MEDICAID

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Medicaid is a program that provides health care coverage to some low-income Michigan residents. Medicaid covers families with children and pregnant women, medically needy individuals, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid after they have resided in the U.S. for five years. Questions concerning immigration status and eligibility should be directed to the Michigan Department of Community Health.

  • For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

    In Michigan you may be eligible for Medicaid if you are an infant, a child, pregnant, the parent of a dependent child, medically needy, elderly, disabled, and your family income meets the Medicaid income standard.

    Income eligibility levels for these categories are described below.  For some Medicaid categories, your assets and some expenses also may be taken into account, so you should contact the Michigan Department of Community Health for more information.

Low income persons eligible for Medicaid in Michigan*

Category                       Income eligibility (as percent of federal poverty level)

Infant 0-1                       185% (monthly income of about $2,647 for family of 3)

Child 1-19                     150%

Parent

Working                      61%

Non-Working              38%

Pregnant woman          185%

Medically Needy

Individual                   57%

Couple                       56%

* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2007:

Size of Family Unit            U.S. Poverty Guideline (annual income)

1                                                 $10,210

2                                                 $13,690

3                                                 $17,170

For larger families, add $3,480 for each additional person.

So, for example, using this guideline, 185% of the federal poverty level for a family of 3 would be an annual income of $31,765, or a monthly income of $2,647.

* Contact the Michigan Department of Community Health for the most up to date information and for other eligibility requirements that may apply.

  • Parents who receive benefits from TANF (also known as FIP or Family Independence Program) should know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12-month transitional period.

    In addition, your children may qualify for Medicaid if your family’s income meets certain income standards.  (See above.)

  • Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid.

    Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage at least for a limited time.

  • Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.

    If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program.

    If your household income is between 100% - 120% of the federal poverty level, Medicaid will pay for your monthly Medicare premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

  • There may be other ways that Medicaid can help.  To find out if you or other members of your family qualify for Medicaid, contact the Michigan Department of Community Health.  In addition, there are a number of local community agencies, such as your local health department, that offer help in applying for Medicaid.


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