Medicaid

Medicaid Work Requirements Are Coming…What Does It Mean?

Medicaid work requirements were written into state law in June of 2018 and were approved by the federal government over a year ago. Now the Michigan Department of Health and Human Services (MDHHS) is preparing to implement work requirements, and IF things continue, people who have the Healthy Michigan Plan may lose their health care if they do not meet the work requirements.

workingpeople.jpg

People who may be subject to Medicaid work requirements:

  • Enrolled in the Healthy Michigan Plan (HMP)

  • Current Michigan resident

  • Age 19-62

  • Not disabled, pregnant, or qualifying for another exemption (listed below)

What are the changes?

HealthyMIplanLogo.jpg
  • Requirement to work or participate in other qualifying activities for at least 80 hours per month.

  • HMP beneficiaries must report to MDDHS on a monthly basis and are allowed 3 months of non-compliance (not reporting, or reporting but not participating in qualifying activities) within 12 months.

  • Loss of eligibility for non-compliance. After 3 months of non-compliance, beneficiaries will lose their healthcare coverage (HMP).

What counts as work or a qualifying activity?

  • Employment or self-employment

  • Education directly related to employment (school, college, etc.)

  • Participation in a substance use disorder treatment program

  • Community service with a 501(c)(3) or 501(c)(4) for 3 months only every 12 months

Who qualifies for an exemption?

  • Caretaker of a family member under 6 years old

  • Beneficiaries receiving temporary or permanent long-term disability benefits

  • Full-time students

  • Pregnant women

  • Individuals who have a medical professional’s order stating they are medically frail or have a medical condition that limits their ability to work

  • Beneficiaries who have been incarcerated in the last 6 months

  • Beneficiaries receiving Michigan unemployment benefits

  • Individuals who are receiving SNAP (food assistance) or TANF (cash assistance) benefits.

What is the timeline for work requirements to begin?

  • September 2019

    DHHS is sending Exemption Forms and Letters to HMP members who need to tell DHHS they qualify for an exemption. If you qualify for an exemption, fill out the form and FAX it to 517-432-6079. Do not mail it.

  • October 2019

    DHHS will send letters to people who are listed as having an exemption (see above). A separate letter will also be mailed to HMP members who are 62 or older because they are also exempt.

  • January 2020

    HMP members who have not qualified for an exemption will need to start reporting their work to MDHHS. When there is more information about how to report, there will be a new blog post. Until then, stay tuned…

Unless…

State advocates are hoping to stop Medicaid work requirements with a lawsuit. And they NEED PLAINTIFFS! They are looking for current Healthy Michigan Plan members who will be adversely affected by the new requirements.

gavel.jpg

Examples of people who would be good plaintiffs include:

  • single working parents with children between the ages of 6-11;

  • people whose hours per week are highly variable or dependent on factors outside their control;

  • people who may not be medically limited but have jobs that are less than 3 hours/day. This might include school lunch supervisors or school bus drivers, part-time home healthcare workers or restaurant workers who may have reduced hours when business is slow.

  • People with sporadic hours like substitute teachers, recently incarcerated people who are looking for a job, and seasonal job workers are also good candidates.

If you have a good candidate, please have them contact Mario Azzi at the Center for Civil Justice: 800-724-7441 or mazzi@ccj-mi.org OR Lisa Ruby at Michigan Poverty Law Program 734-998-6100 ext. 617 or lruby@mplp.org. Click here for a flyer to print.

If you have any questions or concerns about Medicaid work requirements, ask us in the comments below or you can always call the WHP office at 734-544-3030. We are also open for walk-ins 9am-4pm Monday through Friday at 555 Towner, Ypsilanti, MI.

Print Friendly and PDF

Subscribe to our blog here!

Happy 50th Birthday to the AAATA. Are YOU Falling off Medicaid?

Happy 50th Birthday to  The Ride ! Cake picture from  sayitwithcake.ca .

