Medicaid Eligibility in Michigan: 40 Ways

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1 C E N T E R F O R H E A LT H C A R E R E S E A R C H & T R A N S F O R M AT I O N Policy Papr July 2012 Mdicaid Eligibility i Michiga: 40 Ways 503 id 1 U Pla F irst! hil d k Wor aivr Childr s W N wb to dom Fr IC ds ar SW DH Extdd Car M ividuals or s r2 d Early Widow(r) TANF Rcipits C ar C d hil r Ap m Ho Fostr Car Trasiti oal p ali gs SI T rm i icar ts i Prga t Lo w -I Savi gs Prog ram i d, Bl Ag Trasitioal Mdical t ln cia p S dica l Pro gram cy up 2 (Gro S rv its Disabld Car o tw a ly g Pr Halthy Kids Ud r Ag O C hildr K s Spc y h ial H alth alt Car H Srv ics Trasitioal Mdical Assistac Plus or sf id Assistac Child ivr r Wa rbac Distu l a motio ious E w Sr Spcial Nds Adoptio Assistac Out pati Th Ctr for Halthcar Rsarch & Trasformatio (CHRT) illumiats bst practics ad opportuitis for improvig halth policy ad practic. Basd at th Uivrsity of Michiga, CHRT is a o-profit partrship btw U-M ad Blu Cross Blu Shild of Michiga to promot vidc-basd car dlivry, improv populatio halth, ad xpad accss to car. Agrmt t M dica l S rvic s (M Idividuals bld Workig Qualifid Disa OM S) Visit CHRT o th Wb at: t atm r dt B a io t v Pr cr Ca l a ic rv CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION st/c a r 2014 Udr th Patit Protctio ad Affordabl Car Act (ACA), stats hav th optio to xpad ligibility to o-ldrly citizs ad qualifid rsidt immigrats with icoms at or blow 138 prct of povrty icludig thos who ar ot prgat, disabld, udr 21, or parts of dpdt childr ad thr ar o asst tsts. To sur thr ar o gaps i covrag, th ACA also prsrvs ligibility at diffrt icom lvls for parts with dpdt childr, prgat wom, childr udr ag 19, ad thos who rciv Supplmtal Scurity Icom (SSI) or qualify as mdically dy (high mdical xpss rlativ to icom). ic s O m Udr currt fdral ruls govrig th Mdicaid program, idividual stats hav broad discrtio to xpad Mdicaid ligibility byod fdrally-madatd catgoris. I Michiga, thr ar o fwr tha 40 diffrt ways to qualify for Mdicaid or othr govrmt-supportd mdical assistac. Eligibility rquirmts vary widly amog th ligibility catgoris, ad ligibility dtrmiatios ar mad basd o a complx matrix of policis that spcify icom ad asst stadards, catgorical dfiitios, group compositios, bfit limits, ad xclusios. Asst tsts apply; that is, thr ar limits to th amout of assts a idividual may ow to b ligibl. With th xcptio of som vry limitd programs (.g. th Adult Mdical Program), childlss adults who ar ot prgat or disabld ar ot ligibl for Mdicaid covrag. S Appdix 2 for dscriptios of th 40 ligibility catgoris show abov. cip D R Agd or ) 2) roup iv (G t la R Mat ri ty IV Titl Em r g d abl or ildr ldr Chi Dis d or lt M pp /Su Disabld Adult Ch Wom (Grou p 2) d abl Dis cial Sp akr Cart ly Adu W ido w( r) a tio co m F am i Udr Ag 21 (Group 2) ip c IR SS Md CO BR A Othr Ha lthy Kids TODAY Mdicaid Eligibility i Michiga: 40 Ways July

