Health Insurance

Getting Health Insurance

Medicaid

NEW Medicaid eligibility is available to residents of Flint! Anyone under the age of 21 or any pregnant woman who was served by the Flint water system and whose family income is 400 percent or less of the poverty level may be eligible for Medicaid. This includes

  • Children who live in Flint
  • Children who lived in Flint anytime from April 2014 until the present but moved out of the City or is planning to move.
  • Children who live outside of the City of Flint but went to school, daycare, or frequently visited family members who live in Flint
  • Children born to a woman served by the Flint water system from April 2014 to present.

Apply online at https://www.mibridges.michigan.gov/access/

or call 1-855-789-5610

If you already receive Medicaid, this expansion comes with new services. If you have any questions, call the Beneficiary Help Line at 1-800-642-3195.

Healthy Kids

Healthy Kids is a Medicaid health care program for low-income children under age 19 and for Pregnant Women of any age. (Healthy Kids for Pregnant Women is discussed under the Pregnant Women heading). There is only an income test. There is no monthly premium for Healthy Kids. Most children who are eligible for Healthy Kids are enrolled in a Medicaid health plan. Healthy Kids provides a comprehensive package of health care benefits including vision, dental, and mental health services. Contact the local MDHS office in your county to apply for this program or you can call 1-855-275-6424, or apply online.

MIChild

MIChild is a health care program administered by the Department of Health and Human Services. It is for the low income uninsured children of Michigan’s working families. MIChild has a higher income limit than Healthy Kids. There is only an income test. Like Healthy Kids, MIChild is for children who are under age 19. There is a $10 per family monthly premium for MIChild. The $10 monthly premium is for all of the children in one family. The child must be enrolled in a MIChild health and dental plan in order to receive services. For more information and an application, contact MIChild at 1-888-988-6300 or visit the MIChild information website.

Children’s Special Health Care Services (CSHCS)

Children’s Special Health Care Services is a program within the Michigan Department of Health and Human Services that provides certain approved medical service coverage to some children and adults with special health care needs. Children must have a qualifying medical condition and be under 21 years of age. Persons 21 and older with cystic fibrosis or certain blood coagulating disorders may also qualify for services. Click here for more information about Children’s Special Health Care Services .

Under 21

Medicaid is available to eligible persons under age 21. Beneficiaries receive a comprehensive package of health care benefits including vision, dental, and mental health services. Contact the local MDHS office in your county to apply for this program or you can call 1-855-275-6424, or apply online.

Supplemental Security Income (SSI)

SSI is a cash benefit for disabled children whose families have low income. The Social Security Administration (SSA) determines SSI eligibility. The beneficiaries are automatically eligible for Medicaid and they receive the comprehensive package of health benefits including vision, dental, and mental health services. Visit your local Social Security office for more information or apply online.

Special Disabled Children

Medicaid is available to children who received SSI benefits on August 22, 1996, provided the child meets current SSI income and resource standards and the definition of childhood disability in effect before the 1996 revised disability definition. The comprehensive health care package of Medicaid benefits is available. Contact the local MDHS office in your county to apply for this program or you can call 1-855-275-6424, or apply online.

Medicaid Waivers

If your child with special needs is uninsured, needs additional services, or needs wrap-around Medicaid coverage to help with finances and uncovered services, your child may need a Medicaid waiver. Medicaid waivers “waive” one or more Medicaid rules in order to extend eligibility and/or services to children. For children, the most common rule to be waived is the way income is calculated, meaning the waiver is based on the child’s income instead of the family’s income.

Medicaid waivers for children can be confusing. Not only that, but it is often difficult to find information about them. One project, coordinated by Complex Child Magazine, is intended to simplify the process as much as possible. Their first goal was to create a full list of current Medicaid waivers for children.

If you are new to Medicaid waivers, you may want to start with Complex Child Magazine’s About Waivers page, which explains more about the different types of Medicaid waivers and how they work.

To request more information regarding eligibility in Michigan contact your local Community Mental Health Services Program.

Employer-sponsored health insurance

Many families get their health care coverage through an employer, often called group health, employer-sponsored or private insurance. Part of the cost may be the responsibility of the employee. Employer-sponsored plans may include a choice of plan options such as an HMO or PPO and offer additional coverage such as dental and vision. Click here for more information on choosing the best type of plan for your situation.

When an employer offers health insurance to its employees, there may be conditions attached. You may have to wait before coverage takes effect for a new employee. You may have to be employed full time or work a certain number of hours per week, and you may have to pay part of the premium.

When an employee begins a job, he or she may have to decide whether or not to enroll in the employer health plan. There may be different health plans or coverage options to choose from. This can be an important decision for your family.

Here are some questions to consider:

  • How much does it cost? Does it offer coverage for family members? If there are several plans offered, you will have to choose based on your health care needs and the costs of the plans. Click here for how to compare health insurance plans before you purchase health insurance.
  • How does the coverage meet your health care needs? Begin by thinking about your family’s needs. Do you have an illness that calls for a lot of doctor visits and medications? Do you have a child with special needs who requires ongoing therapy? Does the plan require you to see specific doctors?  Are the doctors you want to see within the network?  Click here for a Health Plan Evaluation tool that may help you (also available in Spanish).
  • What are your out-of pocket costs? You  should look to see what is covered and the out-of-pocket costs. These costs include deductibles and co-payments for different covered services, and costs for prescription drugs under the plan. Costs may be higher for services rendered outside of a certain provider network as well.

High Deductible Health Plans

Choosing a plan with a high annual deductible may lower your monthly premium. Generally, if you choose a plan with a low annual deductible, your monthly premium will be higher. An HSA, or Health Savings Account, is a special type of tax-advantaged savings account designed to help you pay for out-of-pocket medical expenses when you have a high deductible health plan, or HDHP. Click here for more information on what is a Health Savings Account and how does it work?

 

Check Back Soon…More Information to Come!!