Happy 50th Birthday to The Ride! Cake picture from sayitwithcake.ca.

The Ann Arbor Area Transit Authority, also known as The Ride, is celebrating its 50th birthday in 2019! People who ride the bus come from all over the county and have all kinds of insurance. But some bus riders may be losing Medicaid, and not know it.

That is why we are so excited to be partnering with The Ride on our Are You Falling off Medicaid? Campaign.

Through their generosity, we have placed posters in all buses starting March 1, 2019! We have timed this campaign to coincide with the mid-March increase in the minimum wage. Our hope is that we will be able to get people to visit or call us before their special enrollment period runs out. If done in time, people who lose Medicaid can get Marketplace or employer insurance.

Want a prize?

Snap a selfie of yourself with our poster and tag @coveragecounts on twitter, @healthcarecounts on facebook or @healthcarecounts on instagram!

Print Friendly and PDF

Subscribe to our blog here!

HELP! I got cut off of Medicaid!

help word clothespins.jpg

ASK: Why did I get cut off Medicaid?

Remember that you can get cut off of Medicaid because your income has risen, because the number of dependents has changed, or because you didn’t fill out an annual renewal (redetermination) form.

thinking-face-small2.png

So first, figure out whether the cancellation was correct.

Should Medicaid Have Been Cancelled?

Let’s take a few examples:

  1. You failed to fill out an annual redetermination form, but nothing else in your life has changed. Medicaid is renewed annually, and sometimes people in a household are on different cycles, so you may need to fill out renewals more than once a year. If nothing has changed, you should still be eligible for Medicaid, and should reapply at MI Bridges.

  2. Your income and/or household size has changed. Even a small increase in hours or pay/hour (minimum wage is going up!) can make a big difference. Especially if there are multiple earners in a household, things can get complicated. Here’s how to figure out if your income is still eligible. Income limits for Medicaid.

    Your household size also may have changed. Perhaps a child has grown up and is now on their own; perhaps you got a divorce; perhaps someone in your family died; perhaps parents or grandparents have moved into your household. While you are looking at income, don’t forget to look at household size.

    Remember that eligibility is a combination of both household size and income. If you feel the determination was made incorrectly, you can reapply, or file a hearing (Part 1 and Part 2).

But What If the Determination Was Correct, And You’re Not Eligible For Medicaid?

Good News: You Qualify for a Special Enrollment Period

Employer Insurance

30-days.png

If your employer offers affordable health insurance, you generally are required to enroll. When your Medicaid ends, it opens a Special Enrollment Period for you to enroll in your employer health care.

It could be that the employer insurance is offered to someone else in the household, but you are eligible. With a Medicaid denial letter, you can get on their employer insurance with a Special Enrollment Period.

For an employer special enrollment period, you only have 30 days to take advantage of the offer, so don’t delay!

Marketplace (Healthcare.gov)

60-days.png

If your employer does not offer you insurance, you can apply on the Marketplace (healthcare.gov), and you will likely qualify for good tax credits. [If you don’t, please give us a call. You may have fallen into a “family glitch” or answered a question incorrectly.]

For the Marketplace, you have 60 days from the day your insurance ends for the special enrollment period. You will need to prove that you have lost your Medicaid insurance with a denial letter.

 

Questions? We Help People.

Call us at 734-544-3030

Walk in to our office at 555 Towner in Ypsilanti,

Monday-Friday 9 a.m. to 4 p.m.

 

Print Friendly and PDF

Subscribe to our blog here!

Public Charge and Public Benefits

If public charge rules changes happen, there will be a notification period. DON'T end any public benefits now. #AllAreWelcomeHere

Want more information? Read the post, Welcome Immigrants—Opposing Public Charge Rules Changes, from December 2018.

#AllAreWelcomeHere

Print Friendly and PDF

Subscribe to our blog here!