2 Itroductio Udr currt fdral ruls, th Mdicaid program provids covrag to thos at or blow a crtai icom lvl who also fit withi crtai catgoris. Ths catgoris ar dfid by charactristics of idividuals or familis othr tha icom lvl, for xampl ag, prgacy, blidss, or disability. Udr currt fdral law, lss tha half of thos who ar at or blow th fdral povrty lvl ar covrd by Mdicaid. Th atioal avrag is 43 prct; i Michiga, 47 prct of thos i povrty ar covrd by Mdicaid. Currt fdral ruls dfi th followig ligibility catgoris for all stats: Childr udr ag six with family icoms udr 133 prct of th fdral povrty lvl (FPL) Childr btw ags 6 ad 18 with family icoms udr 100 prct of th FPL Prgat wom with icoms udr 133 prct of th FPL Parts with icoms blow thir stat s July 1996 wlfar ligibility lvls (which wr oft blow 50 prct of th FPL) Thos who rciv SSI (primarily th agd, disabld, ad blid with icoms up to 75 prct of th FPL) 1 Th fdral ruls also giv idividual stats broad discrtio to xpad Mdicaid ligibility byod th fdrallymadatd catgoris. I Michiga, thr ar o fwr tha 40 diffrt ways (i.., ligibility catgoris or programs 2 ) to qualify for Mdicaid or othr govrmt-supportd mdical assistac. This pictur will chag dramatically i 2014 udr th Patit Protctio ad Affordabl Car Act (ACA). Th ACA givs stats th optio to xtd Mdicaid ligibility to all o-ldrly citizs ad ligibl rsidt immigrats with icoms at or blow 138 prct of th fdral povrty lvl 2, rgardlss of catgorical ligibility. This papr is itdd to provid th public ad policy makrs with isight ito th procsss bhid Mdicaid i Michiga ad th challgs facd by vryo ivolvd: thos who apply for covrag, thos who hlp popl qualify for bfits, ad thos who sk to stramli ligibility or xpad accss to car. It is itdd to show th diffrc btw Mdicaid ligibility i Michiga as w kow it today ad i th futur wh th ACA is implmtd i Mdicaid i Michiga Today I Michiga, thr ar o fwr tha 40 diffrt ways (i.., ligibility catgoris or programs) to qualify for Mdicaid or othr govrmt-supportd mdical assistac. Eligibility rquirmts vary widly amog th ligibility catgoris, ad ligibility dtrmiatios ar mad basd o a complx matrix of policis that spcify icom ad asst stadards, catgorical dfiitios, group compositios, ad xclusios. Th followig dscriptios ar itdd to provid a basic udrstadig of th fudamtal critria ad stadards mbodid i Michiga s mdical assistac policis. Eligibility Catgoris i Michiga Currt policy for govrmt-fudd mdical assistac i Michiga dfis two major sts of ligibility catgoris, o rlatig to th Tmporary Assistac for Ndy Familis program (TANF; also kow i Michiga as th Family Idpdc Program, or FIP), ad th othr rlatig to th Social Scurity Icom (SSI) program 3. TANF/FIP-Rlatd Eligibility Thr ar 23 ways for popl i Michiga to qualify for Mdicaid udr TANF/FIP policy. Grally spakig, thos ligibl for Mdicaid udr TANF/FIP policy ar childr, fostr childr, low-icom familis, prgat wom, thos carig for dpdt childr, ad childlss adults who mt th ligibility rquirmts of th Adult Mdical Program (Adult Bfits Waivr). 1 Mdicaid: A Primr. Ky Iformatio of Our Natio s Halth Covrag Program for Low-Icom Popl. Th Kaisr Commissio o Mdicaid ad th Uisurd. Ju Udr th law, th first 5 prct of icom is ot coutd. Th practical ffct of this icom disrgard is to mak th ligibility thrshold 138 prct of povrty. 3 Michiga is a 1634(a) stat, which mas that th stat cotracts with th Social Scurity Admiistratio to dtrmi ligibility for Mdicaid as it dtrmis ligibility for SSI bfits. For this raso, all idividuals i th Michiga who rciv SSI bfits automatically qualify for Mdicaid. CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

