Michigan Medicaid Requirements: What You Need to Know

Health coverage can feel out of reach when money is tight, and that is exactly where Medicaid steps in. At Bassett Murray Law Group, PLLC, we have more than 30 years helping Michigan families with elder law, estate planning, probate, and Medicaid planning. Our team values long-term relationships, and we give advice that fits your life and your goals.

In this article, we walk through the basics of Michigan Medicaid eligibility. Our aim is to keep the rules clear, highlight common pitfalls, and help you spot next steps that make sense to you.

Eligibility Requirements for Michigan Medicaid

Medicaid covers a wide range of people in Michigan. Your eligibility turns on age, household size, income, assets, disability status, and the program you apply for. The rules differ by group, so it helps to pin down which track fits your situation.

Two broad paths are used in Michigan. Traditional Medicaid, which we will call TM, often includes asset limits. The Healthy Michigan Plan, or HMP, is income-based for adults and does not use an asset test.

General Eligibility Criteria

To start, you generally need to live in Michigan and be a U.S. citizen or a qualified immigrant. You also need to give your Social Security number, or work with the Michigan Department of Health and Human Services, MDHHS, to get one. Be ready to report accurate details about your income, assets, and household members.

Some applicants also file proof of pregnancy, disability, or caring for a minor child. The form of proof varies by program. If something is missing, MDHHS will usually send a notice asking for the item with a deadline.

With the basics in place, the next question is money. Medicaid looks at both what you earn and what you own, though the rules change by program.

Income and Asset Limits

Both TM and HMP have income limits, and the dollar amount shifts by household size and program. TM usually has asset limits, while HMP does not use an asset test for eligibility. MDHHS counts most sources of income unless a rule excludes them.

Income can include:

• Wages and tips from work.
• Self-employment income.
• Child support and alimony received.
• Disability benefits and Social Security.
• Unemployment benefits and some pensions.

Assets usually mean things you own and can convert to cash. The family home, one vehicle, and certain personal items can be exempt under TM rules, but that depends on the case. In general, assets include:

• Cash and money in checking or savings accounts.
• Investments such as stocks, bonds, or mutual funds.
• Retirement accounts, subject to program rules on treatment.
• Real property other than your primary residence.
• Personal property with resale value.

Different Michigan programs cover different people. Knowing which group you fall into helps you focus on the right set of rules.

Specific Medicaid Programs and Eligibility Groups

For children, Michigan offers U-19 Medicaid, MIChild under the Children’s Health Insurance Program, and Children’s Special Health Care Services, CSHCS, for qualifying medical conditions. U-19 is full-scope Medicaid for eligible children. MIChild serves families with incomes a bit higher than U-19 limits, often with a small premium.

Pregnant individuals can qualify for Medicaid based on pregnancy, and people eligible for Emergency Services Only Medicaid can get prenatal and postpartum care through the MOMS program. Coverage can extend for a period after pregnancy ends, based on current state policy. Proof of pregnancy is required.

Adults fit into several categories. Many people of ages 19 through 64 use the HMP track. Others qualify as Caretaker Relatives if they live with and care for a child, or through Aged, Blind, Disabled programs, sometimes called AD Care.

Families can also qualify under the Low Income Families program, LIF, when income is below the program limit. If a family’s earnings go up and they are on LIF, Transitional Medical Assistance, TMA, can extend coverage for a time even with higher income. This helps prevent a sudden loss of health care during a change at work.

Michigan Medicaid Programs at a Glance

Program	Typical Ages	Income Test	Asset Test	Notes
U-19 Medicaid	Under 19	Yes, based on household size	No	Full-scope coverage for eligible children
MIChild, CHIP	Under 19	Yes, above U-19 levels	No	Low-cost coverage for children
CSHCS	Children and some adults	Varies	Varies	For qualifying medical conditions
Pregnancy Medicaid	Any reproductive age	Yes	No	MOMS supports ESO cases for pregnancy care
Healthy Michigan Plan, HMP	19 to 64	Up to 133% FPL	No	Not for people enrolled in Medicare
Caretaker Relatives	Adults caring for a child	Yes	Often yes	Living with and caring for a minor child
Aged, Blind, Disabled, AD Care	65+, blind, or disabled	Yes	Yes	Includes long-term care pathways
LIF and TMA	Parents and caretakers	Yes	Often yes for LIF	TMA can extend coverage after earnings increase

 

Keep in mind that program guidelines change, and some categories have extra rules. If you are unsure which door fits, reach out for a quick review. A short call can save a lot of hassle.

The Healthy Michigan Plan: Key Details

HMP offers health care coverage to adults ages 19 through 64 who meet income rules and other criteria. This program uses Modified Adjusted Gross Income methods, like the Marketplace. HMP does not use an asset limit.

To qualify, income must be at or below 133% of the federal poverty level, FPL, with a 5% income disregard allowed in many cases. Applicants cannot be enrolled in Medicare, and they cannot be pregnant at application for HMP. If pregnancy is present, the pregnancy Medicaid track is used instead.

HMP also requires Michigan residency and citizenship or qualified immigration status. Those rules line up with general Medicaid standards. If your situation shifts, report changes right away to keep records clean.

Applying for Michigan Medicaid

The fastest way to apply is online through MI Bridges. You can also apply in person at your local MDHHS office if that works better. Before you start, pulling documents together speeds things up.

Helpful items to gather include:

• Photo ID and proof of residency, such as a lease or utility bill.
• Social Security numbers for household members applying.
• Proof of income like pay stubs, a self-employment ledger, or benefit letters.
• Information on assets for TM programs, such as bank statements or account summaries.
• Proof of pregnancy or disability, if that applies to your case.

After you submit, watch your mail and MI Bridges account for notices. MDHHS can request more information with a deadline, and late documents can slow the case. If something is missing, turn it in as soon as you can.

Maintaining Medicaid Coverage

Life changes fast. When your household size, income, assets, or address changes, tell MDHHS within 10 days of the change. This keeps your case aligned with the program rules.

Changes to report include:

• New job, raise, or a drop in work hours.
• Someone moving in or out of the home, including a birth or a custody change.
• Receiving or selling assets, such as a second car or property.
• Changes to disability status, pregnancy status, or Medicare enrollment.
• Updated contact information or a new address.

Send changes in writing and keep copies. A short cover note with the date helps. If you hand-deliver papers, ask for a stamped copy for your records.

Challenging Medicaid Decisions

If MDHHS takes an action you disagree with, you have the right to request a hearing. The notice you receive will include a deadline and where to file the hearing request. Missing the deadline can affect your rights, which is why quick action matters.

File the hearing request before the effective action date if you want coverage to continue while the dispute is pending. Keep copies of what you send and how you sent them. Many people also bring a trusted person to the hearing for support.

How Bassett Murray Law Group, PLLC, Can Assist You

Medicaid planning intersects with estate planning, disability rules, and long-term care costs. Our team at Bassett Murray Law Group, PLLC, focuses on solutions that protect health, finances, and family ties. Invested in improving lives, we listen first, then build a plan that fits your real life.

If you need help with eligibility, spend-down strategies, or appeals, reach out. We welcome your questions and will walk through options step by step. Call 734-930-9200 for our Ann Arbor office or 231-427-2292 for our Petoskey office, or connect through our Contact Us page.