Welcome Immigrants—Opposing Public Charge Rules Changes

PIF.png

UPDATE: Over 200,000 comments were received while the public comment period was open. No changes can be made until the regulating body (Department of Homeland Security) responds to every comment. Then they can publish a final rule, which could incorporate changes based on comments received—or they could decide not to publish a rule. After the rule is published there is a waiting period before it takes effect.

Today—in fact—any day—is a good day to tell the world that you welcome immigrants to the United States. The Washtenaw Health Plan and Washtenaw County Health Department have submitted comments opposing the changes in "public charge" regulations. Comments could be submitted until December 10th, 2018.

What Is The Issue?

The Trump administration has published a proposed rule that would force many immigrants and their families to choose between accessing essential public services and keeping their families together. 

There are many reasons why immigrants may be denied permanent residence (aka a “green card”) or not be allowed to enter the United States. Public charge is one of those reasons. Under current laws, the government considers someone a public charge if they are found likely to become primarily dependent on government programs.

Currently, “public charge” is considered very narrowly—an immigrant can only be found to be a public charge if they use cash assistance (like TANF or SSI), or institutionalized long-term care (like living in a nursing home) through Medicaid.

The government is considering changes that would dramatically expand who is considered a public charge. making it much harder to get a green card or visa. These changes include:

  • Expanding the benefits that could classify you as being a “public charge” and

  • Assessing your income differently—meaning that your income would only be viewed positively if you made at least 250% of the poverty level (nearly $63,000 for a family of 4).

  • Adding assessments of age, health, education and skills. Children and seniors could be assessed negatively.

In addition to what the public charge proposed rule actually says (and at this point it is only a proposal), it can also have a “chilling effect,” and make people afraid to access any services, even ones that are not included in the rule. If the “public charge” rule is ­finalized in its proposed form, this would mark a significant and harmful departure from long standing immigration policy. The proposal would make -- and has already made -- immigrant families afraid to seek programs that support their basic needs. These programs help them stay strong and productive, and raise children who thrive. With about one in four children having at least one immigrant parent, this issue touches millions and is critical now and for our nation’s future. And that’s why taking action is so important!

According to the Michigan Immigrant Rights Center, at this point, “If you are applying for a green card within the U.S., the rules have not changed, and there is no reason for you or anyone in your family to stop receiving non-cash benefits (like Medicaid and food stamps) that they are eligible for.”

What Can I Do To Make A Difference?

When the federal government proposes a rule, they have to request comments. We have until December 10, 2018 to submit comments. Your voice matters!

The best way to comment is to go online to the federal public charge comment portal at regulations.gov. Click on “comment now” and either enter your comment in the text box (must be fewer than 5000 characters) or upload your comments as a PDF.

Any comments are good, but it’s best if:

  1. You write comments in your own words.

  2. You share research, experiences, and/or the stories of people you know (friends, relatives, community members). You can even include web links or upload supporting materials (research, or your resume, if you are a content expert).

  3. Look to the Michigan League for Public Policy for some great information about the positive economic impact of immigrants in our communities; use that information in your comments. Talk about why we value immigrants in Michigan!

  4. Talk about the role that access to benefits has played in your life, or the lives of people you know.

More details about comments can be found here.

In fact, there’s even a toolkit with specific comment suggestions. However, don’t worry too much about it, short comments are ok too!

phone tree.jpg

What Else Can I Do?

Use email, phone calls, and social media to get your friends and family to submit comments. (Hint: Share this post!)

You Are In Good Company

If you comment, you are in good company. Not only did the Washtenaw Health Plan submit a comment, but:

And special, special thanks to our partners at the Michigan Immigrant Rights Center for their knowledge, support, and advocacy. Read more about their campaign to Protect Immigrant Families here!

Print Friendly and PDF

Subscribe to our blog here!

Preparing For Open Enrollment - Employer, Marketplace and Medicaid

halloween.png

Don’t be frightened! Health care isn’t scary!