3 SSI-Rlatd Eligibility Thr ar 16 ways for popl i Michiga to qualify for Mdicaid udr SSI policy. Grally spakig, thos ligibl udr SSIrlatd catgoris iclud th agd (65 ad oldr), thos who ar blid or disabld, childr with disabilitis or srious mdical coditios, ad Mdicar rcipits who mt icom stadards (for hlp with mdical costs ot covrd by Mdicar). No-TANF/SSI Eligibility O fial ligibility catgory applis oly to lgal immigrats. Bcaus th Prsoal Rsposibility ad Work Opportuity Rcociliatio Act of 1996 prohibitd most lgal immigrats from rcivig Mdicaid (with th xcptio of mrgcy tratmt) durig thir first fiv yars of rsidc i th U.S., Michiga offrs o-mdicaid mrgcy-oly covrag for idividuals who ar iligibl for Mdicaid du to immigratio status. Icom Stadards i Michiga Icom stadards for Mdicaid ligibility vary by catgory, ad Michiga policy dfis two typs of icom stadards, kow as Group 1 ad Group 2. I Group 1 catgoris, t icom must b at or blow a crtai limit. Th icom limit, which varis by catgory, is th amout dd to mt o-mdical ds, such as food ad shltr. Mdical xpss ar ot dductd from icom wh dtrmiig ligibility. I Group 2 catgoris, mdical xpss ar cosidrd wh dtrmiig ligibility, thrfor ligibility is possibl v wh th applicat s icom xcds th icom limit. Idividuals ar dmd ligibl for Group 2 Mdicaid basd o thir status as mdically dy that is, thy hav high halthcar-rlatd xpss rlativ to thir icoms. Erolls rmai ligibl by mtig a assigd dductibl for mdical xpss ach moth (formrly kow as a spd dow ). Chags Comig i th Affordabl Car Act Th Patit Protctio ad Affordabl Car Act (ACA) givs stats th optio to xtd Mdicaid ligibility to all oldrly citizs ad ligibl rsidt immigrats with icoms at or blow 138 prct of th fdral povrty lvl, bgiig i This is oft rfrrd to as th Mdicaid xpasio. Stats that accpt this optio will rciv a 100 prct fdral match for this wly ligibl populatio for th first thr yars. This fdral matchig rat will th phas dow to 90 prct i 2020, whr it will rmai. Th ACA simplifis Mdicaid ligibility with a w icom dfiitio for most populatios, kow as modifid adjustd gross icom (MAGI). MAGI is a stadardizd mthod for dtrmiig icom basd largly o a icom tax dfiitio ad limiats assts tst, alog with spcial dductios ad disrgards. Stats ar rquird to covrt arly all thir xistig Mdicaid icom stadards to MAGI-quivalt stadards to simplify rollmt procsss. O March 16, 2012, th Ctrs for Mdicar ad Mdicaid Srvics (CMS) rlasd fial ad itrim fial ruls for stats o how to implmt th Mdicaid ligibility ad rollmt chags madatd i th ACA. As of Jauary 1, 2014, ths ruls: Establish a w Mdicaid ligibility catgory for oldrly idividuals with icoms up to 138 prct of povrty (icludig th 5 prct icom disrgard), who ar ot othrwis ligibl for Mdicaid basd o th fdral madat. Spcifically, this group will iclud adults (ags 19 to 64) who mt th icom stadard ad ar ot prgat, ot titld to Mdicar, ad ot ligibl for Mdicaid udr a madatd catgorical group. HHS spcifid that this w adult group will also iclud idividuals currtly ligibl for Mdicaid udr a optioal covrag group, such as idividuals with disabilitis. Simplify ad cosolidat all xistig ligibility catgoris madatd or optioal ito th followig thr (with som diffrcs i icom stadards): 1. Parts ad othr cartakr rlativs of dpdt childr udr Prgat wom 3. Ifats ad childr udr ag 19 Prsrv som xistig mthods for dtrmiig Mdicaid covrag: spcifically, for thos who rciv Supplmtal Scurity Icom (SSI) or qualify as mdically dy (high mdical xpss rlativ to icom). Assumig th ACA is implmtd as plad, Michiga could hav approximatly 600,000 w Mdicaid rolls by prct of whom wr prviously uisurd. 