Requirements for Medicaid in Michigan

Michigan Medicaid is open to low-income children, pregnant women, adults with dependents, individuals age 65 or older, and those with disabilities. Medicaid offers a range of plans and requirements depending on your eligibility group and income. Income eligibility is determined after allowable deductions have been calculated. Applicants must be United States citizens or legal immigrants. Undocumented immigrants may qualify for temporary emergency Medicaid services if they meet other eligibility criteria.

Automatic Eligibility

• Supplemental Security Income (SSI) beneficiaries are automatically eligible for Medicaid coverage and may apply for Medicaid as part of the SSI enrollment process. Families receiving cash aid through the Family Independence Program (FIP)---formerly known as welfare---are also categorically eligible. Additionally, families no longer eligible for FIP due to increased earnings may qualify for up to an additional 12 months of coverage with the Transitional Medicaid Assistance (TMA) program.

Income Limits

• Medicaid income limits for able-bodied adult caretakers of qualified dependents may qualify if their monthly income does not exceed 64 percent of the Federal Poverty Level (FPL). The income limit for pregnant women and infants up to age one is 185 percent of the FPL. Children ages one through nineteen may be eligible if their income is at or below 150 percent of the FPL. Excluding automatically eligible groups, adults age 65 and older or disabled individuals may qualify if their income does not exceed 100 percent of the FPL. There is a resource test for most programs limiting available cash, bank accounts, stocks, bonds and valuable assets.

Secondary Insurance

• Many Medicaid programs allow you to have health insurance and still qualify for coverage. Any insurance you have will be billed prior to Medicaid making payments. Medicare recipients may also qualify for Medicaid if their income does not exceed 135 percent of the FPL. Some individuals with income exceeding Medicaid guidelines may still qualify if they "spend down" their countable income on medical bills.

Specialty Programs

• Medicaid offers family planning services to adults ages 19 to 44 if their income is at or below 185 percent of the FPL. Medicaid also offers waivers to help cover nursing home or home health care for older or disabled individuals. Additionally, adults ineligible for Medicaid due to lack of dependents may qualify for a medical waiver or the Michigan Adult Medical Program if they are considered very low-income and medically needy.