Medicaid Enrollment is Always Open.

alwaysopen.png

You can always apply for Medicaid. Anytime during the year you become eligible, you can apply for Medicaid. No qualifying events, no special documents. Check your income here and apply here. As always if you have questions, call us at 734-544-3030.

Employer Open Enrollment

employer-health-insurance.jpg

If you are offered health insurance through your job, chances are your open enrollment period is in the fall with a January 1, 2019 start date. Some employers (schools, universities, businesses with fiscal years based on other calendars) may have open enrollment during other times of the year.

Evaluate your options every year.

Each year your employer negotiates new benefit packages with health, dental and vision insurance companies. Your open enrollment may also include retirement options, disability and life insurance. When it comes time to evaluate your options make sure to look at each plan. If you don’t understand the details of a benefit, contact your HR department to explain it to you. Here are some tips for thinking about your particular family and your how you use your health insurance.

  1. How much health care do you expect to use?

  2. What is my deductible? What is my maximum out of pocket?

  3. Is my employer insurance affordable? Do I have another option?

You may be wondering if you can sign up on the Marketplace, read more about that option, Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes).

Marketplace Open Enrollment Nov. 1 - Dec. 15

healthcaregovdeadline.png

The Open Enrollment Period for the Marketplace (aka Obamacare, healthcare.gov, ACA) is November 1 to December 15. During open enrollment anyone who is eligible can sign up for health care coverage that will start on January 1, 2019. In order to sign up on the Marketplace ask yourself these 3 questions:

  1. Am I eligible for Medicaid? If yes, you are not eligible to enroll with tax subsidies on the Marketplace. If you are a family, children may be eligible for Medicaid/MIChild and parents may be eligible for the Marketplace.

  2. Does my employer offer affordable insurance? If your employer insurance is less than 9.69% of your income for the lowest priced, ACA-compliant employee only plan, you are not eligible to enroll with tax credits on the Marketplace. Read more here Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes).

  3. Do you have income and are you filing taxes? You must have income and file taxes to receive tax credits and enroll in health care on the Marketplace.

Information needed for a Marketplace application

checklist.jpg

Did you answer yes to all 3 questions? The next step is to gather the documents and information you will need to complete a Marketplace application and select your health care plan. You will need the following:

  • Names and social security numbers for everyone in your tax household. Your tax household includes anyone you will claim on your tax return.

  • Earned income information -recent paystubs for everyone who is working or self-employment records (Schedule C from the previous year’s return).

  • Unearned income information - pension, retirement, real estate income, social security (RSDI or SSI) income or capital gains.

  • 2017 Tax return including Schedule C, if applicable.

  • List of doctors

  • List of prescriptions

  • Marketplace Account information - user id and password.

    • If you don’t have an account and need to create one you will need an active email account that you can access immediately. You must be able to access the email to access a verification email.

The next step is to estimate your income for 2019. For some people this is easy, but for anyone whose income varies during the year, it can be tricky. (We have written many posts about income, click here to browse all the income blogs.)

Now go to the Marketplace website, healthcare.gov, complete an application and select your 2019 health care coverage. You can preview 2019 plans here.

If you have questions, if you need assistance with the application or if you need help with the whole thing, please call the Washtenaw Health Plan and make an appointment. Michigan residents, we can also answer questions over the phone. Call us at 734-544-3030. The sooner you call the better! If you are not in southeast Michigan, use this resource to find local help for healthcare.

happyhealthy.jpg

Washtenaw Health Plan

734-544-3030

We Help People - Like You!




Print Friendly and PDF

Subscribe to our blog here!

Open Enrollment Question: Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes)

employer-health-insurance.jpg

For many employees, Open Enrollment period for employer insurance comes in the fall, and is a short two or four week period where you have to make important decisions about health care for the coming year. This can be a lot of pressure, and so it turns out that a little preparation can go a long way. If you are a new employee at a job, you may be offered insurance right away, or after a period of 90 or 180 days.