5 As ligibility critria ar stramlid ad rollmt procsss ar simplifid, may of th uisurd spcially thos livig i povrty today will bfit from this w approach to Mdicaid. 4 Udr th law, th first 5 prct of icom is ot coutd. Th practical ffct of this icom disrgard is to mak th ligibility thrshold 138 prct of povrty. 5 Mdicaid Covrag ad Spdig i Halth Rform: Natioal ad Stat-By-Stat Rsults for Adults at or Blow 133% FPL. Urba Istitut for th Kaisr Commissio o Mdicaid ad th Uisurd. May CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

4 Appdix 1: Commoly Usd Acroyms ad Trms Dductibl (formrly kow as spd-dow ): Currtly, all of Michiga s mdical assistac programs hav icom tsts, ad som hav asst tsts. For som programs, applicats with icom ovr th limit may still b abl to obtai halth car bfits wh thir mdical xpss mt or xcd thir dductibl, or spd-dow, amout. FIP: Family Idpdc Program, Michiga s tmporary cash assistac program for dy familis. S also TANF. FPL: Fdral povrty lvl, also kow as th fdral povrty guidli, is a admiistrativ masur usd to dtrmi fiacial ligibility for crtai fdral programs (th fdral povrty thrshold, i cotrast, is usd to dtrmi th umbr of popl i povrty). I 2012, th icom lvl for a sigl prso at 138 prct of th FPL was $15,415, ad th icom lvl for a family of four at 138 prct of th FPL was $31,809. Groups 1 ad 2: I Michiga, th trms Group 1 ad Group 2 grally rlat to fiacial ligibility factors. For Group 1, t icom (coutabl icom mius allowabl icom dductios) must b at or blow a crtai icom limit for ligibility to xist. Mdical xpss ar ot usd wh dtrmiig ligibility for Group 1 Mdicaid. For Group 2, mdical xpss ar cosidrd wh dtrmiig ligibility; thrfor ligibility is possibl v wh th applicat s icom xcds th icom limit. Idividuals ar dmd ligibl for Group 2 Mdicaid basd o thir status as mdically dy that is, thy hav high halthcar-rlatd xpss rlativ to thir icoms. MA: Mdical assistac, a trm oft usd itrchagably with Mdicaid i Michiga ad othr stats. It ca also rfr to o-mdicaid sourcs of mdical assistac. RSDI: Rtirmt, Survivors, ad Disability Isurac (RSDI), a bfit program of th Social Scurity Admiistratio that pays rtirmt, survivor, ad disability bfits to workrs, thir dpdts, ad survivors. Spd-dow (ow calld dductibl ): Currtly, all of Michiga s mdical assistac programs hav icom tsts, ad som hav asst tsts. For som programs, applicats with icom ovr th limit may still b abl to obtai halth car bfits wh thir mdical xpss mt or xcd thir dductibl, or spd-dow, amout. SSI: Supplmtal Scurity Icom, a bfit program of th Social Scurity Admiistratio program that pays bfits to disabld adults ad childr with limitd icom ad rsourcs, ad popl 65 ad oldr without disabilitis who mt fiacial limits. TANF: Th Tmporary Assistac for Ndy Familis program (TANF), a fdral/stat cash assistac program. Th fdral govrmt sts th basic ruls, but stats hav flxibility i th admiistratio of th program, icludig bfit lvls ad icom ligibility. Michiga s TANF program is calld th Family Idpdc Program (FIP). CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

