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    Beneficiary Support

    Click one of the following topics:
    Health Care Programs:
    Applying for Medical Assistance:

    To Apply for Medicaid, MIChild, Healthy KidsPlan First! or other Medical Assistance Programs:

    To Apply for the CSHCS program:  Call 1-800-359-3722 (toll-free), or contact the CSHCS office in your Local Health Department for information on how to apply.

    To Apply for MOMS visit http://healthcare4mi.com or contact your Local Health Department.


     Michigan Assistance and Referral Service (MARS):
    • MARS is a pre-screening tool that allows you to find programs offered by the State of Michigan that may help families in need with assistance for medical, nutritional, food, day care, temporary cash or other expenses.

     Medicaid Questions and Answers:

    Q: What is Medicaid?   A: Medicaid is a health care program for low-income families & individuals. This includes families with children, pregnant women, and persons under the age of 21. It also offers help to persons who have a disability, and people age 65 and over.

    Q: What medical services does Medicaid cover?   A: Click here to find the services Medicaid covers (Go to page 4 under Services Michigan Medicaid Covers) 

    Q: Where can I apply for Medicaid?  A: Apply online faster through http://healthcare4mi.com or learn about other ways to apply using the Application for Health Coverage & Help Paying Costs form (DCH-1426).  You can also call your local DHS for more information. 

    Q: Do Medicaid beneficiaries have to join a Health Plan?  A: Most people who get Medicaid must join a Health Plan

    Q: When my Medicaid case is opened, who will contact me about my Health Plan choices? A: You will get a information packet in the mail from MICHIGAN ENROLLS.  It will list the Health Plan choices in your county.  It will also have instruction on how to enroll in a Health Plan and choose a Primary Care Provider (Doctor).  

    Q: How can MICHIGAN ENROLLS help me?  A: They can answer general questions you may have about Medicaid benefits.  They can tell you which doctors, pharmacies and hospitals are part of each Health Plan.  They can also enroll you by phone in the Health Plan you choose. 

    • Call MICHIGAN ENROLLS at 1-888-367-6557.

    Q. When I join a Health Plan, will they mail information to me about that plan?   A: Yes.  The Health Plan will send you a plan handbook.  They will also send you a health plan card.

    Q: Where can I find out which doctors, pharmacy, hospital, or other medical providers participate with my Medicaid Health Plan?  A: Call your Health plan.  Your Health Plan should have list of doctors, pharmacy, hospital, or other medical providers that participate with them. 

    Q: Who do I call if I need to change my Primary Care Physician (PCP) if I'm enrolled in a Medicaid Health Plan?   A: Contact your Health Plan to change your PCP.

    Q: If I am not enrolled in a Medicaid Health Plan, where can I find out which doctors, pharmacy, hospital, or other medical providers that participate straight Medicaid?  A: Contact your local Health Department.  Your health department might have a list of medical providers that participate with straight Medicaid.  Or call the medical provider.  Ask them if they participate with straight Medicaid.  And if they're taking new patients. 

    Q: Do Medicaid beneficiaries get a health ID card?   A: Yes. They will receive a permanent health ID card.  It's called the  mihealth card

    Q: If I'm enrolled in a Medicaid Health Plan, will I get the  mihealth card  A: Yes. You will get a mihealth card and a health ID card from that Health Plan.

    Q:  Who do I call to report changes when I have Medicaid (examples: my name changed, if I moved, I have other insurance or lost my other insurance, etc.)?   A: Call your DHS specialist to report changes.  Click here for DHS office phone numbers. 

    Q :  Where can I find more information on Medicaid?  A: Click here for additional information on Medicaid.


    ABW Questions and Answers:

    Q: What is the Adult Benefits Waiver (ABW) Program?  A: ABW (formerly called the State Medical Program) is a health care program for childless adults, aged 19 through 64 years old, who are uninsured.

    On April 1, 2014, the Adult Benefits Waiver, also known as Adult Medical Program or AMP, has changed to the Healthy Michigan Plan.  The department notified Adult Benefits Waiver beneficiaries of this change, with instructions on choosing a health plan (if applicable). More information about the Healthy Michigan Plan can be found at www.healthymichiganplan.org.


     CSHCS Questions and Answers:

     

    Q: What is the Children Special Health Care Services (CSHCS) program?   A: Children's Special Health Care Services (CSHCS) is a program for children and some adults with special health care needs.

    Q:  I think my child qualifies for CSHCS, how do I apply?    A: Call toll-free at 1-800-359-3722.  Or contact the CSHCS office in your local health department for information on how to apply.

    Q: Do CSHCS beneficiaries get a health ID card?   A: Yes. They will receive a permanent health ID card. It's called the  mihealth card.


     Healthy Kids  Questions and Answers:

    Q: What is the Healthy Kids program?   A: Healthy Kids is a Medicaid health care program for low-income children under age 19.  And for pregnant woman of any age.

    Q.  Who can I call to see if I qualify for Healthy Kids?  A: Call toll-free at 1-888-988-6300 to get more information that will help you find out if you qualify for Healthy Kids.

    Q. How do I apply for the Healthy Kids program?   A:  Apply online faster through http://healthcare4mi.com or learn about other ways to apply using the Application for Health Coverage & Help Paying Costs form (DCH-1426).  You can also call your local DHS for more information. 

    Q: Do Healthy Kids beneficiaries have to join a Health Plan?   A: Yes. You will get a information packet in the mail from MICHIGAN ENROLLS when your Healthy Kids case is opened.  It will list the Health Plan choices in your county.  It will also have instructions on how to enroll in a Health Plan and choose a Primary Care Provider (Doctor).  