Know your options, because if this were a relationship on Facebook, you might say, "It's Complicated!" What follows is a series of questions that will hopefully help you figure it out.

openenrollment clock.jpg

If you are going to turn down your employer insurance, you want to make sure you are clear about the alternatives. Although it doesn't matter to Medicaid if you have an offer of employer insurance, it does matter if you were hoping to get subsidies on the Marketplace. Don't turn down your offer of coverage without studying your options!

1. Does your employer coverage meet Minimum Essential Coverage guidelines?

This would mean the the employer coverage covers:

  • Ambulatory patient services(Appointments and procedures in a doctor's office);

  • Emergency services;

  • Hospitalization;

  • Maternity and newborn care;

  • Mental health and substance use disorder services, including behavioral health treatment;

  • Prescription drugs;

  • Rehabilitative and habilitative services and devices;

  • Laboratory services;

  • Preventive and wellness services and chronic disease management and Pediatric services, including oral and vision care.

If the answer is yes, continue. If the answer is no, consider Marketplace and Medicaid eligibility and enrollment.

BEWARE: Some employers offer very inexpensive medical plans that do not cover hospitalization or emergency services. These do not meet Minimum Essential Coverage guidelines.

 

2. Does your employer coverage meet Minimum Value standards? 

Minimum value standard is a standard of minimum coverage that applies to job-based health plans. If your employer’s plan meets this standard and is considered “affordable,” you won’t be eligible for a premium tax credit if you buy a Marketplace insurance plan instead.

A health plan meets the minimum value standard if both of these apply:

  • It’s designed to pay at least 60% of the total cost of medical services for a standard population

  • Its benefits include substantial coverage of physician and inpatient hospital services

If you are unsure, ask your employer to fill out the Employer Coverage Tool.  

If the answer is yes, continue. If the answer is no, consider Marketplace and Medicaid eligibility and enrollment. 

NOTE: If the answer is no to EITHER the minimum essential coverage or minimum value standard, and you are income-eligible, you should be eligible for advance premium tax credits.

 

3. Is your family income low enough for some or all of your family to qualify for Medicaid?

Look here for the income eligibility tables for Medicaid. If you (or some members of your family) are income-eligible for Medicaid, you can apply for Medicaid instead of or in addition to your employer coverage. Because the income cutoffs for children are higher than for adults, often children can be enrolled in Medicaid or MIChild while the parents enroll in employer coverage. You can also have both Medicaid and your employer insurance--Medicaid will pay co-pays and deductibles not covered by your employer coverage, and this can be useful if you have a high-deductible plan. 

 

4. What is the cost of your insurance, relative to your income? 

To figure this out, look at the lowest-cost plan your employer is offering that meets the minimum standards (see #1 and #2 above), and the cost for the health coverage for the employee alone. 

Example 1: The cost is $100/month for the employee alone, and the employee makes $1000/month. $100/$1000=10% of income.

Example 2: The cost is $100/month for the employee alone, and the employee makes $2000/month. $100/$2000=5% of income.

Generally, if the cost is more than 8% of family income but less than 9.69% of family income, you are exempt from having to take the insurance, but you are not eligible to get advance premium tax credits on the Marketplace. [You may, however, be eligible for Medicaid!]

If the cost is more than 9.69% of family income, you don't have to take your employer insurance, but you can buy on the Marketplace and qualify for advance premium tax credits.

 

5. What about the rest of the family?  The Family Glitch

The Affordable Care Act looks primarily at affordability for the employee only. Different people in a family can get covered in different ways. 

If the cost of insurance for the employee is affordable, and the cost for the rest of the family is not affordable, you fall into what is called the "family glitch." The rest of the family is probably not going to be eligible for subsidized plans on the Marketplace. At this point, help from someone familiar with insurance options can be a big help. You may very well be exempted from the mandate to have health insurance, but that doesn’t help with getting health care. On the other hand, other family members may get covered differently. Possibilities may include: 

Thanks to healthinsurance.org for the image.