5 Appdix 2: 40 Ways to Govrmt-Supportd Mdical Assistac i Michiga Idividuals : Provids Mdicaid ligibility to formr rcipits of Supplmtal Scurity Icom (SSI) who rciv Rtirmt, Survivors, ad Disability Isurac (RSDI) bfits ad would b ligibl for SSI if RSDI cost-of-livig icrass paid sic SSI ligibility dd wr xcludd. 2. Adult Mdical Program: Provids Mdicaid ligibility to vry low icom (up to 35 prct of th fdral povrty lvl), childlss adults btw th ags of 18 ad 62 who hav o othr comprhsiv halth car covrag. Th program is fudd through th Childr s Halth Isurac Program (CHIP). Also kow as th Adult Bfits Waivr. 3. Agd, Blid, or Disabld (Group 2): Provids Mdicaid ligibility to idividuals who ar agd (i.., 65 or oldr), blid, or disabld with icom ovr th icom limit ad mdical xpss that mt or xcd assigd dductibls. 4. Agd or Disabld Car: Provids Mdicaid ligibility to agd or disabld idividuals who ar at or blow 100 prct of th fdral povrty lvl but ot ligibl for Mdicaid udr ay of th followig: Spcial Disabld Childr, 503 Idividuals, COBRA Widow(r)s, Early Widow(r)s, or Disabld Adult Childr. 5. Appalig SSI Trmiatio: Provids Mdicaid ligibility to idividuals who ar ot rcivig Supplmtal Scurity Icom (SSI) bcaus th Social Scurity Admiistratio has dtrmid thy ar o logr disabld or blid, but ar appalig th trmiatio of SSI. Mdicaid cotius util th idividual xhausts appal rights, fails to fil a appal withi th tim limit, or o logr rsids i Michiga. 6. Brast/Crvical Cacr Prvtio ad Tratmt Program: Provids Mdicaid ligibility to wom who hav b scrd or diagosd for brast or crvical cacr or a prcacrous coditio who hav icoms up to 250 prct of th fdral povrty lvl ad o othr comprhsiv mdical covrag. Although commoly rfrrd to as a scrig program, this program provids complt Mdicaid covrag for thos diagosd with ths cacrs durig th tratmt priod (btw th ags of 18 ad 64 for crvical cacr btw 40 ad 64 for brast cacr tratmt). 7. Cartakr Rlativ (Group 2): Provids Mdicaid ligibility to parts ad othr cartakr rlativs of a dpdt child. 8. Udr 21: Provids Mdicaid ligibility for popl ags 19 or 20 who ar ot othrwis ligibl for covrag through Halthy Kids, Low-Icom Family mdical assistac, or ay othr Group 1-typ mdical assistac. 9. Childr s Waivr: Provids Mdicaid ligibility to umarrid ad disabld childr who do ot rciv Supplmtal Scurity Icom (SSI) ad rquir car i itrmdiat car facilitis for prsos with mtal rtardatio but could b card for at hom at a lowr cost. Th child s icom ad assts (ot th part s) ar th oly fiacial factors cosidrd for ligibility dtrmiatio. 10. Childr with Srious Emotioal Disturbac (SED) Waivr: Provids Mdicaid ligibility to umarrid childr who do ot rciv Supplmtal Scurity Icom (SSI) ad rquir car i th stat psychiatric hospital (Hawthor Ctr) but could b card for i th commuity at a lowr cost. Th child s icom ad assts (ot th parts ) ar th oly fiacial factors cosidrd for ligibility dtrmiatio. Th SED Waivr is oly availabl for th followig Michiga coutis: Clar, Gladwi, Grad Travrs, Igham, Isablla, Kalamazoo, Llaau, Livigsto, Macomb, Mcosta, Midlad, Oscola, Sagiaw, ad Va Bur. 11. Childr s Spcial Halth Car Srvics: Provids Mdicaid ligibility to childr up to ag 20 with a qualifyig mdical coditio (or idividuals 21 ad oldr with cystic fibrosis or crtai hrditary blood coagulatio disordrs). Fudd through