Having medical insurance is something that every family, as well as every individual person, needs in order to maintain a healthy lifestyle. Medicaid is a program that helps these individuals get the coverage that they need. The qualifications needed for the program are strict and there are a set amount of guidelines that must be followed in order to participate in the program.
Medicaid Eligibility in Michigan
Deciding if you are eligible is one of the first steps you need to take when it comes to getting Medicaid benefits. There are specific criteria that each state is required to go by and these guidelines will vary from one place to the next. In order to be eligible for Medicaid in Michigan, you will have to verify your income as well as your assets. Certain programs will also need you to verify your citizenship as well. If your family makes more than the amount needed to be eligible for Medicaid, you may still get the program but with a spend down amount that must be met, which is a certain amount of money that must be paid out-of-pocket every month.
To apply for the Medicaid program you can do so by phone, in-person with a paper application, or the fastest way is right online. After doing so you will be able to log on to your account and verify the status of your application at any time.
What does Medicaid Cover in Michigan?
Anyone who signs up for the Medicaid program will receive a copy of everything that is covered under their package. The main things covered are:
- Dental Care or Healthy Michigan Plan
- Emergency Services
- Prescription Drugs
- Doctors’ visits
- Laboratory services
- Habilitative Services
- Maternity and newborn care
- Preventive and wellness care
- Hospitalization
- Mental health services
You will also be able to get a large network of doctors to choose from as well as get help with transportation to and from your doctor’s appointments.
The income guidelines for eligibility will vary depending upon the size of your household.
For those with:
1 - $15,800
2 - $21,307
3 - $26,813
4 - $32,319
5 - $37,825
6 - $43,331
7 - $48,851
8 - $54,384
If there are more than 8 people living in the household, then you will need to add an additional $5,533 per person. This is all annual income before taxes.
There are many services that are completely covered under Michigan’s Medicaid plan while there are others that are only partially covered and will require you to pay a co-pay, most of which or generally under $5.
The types of services that require a co-pay are:
- Vision appointments
- Physician office and free-standing urgent care center visits
- Podiatric visits
- Outpatient hospital clinic visits
- Hearing aids
- Emergency room visits
- Dental visits
- Inpatient hospital stays
- Chiropractic care
- Pharmacy costs
The prescription drug plan for Michigan is provided to members at no cost as long as they are filled out at an approved pharmacy. There are some drugs that you may need to get prior approval before you will be able to get them filled out. As long as the drugs you are prescribed are on the drug list then they will be filled. There are sometimes when more information is needed from a doctor for certain types of medications and you may see a delay in receiving your medications.
Which Medicaid Plan Would Be Best in Michigan?
Michigan has 11 total health plan providers that you can choose from and each one will have varying packages that you may wish to look before you decide just which plan you want to choose for you and your family.
The plans are:
1. Aetna
2. Blue Cross Complete of Michigan
3. Hap- Midwest Health Plan
4. Harbor Health Plan
5. McLaren Health Plan
6. Meridian Health
7. Molina Healthcare
8. Priority Health
9. Total Health Care
10. United Health Care community plan
11. UPHP- Upper Peninsula Health Plan
All of the links to each of these providers sites and what they have to offer can be found on Michigan’s government webpage for you to view, so that you can get a better understanding of what they all have to offer and compare them so that you can find what is right for you and your family.