Thanks to healthinsurance.org for the image.

Don't forget: in many cases, different people in a family are covered in different ways. For example, each parent may be covered by his/her own employer, and the children may be covered by MIChild.

 

6. What if employer coverage gets offered or dropped in the middle of the year?

Changes in employer coverage in the middle of the year create Special Enrollment Period opportunities. If employer coverage is offered, you should evaluate it. If you have Medicaid and will continue to qualify for Medicaid, you may not want to take it. If you have a Marketplace plan and the employer coverage meets minimum standards, you may need to take the employer coverage because you will no longer be eligible for APTCs. If you take it and have a Marketplace plan, make sure to let the Marketplace know!

If you lose employer coverage during the middle of the year, you may be eligible for Marketplace or Medicaid plans. The Special Enrollment Period on the Marketplace after you lose employer insurance is good for 60 days. Medicaid is open year-round.

3QuestionMark.png

If you have questions, call or walk in to the WHP office.

Washtenaw Health Plan, where We Help People like you!

Monday through Friday from 9am to 4pm

555 Towner, Ypsilanti, MI 48198

 

Resources

Employer Coverage Tool:  Use this tool to gather answers about any employer health coverage that you’re eligible for (even if it’s from another person’s job, like a parent or spouse). You’ll need this information to complete your Marketplace application. Complete one tool for each employer that offers health coverage that you’re eligible for.

Healthcare.gov: Apply here for Marketplace insurance. 

MiBridges: Apply here for Medicaid insurance. 

HealthSherpa:  Use this tool to compare health plans. 

Healthcare.gov Estimator: Compare or preview plans and rates with this estimator. Plans for 2019 should be available during the last week of October.

 

Print Friendly and PDF

Subscribe to our blog here!

2019 Medicare Open Enrollment Runs October 15 through December 7

Medicare is a program for people who are 65 or older and people with disabilities. You can read more about Medicare here. If you have Medicare now, then...

It's time to review your Medicare Plan!  

October 15, 2018 to December 7, 2018 is the annual Medicare Open Enrollment Period. During Open Enrollment you may:

OpenEnrollment.jpg
  • Change from original Medicare to a Medicare Advantage Plan

  • Change from a Medicare Advantage Plan back to original Medicare

  • Switch Medicare Advantage plans

  • Join a Medicare Part D Prescription Drug Plan

  • Switch Medicare Part D Prescription Drug Plans

IMPORTANT: Review your coverage--especially Part D and Medicare Advantage Plans--every year!

Premiums, co-pays and the drugs covered can change from year-to-year, even within the same plan.  Your current plan should send you an "Annual Notice of Change" before Open Enrollment that outlines any changes for the next year.  Medicare Part D plans are sold and managed by private companies and vary greatly in terms of monthly premiums, annual deductibles, drugs covered and prescription prices.  

Insurers tweak Medicare Advantage Plans every year, and those changes could mean that you can't see your favorite doctor or that you might need to pay more. 

So--review, review, review!

Note: Low-income individuals on Medicare may be able to change their plans more frequently. A MMAP counselor can explain your options.

MMAP Counselors Are There For You--For Free!

Every state has people who will help you figure out your Medicare options. In Michigan, these people--paid staff, and volunteers--work with the Medicare/Medicaid Assistance Program. In Michigan, you can find your local MMAP program here. Nationally, the SHIP (State Health Insurance Assistance Program) can help you find assistance locally. 

MMAP Counselors can help explain how Medigap and Medicare Advantage programs work, and can help you sift through your options for Part D plans. They can help you figure out if you can defer taking Medicare because you are still working. They can help you figure out if you qualify for extra help!

