Michigan Medicaid Changes: What to Expect

Michigan Medicaid Changes: What to Expect

Mar 26 2020

Michigan’s Medicaid program is changing. Here’s what you need to know about the upcoming rollout.

As you may (or may not) have heard, changes are coming to Michigan’s Medicaid program in 2020—let’s review what’s changing and what you need to do to meet the new requirements.

If you want to learn more about Medicaid and Michigan’s own state program, you can read more in our Medicaid 101 article.

What’s being changed?

Later this year in October, there are two main parts to the Medicaid changes. Some members of the Healthy Michigan Plan will need to pay a premium of 5% of their income, and follow new HRA and healthy behavior requirements. So, what does all this mean if you’re a Healthy Michigan Plan member? Let’s talk about what the changes are, how they work, and who will be affected.

Who is affected?
The changes coming in October only apply to some Healthy Michigan Plan members who fall into this group:

  • They’ve been enrolled in the Healthy Michigan Plan for a total 48 months or longer
  • Are enrolled in a health plan
  • Have income over 100% of the federal poverty level ($12,140 for an individual, $25,100 for a family of four)

It’s important to remember that the new requirements will not apply to all Healthy Michigan Plan members. Some of the reasons to be exempt (excused) from the requirements are:

  • Pregnancy
  • Medically frail
  • Enrolled in Flint Water Waiver
  • Able to demonstrate a good cause circumstance, such as experiencing a disability, hospitalization, or illness.
  • For more information on the reasons to be exempt, visit org

If you’re affected by this change, you’ll receive more information from the Michigan Department of Health and Human Services when the changes are made.

What are the two main parts of the changes?
The first part of the October 2020 changes is an increase in the amount that members pay for their premiums. Healthy Michigan Plan members will be required to pay a premium of 5% of their income.

The second part of the changes gives Healthy Michigan Plan members a couple options on how they meet the requirement. Members can either complete a Health Risk Assessment (HRA) or they can complete a healthy behavior. Healthy behaviors include activities like having a cancer screening, getting help with alcohol or drug abuse, dental visits and more.

So what should you do in the meantime if you’re enrolled in a Healthy Michigan Plan? For starters, stay tuned for more information. The state will send communications to those currently enrolled in Medicaid to keep you updated on the latest news and any changes. You should also start thinking about your yearly “healthy behaviors,” such as scheduling a doctor visit and completing a health risk assessment, which you can learn more about here.

To stay informed of upcoming announcement and changes, make sure to read any emails or letters that you get from Priority Health or the State of Michigan. If it’s time for you to renew your Medicaid eligibility, you can do so at michigan.gov/mibridges.

N4001-05 Approved MH03252020