The Healthy Michigan Plan is a part of the state’s Medicaid program. It provides comprehensive coverage for low-income or disabled individuals with prescription medications, medical assistance, emergency services, and resources to improve their mental and physical health. It aims to educate residents and make much-needed resources more widely accessible.
Permanent residents of Michigan who meet broader Medicaid criteria may qualify for the Healthy Michigan Plan. Covered topics include how to apply for this and other plans, covered services, and eligibility requirements.
Finding affordable healthcare might seem daunting, but Medicaid in Michigan makes the process easier than many expect. In fact, as of July 2023 and according to medicaid.gov, 3,113,849 residents were enrolled in the plan. Plans like Healthy Michigan offer comprehensive benefits with a simple enrollment process. The following guide will take you through each step of enrollment, renewal, and card replacement.
You’ll also learn what the Healthy Michigan Plan and other Medicaid programs cover. To prevent shouldering the debt of unexpected medical expenses, many Michiganders extend their Medicaid coverage to include a more comprehensive range of benefits and services by way of private health insurance.
Medicaid in Michigan is a state branch of an expansive federal health program designed to ensure low-income individuals can access the necessary health resources. Without insurance or other avenues of financial assistance, many individuals struggle to afford healthcare services from qualified medical professionals.
Medicaid in Michigan offers free or low-cost care options to such individuals. The Michigan Department of Health and Human Services oversees the Healthy Michigan Plan and similar Medicaid programs. Common questions about Michigan’s Medicaid program include the following:
Finally, you need to know about the Healthy Michigan Plan vs. Medicaid. How do they differ? Medicaid refers to a collection of government-funded healthcare plans, including but not limited to the Healthy Michigan Plan. Each plan covers a different demographic.
The mihealth card is the card you will receive when you are approved for medicaid in Michigan. When you receive your mihealth card in the mail, you'll notice a unique member number that links to your personal and coverage information. It will also include your name. You may present it at any pharmaceutical or healthcare location that accepts Medicaid. For more information on the mihealth card, refer to this site.
Learning how to apply for the Healthy Michigan Plan and other Medicaid programs is quite simple:
Choose from one of the three application methods: online, in person, or over the phone.
To apply online, visit the MI Bridges web portal and create an account or log into an existing one. Input the information requested and scan any required documents as needed. You can request assistance from a helpline if needed.
Visit the nearest Department of Health and Human Services to apply in person. Organize and secure all necessary documents in a folder to ensure a speedy, productive process. Call the Michigan Health Care Helpline at 1-855-789-5610 to apply by phone.
What requirements should a Healthy Michigan Plan member or other program enrollee meet? Some basic qualifications include:
Carefully review your chosen plan’s eligibility outline to ensure you meet the minimum requirements.
After completing the application process, you should receive an acceptance letter within 45 days of submitting it. However, the MDHHS can take up to 90 days to determine whether a disability qualifies for enrollment. The acceptance letter will contain your new Michigan Medicaid card with information about your plan and carrier.
Under most circumstances, you must complete a renewal form annually to retain your Medicaid coverage. The MDHHS typically sends renewal documents to your physical address in paper form or via text with a link. Complete this form as soon as you receive it to prevent coverage gaps and other complications.
What should you do if you lose your card? Call the Beneficiary Helpline at 1-800-642-3195, following the teleprompt menu options. Alternatively, you can sign into the MDHHS’s myHealthPortal to request a replacement card online.
What does Medicaid in Michigan cover for beneficiaries? Medicaid will cover most medically necessary services. Medically necessary healthcare products and services are typically required to properly diagnose and treat a sickness, health condition, or injury. Learn more about coverage specifics below.
Although some state Medicaid programs don’t prioritize oral health, Michigan’s Medicaid does. Oral health plays a key role in overall wellness. MDHHS extends dental services to children, adults, and seniors through its subsequent Medicaid programs. Included in Michigan Medicaid dental coverage are services such as:
Michigan Medicaid programs offer dental coverage for more than just kids, teens, and young adults. If you’re 21 years old or older, you may be eligible to receive the following dental services through the program:
For those who have more serious dental issues and anticipate requiring more visits to the dentists, investing in private dental plans in Michigan is advisable.
