The Healthy Michigan Plan is a Medicaid program that provides health insurance to eligible low-income adults between the ages of 19 and 64 who are not pregnant or disabled. It is a state-federal partnership program, meaning that the federal government provides funding and the state government administers the program. The Healthy Michigan Plan offers a range of benefits, including preventive care, doctor visits, hospitalization, prescription drugs, and mental health services. To be eligible for the Healthy Michigan Plan, individuals must meet certain income and residency requirements.
Medicaid Expansion in Michigan
The Healthy Michigan Plan is a Medicaid expansion program in the state of Michigan. It provides expanded access to Medicaid coverage to adults who are not otherwise eligible for traditional Medicaid.
How Medicaid Expansion Works in Michigan
- The Healthy Michigan Plan is a state-based program that is funded by both the state and the federal government.
- To be eligible for the Healthy Michigan Plan, you must be a Michigan resident who is between the ages of 19 and 64.
- You must also meet certain income and other requirements.
- If you are eligible, you will be able to receive a variety of Medicaid benefits, including:
- Medical care
- Dental care
- Vision care
- Mental health services
- Substance abuse treatment
- Prescription drug coverage
The Healthy Michigan Plan has helped to reduce the number of uninsured adults in Michigan. In 2013, before the Healthy Michigan Plan was implemented, an estimated 10% of adults in Michigan were uninsured. By 2020, that number had dropped to 5%.
The Healthy Michigan Plan has also helped to improve the health of Michigan residents. A study published in the journal JAMA Internal Medicine found that adults who were enrolled in the Healthy Michigan Plan were more likely to have a regular doctor, get preventative care, and manage chronic conditions.
Eligibility for the Healthy Michigan Plan
To be eligible for the Healthy Michigan Plan, you must meet the following requirements:
- Be a Michigan resident
- Be between the ages of 19 and 64
- Have an income at or below 138% of the federal poverty level
- Not be eligible for other types of health insurance, such as Medicare or employer-sponsored insurance
You can apply for the Healthy Michigan Plan online, by phone, or in person at your local DHS office.
Benefits of the Healthy Michigan Plan
The Healthy Michigan Plan provides a variety of benefits to eligible adults, including:
- Medical care, including doctor visits, hospital stays, and prescription drugs
- Dental care, including cleanings, fillings, and X-rays
- Vision care, including eye exams and glasses
- Mental health services, including counseling and therapy
- Substance abuse treatment, including detoxification and counseling
The Healthy Michigan Plan also provides a number of preventive care services, such as cancer screenings, immunizations, and well-child visits.
How to Apply for the Healthy Michigan Plan
You can apply for the Healthy Michigan Plan online, by phone, or in person at your local DHS office.
- Online: You can apply online at the Michigan Department of Human Services (DHS) website.
- By phone: You can apply by phone at 1-855-789-5610.
- In person: You can apply in person at your local DHS office.
You will need to provide the following information when you apply:
- Your name, address, and date of birth
- Your Social Security number
- Your income information
- Information about your health insurance coverage
You will also need to provide proof of your identity and residency.
Contact Information
If you have any questions about the Healthy Michigan Plan, you can contact the Michigan Department of Human Services (DHS) at 1-855-789-5610.
| Service | Benefit |
|---|---|
| Medical care | Doctor visits, hospital stays, prescription drugs |
| Dental care | Cleanings, fillings, X-rays |
| Vision care | Eye exams, glasses |
| Mental health services | Counseling, therapy |
| Substance abuse treatment | Detoxification, counseling |
Eligibility Requirements for Healthy Michigan Plan
The Healthy Michigan Plan is a Medicaid program designed to provide health care coverage to eligible Michigan residents. To qualify, individuals must meet specific eligibility requirements, which are determined by several factors, including age, income, and household size.
Age Requirements
- Pregnant women of any age.
- Children under the age of 19.
- Adults between the ages of 19 and 64.
- Individuals who are 65 or older and meet certain income and asset limits.
Income Requirements
Income eligibility is based on the federal poverty level (FPL). To qualify for the Healthy Michigan Plan, an individual’s or family’s income must be at or below certain percentages of the FPL.
| Household Size | Income Limit (% of FPL) |
|---|---|
| 1 | 138% |
| 2 | 185% |
| 3 | 233% |
| 4 | 281% |
| 5 | 329% |
| 6 | 377% |
| 7 | 425% |
| 8 | 473% |
Household Size
Household size also plays a role in determining eligibility. The number of people living in the household is used to calculate the total household income and determine if it meets the income limits.
Other Eligibility Factors
- Pregnancy status.
- Disability status.
- Citizenship or lawful immigration status.
- Residency in Michigan.
It is important to note that the eligibility requirements for the Healthy Michigan Plan can change over time. Individuals who are interested in applying for coverage should check with the Michigan Department of Health and Human Services (MDHHS) for the most up-to-date information.
Covered Benefits Under the Healthy Michigan Plan
The Healthy Michigan Plan (HMP) offers comprehensive healthcare coverage to eligible individuals and families in Michigan. The program’s benefits include a wide range of essential medical services, preventive care, and treatment options. Let’s explore the covered benefits of HMP in more detail:
Essential Health Benefits:
- Ambulatory Patient Services: This category covers outpatient medical, surgical, and diagnostic services provided in a physician’s office, clinic, or other outpatient setting.