Titl V of th Social Scurity Act. 12. COBRA Widow(r): Provids Mdicaid ligibility to idividuals (agd, blid, or disabld) titld to ad rcivig Rtirmt, Survivors, ad Disability Isurac (RSDI) bfits for disabld widow(r)s, but ot ligibl for Supplmtal Scurity Icom (SSI) du to cost-of-livig icrass i RSDI. 13. Dpartmt Wards: Provids Mdicaid ligibility to childr who ar wards of th Michiga Dpartmt of Huma Srvics (i.. childr who hav b committd to or placd with th dpartmt by court ordr ad do ot liv with thir part/s). 14. Disabld Adult Childr: Provids Mdicaid ligibility to idividuals ag 18 ad oldr rcivig disabld adult childr s Rtirmt, Survivors, ad Disability Isurac (RSDI) bfits, whos Supplmtal Scurity Icom (SSI) bfits hav b trmiatd du to thir RSDI icom. CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

6 15. Early Widow(r): Provids Mdicaid ligibility to idividuals ag 50 through 64 who ar ot titld to Mdicar Part A ad who rciv Rtirmt, Survivors, ad Disability Isurac (RSDI) bfits for arly widow(r)s, but ar ot ligibl for SSI du to thir RSDI icom. 16. Emrgcy Srvics Oly (ESO): Provids ligibility for limitd covrag (labor ad dlivry mdical srvics, ad thos srvics cssary to trat mrgcy coditios) to all mdical assistac classificatios whr th idividual is iligibl du to immigratio status; i.. has b a rsidt of th U.S. for fwr tha fiv yars. Th Prsoal Rsposibility ad Work Opportuity Rcociliatio Act of 1996 prohibitd most lgal immigrats from rcivig Mdicaid durig thir first fiv yars of rsidig i th U.S., with th xcptio of mrgcy tratmt. 17. Extdd-Car: Provids Mdicaid ligibility to agd, blid, or disabld idividuals wh thy ar i log-trm car or hospital car, but ot ligibl for mdical assistac udr ay of th followig classificatios: Spcial Disabld Childr; 503 Idividuals; COBRA Widow(r)s; Early Widow(r)s; Disabld Adult Childr; or Agd or Disabld Car. 18. Fostr Car Trasitioal Mdicaid: Provids Mdicaid ligibility to childr udr ag 21 who ar trasitioig out of fostr car, rgardlss of chags i fiacial or o-fiacial ligibility. Eligibility is automatic basd o idividual s status udr th Titl IV-E fostr car program. 19. Frdom to Work: Provids Mdicaid ligibility to disabld idividuals ags 16 through 64 who hav ard icom (i.. workig idividuals). 20. Halthy Kids for Prgat Wom: Provids Mdicaid ligibility to prgat wom up to 185 prct of povrty whil thy ar prgat (icludig th moth th prgacy ds) ad th two caldar moths followig th moth th prgacy dd, rgardlss of th raso for th d of prgacy. 21. Halthy Kids Udr Ag O: Provids Mdicaid ligibility for childr udr ag o whos family s t icom is at or blow 185 prct of povrty. 22. Hom Car Childr: Provids Mdicaid ligibility to umarrid ad disabld childr who do ot rciv Supplmtal Scurity Icom (SSI) but rquir istitutioal car (i.. hospital, skilld ursig facility or itrmdiat car facility), ad could b card for at hom at a lowr cost. Th child s icom ad assts (ot th parts ) ar th oly fiacial factors cosidrd for ligibility dtrmiatio. 