Some People Qualify For Extra Help

If your income is low, you may qualify for extra help. For instance, the Medicare Savings Program may help you pay your Medicare premium, or you may qualify for Medicaid and Medicare which together will cover all your health care costs. To qualify for the Medicare Savings Program you must be low-income and not have many assets.  For married couples, your combined income must be less than $1871.75/month and you must have less than $11,340 in assets (excluding a house and car).  For single people, your income must be less than $1391.67 and you must have less than $7560 in assets.  

If you think you may qualify for Extra Help, talk to a MMAP (Medicare/Medicaid Assistance Program) counselor. 

Just MMAP It!

Washtenaw County is in a MMAP region that includes Livingston, Monroe, Macomb, St. Clair and Oakland counties. There are multiple ways to meet with MMAP counselors and MMAP and the Area Agency on Aging 1B have multiple events scheduled for Open Enrollment.  Call 1-800-803-7174 to schedule an appointment.  Call now because availability is limited!


 

 2019 Open Enrollment Washtenaw County Events - Medicare beneficiaries can make an appointment to meet one-on-one with a MMAP Counselor and review their 2019 Medicare coverage options.  Call 800-803-7174 to schedule an appointment.  Appointments are required.

Washtenaw ISD 1819 S. Wagner Rd. Ann Arbor, MI 48103

  • Tuesday, October 16 9am - 4pm,

  • Monday, November 12 9am - 4pm

  • Thursday, December 6 9am - 4pm

Milan Seniors for Healthy Living 45 Neckel Ct. Milan 48160

Call 734-508-6229 for appts

  • Thursday, October 18 9am-3pm

  • Thursday, November 15 9am - 3pm

Pittsfield Twp. Senior Center 710 W. Ellsworth Rd Ann Arbor 48108

Call 734-508-6229 for appts

  • Wednesday, October 24 9am - 2pm

  • Wednesday, November 14 9am - 2pm

Printable schedule of events for Southeastern Michigan  including Washtenaw, Livingston, Monroe, Macomb, St. Clair and Oakland.

New Medicare Cards

A quick note about Medicare cards. Medicare is no longer using your Social Security number as your Medicare number. Everyone (all 55 million people on Medicare!) will receive a new card before May 2019. You do not need to call to receive your card and no one will call you asking for your Medicare information to receive a new card. Read 10 Things to Know About Your New Medicare card.

Medicare cards will no longer include your Social Security number. Everyone should have a new cared before May 2019.   Read more.

Medicare cards will no longer include your Social Security number. Everyone should have a new cared before May 2019. Read more.

Print Friendly and PDF

Subscribe to our blog here!

Medicaid: A State By State Program

Medicaid differs state by state. The income limits for children’s Medicaid, Medicaid for low-income parents, and Medicaid for adults vary. Even some of the rules for immigrants vary. Most of the advice on our website is specific to Michigan. This blog post attempts to give you some more resources if you are located in a different state. But if the relationship between different states on Medicaid were a Facebook relationship status, it would be: “It’s Complicated.”

Find Your State—What Does Your State Offer?

Are you looking for information about your state? This map links to information about each state including eligibility, expansion, CHIP (Children’s Health Insurance Program) and enrollment. The map does not include links to enrollment sites.

State Overviews from Medicaid.gov

Covering Adults: Medicaid Expansion

The Affordable Care Act offered states the option to expand Medicaid to cover adults between the ages of 19 and 64 who are making up to 138% (133% + 5% disregard) of the Federal Poverty Levels. States voted to expand Medicaid and the federal government agreed to pay for 100% of the program from 2014 to 2016, dropping to 90% of the program after 2020. Currently 34 states including DC have expanded Medicaid, 3 states are considering expansion and 14 are not expanding. Low-income adults who previously had no healthcare could now be covered by Medicaid.

If you are from another state, find out the status of the Medicaid expansion in your state below.