- Emergency Services: HMP covers emergency medical care, including emergency room visits, ambulance services, and stabilization services provided in a hospital emergency department.
- Hospitalization: The plan provides coverage for inpatient hospital care, including semi-private room and board, general nursing services, and medically necessary treatments during a hospital stay.
- Maternity and Newborn Care: HMP covers prenatal care, labor and delivery services, postpartum care, and newborn care, including well-baby checkups.
- Mental Health and Substance Use Disorder Services: The plan offers mental health assessments and treatment, substance abuse treatment, and counseling services for individuals with mental health and substance use disorders.
- Prescription Drugs: HMP provides coverage for a wide range of prescription medications, including brand-name and generic drugs, with a copay or coinsurance cost for each prescription.
- Rehabilitative and Habilitative Services and Devices: The plan covers services and devices that help individuals regain or improve their physical or mental functioning, such as physical therapy, occupational therapy, speech therapy, and assistive devices.
- Laboratory and X-Ray Services: HMP covers laboratory tests, X-rays, and other diagnostic imaging services necessary for medical diagnosis and treatment.
- Preventive and Wellness Services: The plan provides coverage for preventive care services such as annual checkups, well-child visits, immunizations, and screenings for early detection of diseases.
Additional Benefits:
- Family Planning Services: HMP covers a range of family planning services, including contraception, counseling, and sexually transmitted infection (STI) testing and treatment.
- Pediatric Dental Services: The plan provides coverage for comprehensive dental care for children under the age of 21, including preventive services, routine exams, and treatment.
- Vision Care Services: HMP covers basic vision care services, including eye exams, eyeglasses, and contact lenses, for eligible individuals.
- Hearing Care Services: The plan offers coverage for hearing exams and hearing aids for eligible individuals with hearing impairments.
| Category | Covered Benefits |
|---|---|
| Ambulatory Patient Services | Outpatient medical, surgical, and diagnostic services |
| Emergency Services | Emergency room visits, ambulance services, and stabilization services |
| Hospitalization | Inpatient hospital care, semi-private room and board, and medically necessary treatments |
| Maternity and Newborn Care | Prenatal care, labor and delivery services, postpartum care, and newborn care |
| Mental Health and Substance Use Disorder Services | Mental health assessments, treatment, and counseling services |
| Prescription Drugs | Wide range of brand-name and generic medications, with copay or coinsurance |
| Rehabilitative and Habilitative Services and Devices | Services and devices to improve physical or mental functioning |
| Laboratory and X-Ray Services | Laboratory tests, X-rays, and other diagnostic imaging services |
| Preventive and Wellness Services | Annual checkups, well-child visits, immunizations, and disease screenings |
| Family Planning Services | Contraception, counseling, and STI testing and treatment |
| Pediatric Dental Services | Preventive services, routine exams, and treatment for children under age 21 |
| Vision Care Services | Eye exams, eyeglasses, and contact lenses for eligible individuals |
| Hearing Care Services | Hearing exams and hearing aids for eligible individuals with hearing impairments |
The Healthy Michigan Plan provides comprehensive coverage for essential medical services, preventive care, and treatment options to eligible individuals and families in Michigan. The plan’s benefits are designed to ensure access to quality healthcare, promote overall health and well-being, and support individuals in managing chronic conditions.
Who is Eligible for the Healthy Michigan Plan?
Individuals living in Michigan and meeting the following requirements are eligible for the Healthy Michigan Plan:
- Must be a legal resident of Michigan
- Must be a U.S. citizen or qualified non-citizen
- Must meet certain income and resource limits
- Must not be eligible for other health insurance, such as Medicare or employer-sponsored insurance
How to Apply for the Healthy Michigan Plan
There are a few ways to apply for the Healthy Michigan Plan:
- Online: You can apply for the plan through the Michigan Department of Health and Human Services (MDHHS) website.
- By phone: You can call the MDHHS customer service line at 1-877-947-4328.
- In person: You can apply in person at your local MDHHS office.
What Documents Do I Need to Apply?
When you apply for the Healthy Michigan Plan, you will need to provide the following documents:
- Proof of identity, such as a driver’s license or state ID card
- Proof of citizenship or qualified non-citizen status, such as a birth certificate or passport
- Proof of income, such as pay stubs or tax returns
- Proof of resources, such as bank statements or investment account statements
What Benefits Does the Healthy Michigan Plan Offer?
The Healthy Michigan Plan offers a range of benefits, including:
- Doctor’s visits
- Hospital care
- Prescription drugs
- Mental health and substance abuse treatment
- Dental care
- Vision care
The plan also offers a number of preventive services, such as screenings for cancer, heart disease, and diabetes.
Well, folks, that’s all for today’s dive into the world of health insurance. I hope you found these insights helpful. Remember, the Healthy Michigan Plan is a Medicaid program that provides healthcare coverage to low-income residents of the state. It’s a great option for those who qualify and need affordable, quality healthcare. Remember to explore our other pieces on health insurance, where we break down complex topics into easy-to-understand chunks. Dive in, get informed, and make empowered decisions about your healthcare. Thanks for reading, and be sure to swing by again soon for more informative adventures!