Affordable Care Act, Michigan, Obamacare — March 26, 2014 at 8:20 am

Medicaid expansion comes to Michigan April 1: What you need to know


It should have come sooner, but let’s just be glad it’s finally happening.

Finally, Michigan’s expanded Medicaid program is almost here. I’d be remiss if I didn’t mention the fact that Medicaid expansion was delayed by four months because the Republican-led Michigan Senate refused to give it immediate effect — and Gov. Snyder did none of the things in his power to change that. It’s cost the state more than $600 million in funding and prevented nearly 500,000 low-income working Michiganders from getting health insurance until now. Come November, remember that this all happened as a result of political posturing on the part of Michigan Republicans.

But, for now, let’s focus on the good stuff. The Michigan Department of Community Health has announced that enrollment in the expanded Medicaid program that’s part of the Affordable Care Act (ACA) begins April 1.

Gov. Snyder has dubbed the program the Healthy Michigan Plan, and the Michigan League for Public Policy‘s President & CEO Gilda Z. Jacobs applauded the launch announcement.

The April 1 launch of the Healthy Michigan plan is fantastic news for the many uninsured in Michigan. Moving ahead with an expanded Medicaid program in Michigan will wisely use available federal dollars to improve health in our state. It will make sure parents and single adults get the health care they need to be productive workers and citizens.

Here’s what you need to know, courtesy of the Michigan League for Public Policy:

Who’s eligible? People between the ages of 19 and 64 who aren’t currently eligible for Medicaid or Medicare. You must be a citizen or lawfully admitted to the U.S., and have an income less than 133% of the federal poverty level (up to $15,521 for an individual or $31,721 for a family of four).

What’s covered? The comprehensive services required by the ACA, including doctor visits, prescriptions and hospital services — plus additional key services such as dental, vision, hearing, and enhanced substance use disorder services — will be covered. Most people will select and be enrolled in the managed care plan of their choice.

How much does it cost? After the first six months, everyone enrolled in the program will be responsible for nominal co-pays for certain services, such as doctor visits ($2), prescriptions ($1 or $3), and dental services ($3). Co-pay amounts will be the same as the current Medicaid program. There will be no co-pay requirements for preventive services or emergency services. Co-pays can be waived for services that allow enrollees to better manage chronic diseases or prevent complications.

People between 100% ($11,670 for an individual, $23,850 for a family of four) and 133% of the federal poverty level will be required to make an income-based contribution to a MI Health Account. This amount will be up to 2% of annual family income, and must be contributed on a monthly basis beginning the 7th month of enrollment. Contributions will not be required during the first six months of enrollment. Contributions can be made by the enrollee, by an employer, charitable organization, family member, or other entity on the enrollee’s behalf.

Both the co-pay amounts and the 2% contributions can be reduced if “healthy behaviors,” which are yet to be defined, are maintained or attained. Together they can’t exceed 5% of family income. Required co-pays and contributions will be paid to the health plan selected by the individual.

When does enrollment start? New applications will be accepted April 1 for enrollment effective April 2014. All applications will be screened for Medicaid eligibility before Healthy Michigan Plan eligibility is approved.

People participating in the current Adult Benefits Waiver program are currently being transitioned from that program to the Healthy Michigan Plan. People with incomes between 100% and 133% of the federal poverty level who purchased coverage through the ACA Marketplace will also be transitioned from their Marketplace plans to the Healthy Michigan Plan. If you’re not sure about your status, contact the Michigan Department of Community Health (see below).

The Department hopes to retrieve Medicaid applications denied on or after Oct. 1, 2013 and reprocess them to determine Healthy Michigan Plan eligibility.

What’s the enrollment process? A streamlined application and eligibility process, using the new tax-related income methodology and no asset test, will be used. Applications will be available by phone, online or in person.

Where can I learn more? Visit the Michigan Department of Community Health website to get updates about the program and how to enroll, as well as contact information for assistance. You can also get information via text message. Just text InfoMI to 69866. For even more, the Michigan League for Public Policy has details online.