Your Medicaid coverage will pay for most generic and name-brand prescriptions. You might pay a small fee, depending on your income level. Speak with your primary physician or the doctor prescribing the medications if you have questions or concerns about the coverage level or affordability. They may recommend a less expensive but similar medication or find an alternative route. Also, the drug must be listed on the Michigan Preferred Drug List (PDL) in order to qualify for Medicaid coverage.
Extended care services are often integral to a person’s quality of life. You might seek extended care options under the following circumstances:
Michigan’s Medicaid provides resources through the Healthy Michigan Plan that include but are not limited to hospice care, mental health services, and physical therapy. Many patients require additional care, but they go without because of financial concerns, lack of coverage, and restricted access. Investing in quality disability insurance is an excellent way to assist with some of the costs incurred with not being able to work either temporarily or permanently, and to help with the cost of medical needs outside of what the program covers.
Medicaid covers in-state travel for emergency rides or to doctor appointments. It may also assist with some out-of-state medical expenses for emergencies, according to the Medicaid & MIChild Fee-for-Service Handbook. However, you cannot use your Michigan Medicaid card outside state boundaries for non-emergency medical services. If you are traveling outside of Michigan for leisure, invest in proper travelers insurance.
Although the MDHHS doesn’t offer a plan specifically for college students, any permanent Michigan resident aged 19 or older who meets other eligibility requirements may apply for the Healthy Michigan Plan. However, Michigan college students must use this plan within state borders outside of emergency services. The Department of Insurance and Financial Services covers commonly asked questions about this topic.
While the Healthy Michigan Plan coverage only applies to people under the age of 65, Medicare programs can assist senior adults beyond that age range. Your Medicaid coverage can work in tandem with Medicare coverage for benefits, including:
PACE and similar programs can help senior adults remain in their homes while maintaining independence. Explore the criteria to learn whether you meet the requirements for Medicare and Medicaid programs for seniors.
Michigan’s Medicaid coverage goes beyond children, adults, seniors, and people with disabilities. You can also receive specific coverage if you fall into one of the categories listed below.
Native American residents who can verify their tribal affiliations or membership may apply for and receive benefits from Medicaid programs and CHIP. This demographic is not required to make Healthy Michigan Plan payments or pay copayments or deductibles. Learn more about coverage for American Indians and tribe verification.
Veterans can also apply for Medicaid in Michigan. You may still qualify for the Healthy Michigan Plan if you have VA coverage. However, your VA coverage will supply primary coverage over your chosen Medicaid program.
This means that the VA will cover most of your healthcare bills. Once it reaches its limit, your Medicaid plan will cover any remaining costs.
Now that you know more about who the Healthy Michigan Plan and other Medicaid programs cover, find out more about its limitations. Your plan may not cover certain treatments, services, and equipment. Those items typically fall under the following categories:
Enrollees must purchase disposable items such as diapers and bandages out of pocket. Michigan’s Medicaid program does not cover these extra expenses.
Elective procedures are typically unnecessary to benefit the individual’s health. However, the state may deem some joint replacements medically unnecessary. Therefore, you will need third-party insurance to assist with such treatments.
If you need to travel to a different state to obtain treatment, you must pay out of pocket or have a private provider cover the expenses. The same applies to services provided by private institutions vs. state-funded ones.
Medicaid programs do not cover facelifts and other cosmetic surgeries. The state deems these procedures medically unnecessary.
If you undergo any medically unnecessary procedure that results in medical complications, your Medicaid plan won’t fund your treatment.
The State of Michigan offers very little assistance towards the cost of funerals. Considering the rising cost of burial and related fees, ensure that your family is secured with comprehensive funeral insurance.
You can review the details with your primary physician or call the helpline for more information. Remember that coverage often changes by the year. Stay updated about any changes to the Healthy Michigan Plan and other applicable programs.
Many state Medicaid plans have limitations on the services they pay for. Medicaid in Michigan is no different. The following lists identify the services that MIChild, the Healthy Michigan Plan, and various Medicaid and Medicare programs for seniors. Service allowance may vary based on your Medicaid program.
