GET GET IT IT, KEEP , KEEP IT IT, , KNO KNOW W IT IT, USE , USE IT IT What you need to know about the Medicaid Healthy Michigan Plan changes .
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Co Cover ered T ed Topics opics • 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
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT 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? → Doctor Visits → Labs & X-rays → Preventive & Wellness Services/Screenings → Dental → Prescription Drug Coverage → Vision → Hospital & Emergency Services → Mental Health & Substance Abuse Treatment → Transportation to Medical Appointments → Maternity Care
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Wha hat t t to e o expect xpect w when enr hen enrolling olling int into H o Healt ealthy hy Michigan Plan Mic higan Plan • PARTICIPANTS MUST OPEN ALL MAIL FROM MDHHS IMMEDIATELY! • After enrolling, a participant will receive a “ mihealth card” in the mail
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Wha hat t t to e o expect xpect w when enr hen enrolling olling int into H o Healt ealthy hy Michigan Plan Mic higan Plan-Continued Continued • 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
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Changes to Healthy Mic Changes to Healthy Michigan Plan higan Plan-Ov Over erview view Beginning in 2020, Healthy Michigan Plan participants must do the following in order to continue receiving coverage from the Healthy Michigan Plan. • Individuals and families age 19-62 must meet a new work January 2020 requirement , or prove they are exempt (excused) from it • Some individuals and families will have to pay a higher October 2020 monthly fee ( premium payment ) that is 5% of their income and could lose coverage for non-payment • Complete a healthy behavior October 2020
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Wor ork 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? → Unpaid work (internship) → Employment, including self-employment → Tribal employment program → Job training and search activities → Substance abuse/rehab treatment → Vocational training → Full-time student → Community service (up to 3 months per year only)
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Repor eporting W ting Wor ork 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
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Year early R y Repor eporting Sc ting Schedu hedule le 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*
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Exempt Ex emptions t ions to W o Wor ork 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: → Pregnant or were pregnant in the last 2 months → Medical condition that limits work (approved by doctor) → Medically frail (for complete list visit Michigan.gov/healthymiplan) → Caring for a dependent with a disability (has a → Main caretaker for a family member under age 6 doctor’s order for full -time care, one claim per household) (one parent per household) → Caring for a person who cannot make decisions → Full-time student for themselves → Under the age of 21 and in Michigan foster care → Good cause where the individual or a family → In prison or jail within the last 6 months member has: → Receiving unemployment benefits ▪ A serious illness, or ▪ → Receiving temporary or permanent disability Is hospitalized, or ▪ Has a disability that meets the government definition payments
GET GET IT IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Claiming an Ex Claim 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
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Premium P Pr 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 Household 100% Federal ▪ Size Poverty Level Does not have to pay a copay ▪ Failure to pay will result in disenrollment until payment is made 1 $12,490 → Enrolled for less than 48 months 2 $16,910 ▪ Premium payment that is 2% of income 3 $21,330 ▪ Coverage/services will not be denied for failure to pay 4 $25,750 → Enrolled for 48 months or less and annual income is less than 5 $30,170 the amounts listed on the chart 6 $34,590 ▪ No premium payment required 7 $39,010 ▪ Responsible for any copays ▪ Coverage/services will not be denied for failure to pay 8 $43,430
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Pr Premium P emium Payments ayments Cont. Cont. • 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 15 th 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
GET IT GET IT, , KEE KEEP P IT IT, , KNO KNOW W IT IT, , USE USE IT IT Healthy Behavior Healthy Beha 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: → Annual wellness visit with your doctor → Dental check-up → Cancer/HIV/STI/TB Screenings → Flu vaccine • 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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