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What you need to know about the Medicaid Healthy Michigan Plan changes.

Co Cover ered T ed Topics

• pics
• What is the Healthy Michigan Plan?
• What are the changes to the Healthy Michigan

Plan? → Work requirements and reporting → Exemption (excused) from work requirements and claiming an exemption → Premium payments → Healthy behaviors

• Impact on Michigan and Genesee County Healthy

Michigan Plan participants

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Wha hat is the Healthy t is the Healthy Mic Michigan Plan? higan Plan?

• The Healthy Michigan Plan (Medicaid) is full health care coverage for adult

residents of Michigan ages 19 to 64 who meet income guidelines

• What does Healthy Michigan Plan cover?

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→ Doctor Visits → Preventive & Wellness Services/Screenings → Prescription Drug Coverage → Hospital & Emergency Services → Transportation to Medical Appointments → Labs & X-rays → Dental → Vision → Mental Health & Substance Abuse Treatment → Maternity Care

Wha hat t t to e

• expect

xpect w when enr hen enrolling

• lling int

into H

• Healt

ealthy hy Mic Michigan Plan higan Plan

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• PARTICIPANTS MUST OPEN ALL MAIL FROM MDHHS IMMEDIATELY!
• After enrolling, a participant will receive a “mihealth card” in the mail

Wha hat t t to e

• expect

xpect w when enr hen enrolling

• lling int

into H

• Healt

ealthy hy Mic Michigan Plan higan Plan-Continued Continued

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• Next, a participant will receive a letter from MI Enrolls asking to choose a

health plan listed:

• If participant wants to keep current doctor they must call their primary

care physician and see what health plan they accept

• Complete and return letter or call MI Enrolls at 1-888-367-6557 with

doctor and health plan choice

• If a plan and doctor are not chosen, one will be chosen automatically

Changes Changes to Healthy Mic to Healthy Michigan Plan higan Plan-Ov Over erview view

• Individuals and families age 19-62 must meet a new work

requirement, or prove they are exempt (excused) from it

• Some individuals and families will have to pay a higher

monthly fee (premium payment) that is 5% of their income and could lose coverage for non-payment

• Complete a healthy behavior

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Beginning in 2020, Healthy Michigan Plan participants must do the following in order to continue receiving coverage from the Healthy Michigan Plan.

January 2020 October 2020 October 2020

Wor

• rk

k Requir equirements ements-January 2020

• Participants must report 80 hours of work or other qualifying

activities per month

→ Documentation is not required but may be requested → Keep all documentation of your work/qualifying activities

• What counts as work or other qualifying activities?

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→ Employment, including self-employment → Job training and search activities → Vocational training → Full-time student → Unpaid work (internship) → Tribal employment program → Substance abuse/rehab treatment → Community service (up to 3 months per year

• nly)

Repor eporting W ting Wor

• rk R

k Requir equirement ements

• Participants must self-report their 80 hours of work or other qualifying activities

to the Michigan Department of Health and Human Services (MDHHS) by one of the following ways:

→MI Bridges online at www.Michigan.gov/MIBridges

▪ Must be the head of household to report online

→ By phone at 1-833-895-4355 (TTY 1-866-501-5656)

• Failure to report monthly work or other qualifying activities for three months or

more could result in Medicaid coverage being suspended for at least one month (penalty month) until the requirement is met

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Year early R y Repor eporting Sc ting Schedu hedule le

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If you completed work or other activities in: You must report work or activities to MDHHS between: January January 11* – February 28 February February 11 – March 31 March March 11 – April 30 April April 11 – May 31 May May 11 – June 30 June June 11 – July 31 July July 11 – August 31 August August 11 – September 30 September September 11 – October 31 October October 11 – November 30 November November 11 – December 31 December December 11 – January 31, 2021

*For January 2020 work and other activities, report those activities between January 25 – February 29, 2020*

Ex Exempt emptions t ions to W

• Wor
• rk R

k Requir equirement ements

• Some participants were identified by MDHHS as meeting an exemption (excused)

from work requirements

→ Letters were mailed in October 2019

• Exemption (excused) reasons include:

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→ Medical condition that limits work (approved by

doctor)

→ Caring for a dependent with a disability (has a

doctor’s order for full-time care, one claim per household)

→ Caring for a person who cannot make decisions for themselves → Good cause where the individual or a family member has:

▪ A serious illness, or ▪ Is hospitalized, or ▪ Has a disability that meets the government definition

→ Pregnant or were pregnant in the last 2 months → Medically frail (for complete list visit Michigan.gov/healthymiplan) → Main caretaker for a family member under age 6

(one parent per household)

→ Full-time student → Under the age of 21 and in Michigan foster care → In prison or jail within the last 6 months → Receiving unemployment benefits → Receiving temporary or permanent disability payments

Claim Claiming an Ex ing an Exempt emption ion

• Some participants were identified by MDHHS as meeting an exemption and are

excluded from work requirements

→ Participants were notified of their exemption via mail in October of 2019 ▪ Letter B 19-37 ▪ Letter B 19-43

• Where to claim an exemption

→ Online at www.Michigan.gov/MIBridges ▪ Must be head of household to claim exemption online → By calling the work reporting and exemption phone number at 1-833-895-4355

• Genesee Health Plan (GHP) can help assist individuals in understanding if they are

exempt and help in applying for an exemption, call GHP at 844-232-7740

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Pr Premium P emium Payments ayments

• Participants enrolled in the Healthy Michigan Plan for 4 or more years since April 1, 2014 may be required to pay a monthly premium to keep

their coverage if they have an annual income higher than the amount on the chart based on their household size:

→ Enrolled for 48 months or more

▪ Premium payment that is 5% of income ▪ Does not have to pay a copay ▪ Failure to pay will result in disenrollment until payment is made

→ Enrolled for less than 48 months

▪ Premium payment that is 2% of income ▪ Coverage/services will not be denied for failure to pay

→ Enrolled for 48 months or less and annual income is less than the amounts listed on the chart

▪ No premium payment required ▪ Responsible for any copays ▪ Coverage/services will not be denied for failure to pay

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Household Size 100% Federal Poverty Level 1 $12,490 2 $16,910 3 $21,330 4 $25,750 5 $30,170 6 $34,590 7 $39,010 8 $43,430

• Participants will receive their first bill six (6) months after enrollment and a new bill every three

(3) months after that → Payment statements and coupons will also be mailed to participant

• Payments due on the 15th of each month
• Payments can be made by:

→ Mailing payment coupon with a check or money order to MDHHS → Online at www.healthymichiganplan.org

• For questions on amounts owed, call Healthy Michigan Plan (MI Health Account) at

1-800-642-3195 (TTY 1-866-501-5656)

NO PREMIUM PAYMENT = NO COVERAGE

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Pr Premium P emium Payments ayments Cont. Cont.

Healthy Beha Healthy Behavior viors-Changes coming Oct. 2020

• Participants are required to complete one (1) healthy behavior each

year in order to keep their coverage

• Healthy behavior examples include:
• How to complete a healthy behavior

→ Participants will receive a packet in the mail with their health plan card and information: ▪ Call doctor listed on card ▪ Schedule free wellness visit, even if not sick ▪ Complete Health Risk Assessment paperwork that is also in the health plan packet and bring to doctor’s appointment

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→ Annual wellness visit with your doctor → Cancer/HIV/STI/TB Screenings → Dental check-up → Flu vaccine

Impact Impact

• Statewide: 654,249 individuals on Healthy MI Plan

→ 235,000 could be affected with new changes

• Genesee County: 38,000 individuals on Healthy MI Plan

→ 10,000 could be affected with new changes → These individuals are at risk of losing their health coverage if they do not complete requirements → Can lose health coverage if they are exempt but do not claim exemption

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Medicaid Co Medicaid Contact Inf ntact Infor

• rma

mation tion

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Michigan Enrolls Beneficiary Help Line MDHHS Genesee County Local Office Work Reporting and Exemption Line

1-888-367-6557 1-800-642-3195 1-844-464-3447 1-833-895-4355

WHEN TO CONTACT:

• Pick your Medicaid

Health Plan

• Pick your doctor
• Replace your MI Health

card

• General questions about

Medicaid benefits

• Questions about claims
• Report a complaint
• MI Health Account balance
• Report any changes
• Verification Checklist
• Questions about your

MDHHS case or paperwork

• Status of application
• Verification Checklist
• Report work
• Claim exemption

(excuse)

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What you need to know about the Medicaid Healthy Michigan Plan changes.

QUESTIONS? QUESTIONS?

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