    Q: How can MICHIGAN ENROLLS help me?  A: They can answer general questions you may have about Medicaid benefits.  They can tell you which doctors, pharmacies and hospitals are part of each Health Plan.  They can also enroll you by phone in the Health Plan you choose. 

    • Call MICHIGAN ENROLLS at 1-888-367-6557.

    Q. When I join a Health Plan, will they mail information to me about that plan?   A: Yes.  The Health Plan will send you a plan handbook.  They will also send you a health plan card. 

    Q: Where can I find out which doctors, pharmacy, hospital, or other medical providers participate with my Medicaid Health Plan?  A: Call your Health plan.  Your Health Plan should have list of doctors, pharmacy, hospital, or other medical providers that participate with them.

    Q: Who do I call if I need to change my Primary Care Physician (PCP) if I'm enrolled in a Medicaid Health Plan?   A: Contact your Health Plan to change your PCP.

    Q: Do Healthy Kids beneficiaries get a health ID card?   A: Yes. They will receive a permanent health ID card.  It's called the  mihealth card

    Q: If I'm enrolled in a Health Plan, will I get the  mihealth card? A: Yes.  You will get a  mihealth card and a health ID card from that Health Plan.

    Q:  Where can I find more information on Healthy Kids program?  A:  Click here for more information on Healthy Kids. 


     MIChild Questions and Answers:

    Q: What is the MIChild program?   A: MIChild is a health coverage program for uninsured children of Michigan's working families.  MIChild is not a Medicaid program.

    Q. Who can I call to see if I qualify for MIChild?  A: Call toll-free  1-888-988-6300  to get more information that will help you find out if you qualify for MIChild.

    Q: Where can I apply for MIChild?   A:  Apply online faster through http://healthcare4mi.com or learn about other ways to apply using the Application for Health Coverage & Help Paying Costs form (DCH-1426).  You can also call your local DHS for more information. 

    Q: Where can I find more information on MIChild?   A:  Click here for more information on MIChild. 
     
    Q: What if I am denied MIChild?   
    A: You can request a Department Review of your denial from the program.   Click here for Request for Departmental Review (DCH-0892).

    Q: What if MIChild has been approved and a service is denied?   A:  You must file a grievance with the health plan.



    Maternity Outpatient Medical Services (MOMS) Questions and Answers: 

    Q: What is the MOMS program?   A: The MOMS program provides immediate health coverage for pregnant women.  The MOMS program is available to provide immediate prenatal care while a Medicaid application is pending.

    Q: What medical services does MOMS cover?   A: It provides outpatient prenatal coverage only.

    Q: Where can I apply for MOMS?  A: Contact your Local Health Department to apply for the MOMS program.  Click here to locate your Local Health Department and WIC agency.

    Q: Where can I find more information on other Health Care programs available for pregnant women?  A:  Click here for other health care programs for pregnant women. Or  Click here for Women, Infants & Children (WIC)


     Medicare Questions and Answers:

    Q: What is Medicare?   A: Medicare is a Federal Health Insurance Program.  The  Centers for Medicare & Medicaid Services (CMS) administers this program.   CMS is a Federal agency within the  U.S. Department of Health and Human Services.

    Q: Who might be eligible for Medicare?  A: People 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant).

    Q: Where can I find more information on Medicare?  A: Click here for more information on Medicare.  


      Medicaid and CSHCS Complaints:

    You may file a complaint when you have the following problems:

    • Have problems getting medical care and/or prescriptions.
    • Denied a covered Medicaid or CSHCS benefit.
    • If you receive bills you feel Medicaid or CSHCS should have paid.
    • Have problems with your Medicaid health plan.

    You may file a complaint by doing the following:

    Michigan Department of Community
    Medical Services Administration
    PO Box 30470
    Lansing, MI 48909-7979
     

    If you have question about the Beneficiary Complaint form or this process, call the Beneficiary HelpLine at 1-800-642-3195.


    Medicaid Health Plan Complaints: 

    You may file a Health Plan complaint when you have the following problems:

    • Have problems getting medical care and/or prescriptions.
    • Denied a covered Medicaid (CSHCS) benefit.
    • If you receive bills you feel Medicaid should have paid.

    You may file a Health Plan complaint by doing the following:


    Administrative Hearing:

    If you receive a denial, reduction or termination in medical benefits,   you have the right to   request an administrative hearing using the following form:

     
    Request for Administrative Hearing
    Michigan Administrative Hearing System
    Michigan Licensing and Regulatory Affairs
    P.O. Box 30763
    Lansing, MI 48909

     
    To withdraw your request for an appeal:

    Michigan Administrative Hearing System
    Michigan Licensing and Regulatory Affairs
    P.O. Box 30763
    Lansing, MI 48909
    For more information:


    Important Phone Numbers:

    Medicaid

    • Medicaid questions and/or problems: Beneficiary Help Line 1-800-642-3195
    • mihealth card questions,  and if you need a card replacement: 1-800-642-3195
    • To enroll in a Medicaid Health Plan: MICHIGAN ENROLLS 1-888-367-6557

    CSHCS

    • If you think you or your child qualifies for CSHCS: 1-800-359-3722
    • Or call your local Health Department for information:

    Healthy Kids

    • Healthy Kids questions and to see if you qualify:  1-888-988-6300

    MIChild

    •  MIChild questions and to see if you qualify: 1-888-988-6300

    MOMS

    Department of Human Services (DHS)

    Health Department


      Need more information:



     

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