships between professionals and families to improve quality of services for children and youth with special health care needs. To learn more, visit them today at:
Family Voices also has resources to help families and youth partner with health care providers and other professionals including Tip Sheets to help you to partner with your child’s provider and your child’s health plan.
What is The Affordable Care Act?
The Patient Protection and Affordable Care Act (ACA) otherwise known as Obamacare was signed into law in 2010. This new law provides more coverage for kids and young people in a variety of ways including expanding eligibility income limits for Medicaid (under Healthy Kids In MI), allowing children to remain on their parents’ insurance comprehensive package of items and policies until age 26. It also prohibits insurance companies from denying or charging more for coverage due to a pre-existing condition, or stopping coverage due to the high cost or the amount of services already used and by eliminating lifetime limits on insurance coverage.
The Affordable Care Act also requires health care plans to offer a wide variety of services known as essential health benefits. These essential benefits cover a variety of things including behavioral health or mental health services and substance abuse services as well as emergency services and hospitalization; laboratory services; maternity and newborn care; rehabilitative services and devices; pediatric services, including oral and vision care; preventative and wellness care and prescription drugs coverage.
For more information about the marketplace, visit www.healthcare.gov or call: 1-800-318-2596.
OTHER SPECIALTY HEALTH CARE PROGRAMS:
Children’s Special Health Care Services
Children’s Special Health Care Services is a program within the Michigan Department of Health and human Services that provides certain approved medical service coverage to some children and adults with special health care needs. Children must have a qualifying medical condition and be under 21 years of age. Persons 21 and older with cystic fibrosis or certain blood disorders may also qualify for services. To get more information about hoe to apply for the children’s Special Health Care Program click on the following link:
IS a Medicaid program available to eligible young people under age 21. In order to qualify there is both an income test and an asset test. If a young person’s income falls over the limit, the person is assigned a deductible. Young people that accumulate medical expenses that equal to or exceed the deductible may still qualify for this program. Eligible young people receive a comprehensive package of health care benefits including vision, dental, and mental health services.
Supplemental Security Income (SSI)
SSI is a cash benefit for disabled children whose families have low income. The Social Security Administration (SSA) determines if a child is eligible. Eligible children and youth are automatically eligible for Medicaid and they receive the comprehensive package of health benefits including vision, dental, and mental health services. Most SSI recipients are enrolled in a Medicaid health plan. You apply for this benefit at your local Social Security Administration Office.
Special Disabled Children
Medicaid is available to children who received SSI benefits on August 22, 1996, provided the child meets current SSI income and resource requirements and the definition of childhood disability that was in effect before the 1996 revised disability definition. The comprehensive health care package of Medicaid benefits is available.
Healthy Kids for Pregnant Women
Is a Medicaid program available to eligible women while they is pregnant, including the month a pregnancy ends and during the two calendar months following the month her pregnancy ends, regardless of the reason (for example: live birth, miscarriage). Applicants must fall below the income limit.
Group 2 Pregnant Women
Women whose income exceeds the income limit for Healthy Kids for Pregnant Women, may be eligible for Medicaid under the Group 2 Pregnant Women program. Under this program much like the Under 21 program a recipient is assigned a deductible and then may incur medical expenses that equal or exceed the deductible and still qualify for this program.
MOMS, Maternity Outpatient Medical Services
The MOMS program provides immediate outpatient prenatal health coverage for pregnant women and is intended to provide immediate prenatal care while a Medicaid application is pending. Other women who may be eligible for MOMS include non-citizens who are only eligible for emergency services only. There is an income test for all persons except teens. The local health department can help women apply for the MOMS program.
Caretaker Relatives Medicaid
Is a program available to eligible parents and people who act as parents, caring for a dependent child. There is an income test and an asset test for this program. If the income test is over the income limit, persons may incur medical expenses that equal or exceed the deductible and still qualify for this program.
For more information about the specialty health programs listed above visit the Michigan Department of Community Health’s Website at:
**Unless otherwise noted most of these program can be applied for by contacting your local Department of Human Services Office and you may find out you are eligible for some of them when if you apply on the MiBridges Online Application.
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