Find out which healthcare services your plan may cover below.
|Full and partial dentures
|If you have lost teeth, you may qualify for a set of dentures to complete your smile and help you enjoy more foods.
|Routine dental cleanings and checkups
|Everyone needs a dental checkup from time to time. The Healthy Michigan Plan and other programs ensure they can.
|Extractions and fillings
|Sometimes, teeth develop decayed areas that can become infected. A dentist will treat these issues at little to no cost to you.
|Root planing periodontal scaling
|Tooth anatomy consists of roots beneath the gum line. Your dentist might need to check on this area.
|If you require services such as implants, you must find other ways to pay for them.
|Glaucoma screenings and diagnosis
|Around three million Americans suffer from glaucoma. Michigan residents can help reduce the number through glaucoma diagnosis and treatment.
|Routine eye exams
|Let a specialist check your eyes to ensure you can still see well!
|One pair of eyeglasses
|If you learn your eyesight has become poorer during an exam, you may receive a prescription for a pair of glasses to help your vision.
|Replacement eyeglasses (if you meet certain qualifications)
|If you learn your eyesight has become poorer during an exam, you may receive a prescription for a pair of glasses to help your vision.
|Medicaid only covers contact lenses on a case-by-case basis.
|Your plan will pay for any medically necessary surgical procedures and related services, such as:
|Invasive surgeries are often inpatient procedures. Your Medicaid plan should cover most or all expenses.
|If you need surgery, you shouldn’t stress about the cost. The Healthy Michigan Plan and other programs can help pay for it.
|Some drugs needed to facilitate the surgery safely
|Your Medicaid plan may cover costs for drugs prescribed before, during, or after the surgery.
|Your Healthy Michigan plan covers hospital stays, including inpatient and outpatient services. It also covers:
|No one plans for or expects an emergency. Medicaid in Michigan can assist with the transportation costs.
|Transportation to and from appointments
|MDHHS supplies transportation to regular appointments for all cardholders.
|Medical supplies and equipment
|Most hospital visits require equipment. Medicaid covers the cost.
If you struggle with substance abuse or mental health disorders, you can access various behavioral health resources, including:
|As a Medicaid card holder, you have access to various services designed to educate you and protect your sexual health, such as:
|Sometimes, you need a second opinion beyond a store-bought pregnancy test. The Healthy Michigan Plan will confirm your pregnancy with professional tests.
|Birth control education, prescriptions, and products
|Ready to learn more about protecting yourself and your partner? Michigan’s Medicaid resources will show you the way!
|Testing and diagnosing sexually transmitted infections
|Proactively protect your body with prompt STI tests and treatment.
|Prescriptions to combat STIs
|STI prescriptions can be expensive. Medicaid assistance makes them accessible.
|HIV/AIDs testing and treatment
|The prospect of contracting HIV scares most people. You can manage and treat your diagnosis responsibly with the help of state resources.
|General family planning assistance
|Find the personalized care you deserve during pregnancy and after birth.
|Michigan’s Medicaid programs cover your appointments with and treatments prescribed by various specialists. You may seek services from the following providers within the state network:
|Your feet help you move, work, and participate in life. Podiatrists specialize in keeping the healthy and treating any injuries.
|Injuries or chronic conditions can cause intense back or neck pain. Some chiropractors who accept Medicaid will treat those issues.
|Surgeons have the skills and education to conduct routine surgeries safely. Although surgeries can be expensive, the Healthy Michigan Plan and similar programs greatly reduce the costs.
|Physical and occupational therapists
|Some injuries or major health events may limit your mobility. Michigan’s network of physical and occupational therapists can get you moving again.
|People of all ages can access audiologist appointments and receive hearing aids. You’ll qualify for a new pair every five years.
|Optometrists specialize in eye care and can prescribe glasses and treatments for conditions like glaucoma.
|Specialist access goes beyond these professionals. Explore the specialists identified within your nearby medical network.
Although Medicaid in Michigan makes healthcare more accessible and affordable for over one million Michigan residents, many individuals still struggle to work around the program’s strictures to access the personalized care they need. Since Medicaid coverage can change without warning, supplementary coverage gives you peace of mind about your family’s well-being. It eliminates concerns about access and treatment variety from the equation.
That’s where Insurdinary comes in. You can use private insurance providers to fill the gaps in your Michigan Medicaid plan and get the coverage you need. Other types of private insurance, such as life insurance, can help pay for medical costs Medicaid will not cover, especially in the event of your passing. We help Michigan residents navigate the insurance marketplace to find affordable, customized coverage that works with their Medicaid plans. Third-party or privacy insurance policies empower you to diversify your health management options.
A private or third-party provider can offer the following:
Craft a healthcare plan that serves your family best. Take your health into your own hands. Compare quotes from numerous insurance companies ready and willing to work with your budget, lifestyle, and Medicaid in Michigan.
Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following: