Michigan's Medicaid work rules: 5 tips for not losing health care coverage
Megan BantaLANSING – Policy experts estimate tens of thousands of Healthy Michigan Plan recipients could lose coverage once work requirements go into effect.
State officials hope a series of public forums can help as many people as possible avoid that outcome.
Jackie Prokop, who directs the department's Medicaid Program Policy Division, said the goal of the meetings is to increase awareness.
"We don’t want people to not understand what they need to do and then lose eligibility because of that," she said Monday during the first meeting in the series at Lansing Community College's west campus.
The 90-minute forum focused on explaining the requirements and exemptions and laid out tips for insurers, providers, community partners and recipients.
Here are five basic recommendations officials had for recipients:
Learn your health care plan
Most people associate their health care as coming from a company — just as Molina or UnitedHealthcare or Anthem — and might not know that they fall under the requirements, officials said during a Monday forum.
The state recommends people on Medicaid check their plan to see if they received benefits through the Healthy Michigan Plan, regardless of what company provides the state-sponsored insurance.
People can check their plan type by calling their insurance company or through the state's MI Bridges system available at newmibridges.michigan.gov. The website is mobile friendly.
Find out if you're required to report
Anyone who is between the ages of 19 and 61 enrolled in Healthy Michigan Plan will have to report work or similar activities unless they are exempt.
There are 13 exemptions covering people who:
- Are pregnant or were pregnant in the last two months.
- Are medically frail due to a condition that limits daily activities like bathing or eating or would otherwise limit someone's ability to work.
- Are the main caretaker for a family member younger than 6.
- Are full-time students
- Are younger than 21 and were in foster care in Michigan
- Were in prison or jail in the last six months
- Receive State of Michigan unemployment benefits
- Receive temporary or permanent disability payments from a private insurer or the government
- Have a medical condition that limits work, approved by a doctor
- Are caring for a dependent with a disability and has a doctor's order for full-time care
- Are caring for a person who cannot make decisions for themselves
- Have another good cause, including a serious illness, hospitalization or a disability that meets the government definition
- Receive food or cash assistance through Supplemental Nutrition Assistance Program or Temporary Assistance for Needy Families
Michigan officials have identified more than 270,000 Healthy Michigan Plan recipients who may have to meet the requirements to keep qualifying for their government insurance coverage. That's around 40% of all lower-income adults who received benefits through the plan.
Prokop and Phil Kurdunowicz, an assistance administrator, recommended people keep an eye on their mail.
The department has already sent out, or is in the process of sending, letters notifying people if they:
- Will be required to report.
- Meet an exemption and don't have to report.
- Don't have to report because they're 62 or older.
Prokop and Kurdunowicz said there will be another set of letters going out to notify people of whether they will have to report and give another opportunity to apply for an exemption.
Others might receive a different letter informing them they don't have to report because the state has found them to be already in compliance.
"We may be able to figure out in the system they're already meeting it (the requirement)," Prokop said.
If necessary, report an exemption
Anyone who received a letter because of exempt status or age already is excluded from the requirements.
People who think they meet one of the exemptions and didn't receive a letter can fill out an exemption form.
These forms are available on the DHHS website and should have been mailed to the 270,000 recipients the state has identified as people who will have to meet the requirements.
Forms must be mailed or faxed to DHHS by Jan. 31, 2020.
The mailing address is: MDHHS Special Processing Office, Suite 1405, PO Box 30800, Lansing, MI, 48909. The fax number is 517-432-6079.
After Feb. 1, people can apply for an exemption at michigan.gov/mibridges, over the phone by calling 1-833-895-4355 or at a local MDHHS office.
Start documenting now
Kurdunowicz recommended that people start gathering documentation and tracking hours now.
He stressed people do not need an employer, college or university or any other institution to provide verification when they report hours.
Each person will simply tell DHHS that they made at least $772 in a month or that they did 80 hours of some combination of the following:
- Having a job or income
- Being a student
- Looking for a job
- Volunteering (can only be used three months each year)
- Doing job training
- Participating in a tribal employment program
- Participating in rehab for substance abuse
- Doing vocational training
- Doing an internship
But people should keep some sort of documentation in case they're selected for a compliance review, he said.
Report on time
People don't have to start reporting work activities until Feb. 1.
There also will be a grace period — people have to miss the deadline for reporting three times before they lose eligibility.
They'll also have a chance to go back and report a month they missed, which will "cure" the deadline issue, Prokop said.
But she recommended people always seek to report on time — for example, reporting work hours for September by the end of October — so they don't lose eligibility after a fourth missed deadline on accident.
"It’s very important that people do report their activities timely," she said.
They can make those reports in one of three ways:
- Online through the MI Bridges portal at michigan.gov/mibridges
- Over the phone by calling 1-833-895-4355
- In person at an MDHHS office
Contact reporter Megan Banta at (517) 377-1261 or mbanta@lsj.com. Follow her on Twitter @MeganBanta_1.
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