Different states have given their Medicaid expansion different names. In Michigan, expanded Medicaid is called Healthy Michigan Plan. In Illinois, the program is called HealthChoice Illinois, and it is Medi-Cal in California. These plans do differ from state to state but must cover the essential health benefits set in the Affordable Care Act of 2010. Under the current administration, some states are requesting and being approved for waivers that include work requirements and other restrictions. Read more about current and pending waivers here. If you are really interested in waivers, check out the Kaiser Family Foundation’s (KFF) Waiver Tracker.

Need Help With Figuring Out Eligibility?

If you have questions about your eligibility, your child, your parent or someone else’s eligibility, call us at 734-544-3030 if you are in Michigan. If you are not in Michigan and need information about eligibility or enrolling, there are two resources.

The first is Federally Qualified Health Centers (FQHC). FQHCs are federally funded health centers that provide medical (and sometimes other) services. If you are looking for information about healthcare, an FQHC is a good place to start. Because they provide sliding fee scale services, they usually have information about Medicaid for adults, families and children, as well as patient advocates who can help you navigate the system.

FQHC Locator

The second resource for finding out about healthcare is the Marketplace’s Find Local Help (https://localhelp.healthcare.gov). This lists organizations and individuals who can help with the Marketplace and sometimes Medicaid. Choose your contacts wisely, brokers and agents are paid to sell insurance and may or may not be familiar with Medicaid programs and eligibility. Assisters are certified to enroll you on the Marketplace and should be familiar with Medicaid/CHIP eligibility in your area.

The Washtenaw Health Plan (left) is listed as an Assister; on the right, you find an Agent or Broker.

The Washtenaw Health Plan (left) is listed as an Assister; on the right, you find an Agent or Broker.

What If You Are Traveling and Need Emergency Care?

If you have Medicaid but need to go to an Emergency Room in another state, show them your Medicaid card and make sure to talk with the billing department before you leave. Most states have reciprocal agreements for emergencies for Medicaid clients—you cover mine and I’ll cover yours. Medicaid does not cover routine care in other states.

Planning A Move? Figure Out Your Health Care Options First!

If you are moving, make sure to cancel your Medicaid and apply in your new state. If you are wondering what your healthcare options are in your new state, use one of the tools above or go to this directory to find Medicaid contact information for any state.

Because different states have different rules, you may or may not be eligible for Medicaid in your new state. For instance, currently Texas has not expanded Medicaid. If your income is $1100/month (single person) in Michigan you could get Medicaid, but in Texas, you could not. Move from Texas to Michigan, and you’d be in luck.

For people who are in a state that did not expand Medicaid, if your income is below 100% of the poverty level, and especially if you are not a parent of minor children, you may need to rely on charity care programs. If you are above 100% of the poverty level, you may be able to go on the Marketplace. So when you are moving, don’t forget about the special enrollment period—it’s time-limited!

50colorfulstate.jpg
Print Friendly and PDF

Subscribe to our blog here!

Medicaid Work Requirements Signed--What Next?

Keep Calm Graphic.png

On Friday, June 22nd, Governor Snyder signed SB 897, the Medicaid work requirements bill. (Read about its details here. Read the full bill here.) We have been getting phone calls about what this means for individuals. For now, nothing has changed.

What happens next? The Michigan Department of Health and Human Services needs to submit a request for a waiver to the federal Centers for Medicare and Medicaid Services (CMS), and they need to approve the waiver, before any work requirements will be in place. In the meantime, if you are eligible for Medicaid, you should apply. (Figure out if you are income eligible here.)

Remember that Medicaid is open year-round, so a change in circumstances (losing a job or losing insurance, getting married, getting pregnant, etcetera) can mean you are now eligible when you were not before. If that is the case, please give us a call at 734-544-3030 or come into our offices at 555 Towner in Ypsilanti, Michigan, Monday-Friday from 9 a.m. to 4 p.m.

We will be helping people learn how to comply with Medicaid work requirements once they are in place, but for now, the Medicaid program is the same as it was yesterday. Keep Calm! Apply On!

Print Friendly and PDF

Subscribe to our blog here!