23. Low-Icom Family: Provids Mdicaid ligibility to familis (with childr) who ar ot rcivig or ligibl for th Tmporary Assistac for Ndy Familis (TANF) program (kow i Michiga as th Family Idpdc Program, or FIP). To qualify for covrag udr Low-Icom Family, icom must b vry low, about 37.5 prct of th 2006 fdral povrty lvl. 24. Matrity Outpatit Mdical Srvics (MOMS): Provids ligibility for outpatit pratal-covrag-oly to prgat wom durig prgacy ad two moths aftr th prgacy ds. Ths srvics ar availabl to prgat wom ad ts with a pdig Mdicaid applicatio, ad o-citizs who ar ligibl for Emrgcy Srvics Oly Mdicaid. Prgat wom ar ligibl for this program at or blow 185 prct of th fdral povrty lvl. 25. Mdicar Savigs Program: Allows Mdicaid to pay crtai Mdicar costs for a ligibl idividual titld to Mdicar Part A. Eligibl idividuals may rciv bfits udr th Mdicar Savigs Program i additio to rgular Mdicaid bfits. Th Mdicar Savigs Program icluds thr catgoris, ad idividuals must mt crtai icom lvls ad asst limits to qualify: a. Qualifid Mdicar Bficiaris: QMB is a full-covrag Mdicar assistac program which Mdicaid pays Mdicar prmiums (both Part A ad Part B), coisuracs, ad dductibls. I ordr to b ligibl for QMB, a idividual s t icom caot xcd 100 prct of povrty. b. Spcifid Low-Icom Mdicar Bficiaris: Th SLMB bfit provids limitd Mdicar cost covrag ad pays Mdicar Part B prmiums. I ordr to qualify for this bfit, a idividuals t icom must b ovr 100 prct of povrty but ot ovr 120 prct of povrty. c. Q1 Additioal Low-Icom Mdicar Bficiaris (ALMB, or Q1): Pays Mdicar Part B prmiums if Mdicaid fudig is availabl. A idividual s t icom must b gratr tha 120 prct of povrty, but at or blow 135 prct of povrty to qualify for this bfit. 26. MIChild: Provids ligibility for halth covrag to childr who ar ot ligibl for Mdicaid ad hav o othr form of halth covrag. Childr must b udr th ag of 19 ad hav a family whos houshold icom is at or blow 200 prct of povrty for MIChild ligibility. Fudd through th Childr s Halth Isurac Program (CHIP). CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

7 27. Nwbors: Provids Mdicaid ligibility to wbors from birth util ag o if th mothr rcivs Mdicaid covrag o th wbor s dat of birth (ad if that wbor mts othr ligibility factors.g. stat rsidcy). 28. Othr Halthy Kids: Provids Mdicaid ligibility for childr udr ag 19 wh t icom dos ot xcd 150 prct of povrty. 29. Udr Ag 21 (Group 2): Provids Mdicaid ligibility for idividuals udr th ag of 21. Som i this group hav icom ovr th icom limit ad ar subjct to dductibls, which may b offst by icurrd mdical xpss that qual or xcd th xcss icom. 30. Pla First!: Provids family plaig srvics to o-prgat wom btw th ags of who ar without comprhsiv halth isurac. Oly thos with icoms at or blow 185 prct of povrty may b ligibl for Pla First! 31. Prgat Wom (Group 2): Provids Mdicaid ligibility for prgat wom who xcd th icom limit for Halthy Kids for Prgat Wom (185 prct of povrty), but icur mdical xpss qual to or xcdig th amout of thir icom ovr th limit. 32. Qualifid Disabld Workig Idividuals: Pays th Mdicar Part A prmium for thos who rciv or ar ligibl to roll i Mdicar Part A du to disability. 33. Spcial Disabld Childr: Provids Mdicaid ligibility for childr who wr paid SSI bfits o August 22, 1996, ad would still b ligibl for SSI bfits if ot for th 1996 fdral chag i th dfiitio of ligibility. 34. Spcial N/Support : Allows cotiuatio of Mdicaid for a priod of four moths for familis who ar o logr ligibl udr th Low-Icom Family Mdical Assistac catgory bcaus of icom from child support paymts. 35. Spcial Nds Adoptio Assistac Agrmt: Provids Mdicaid ligibility to childr who hav a spcial ds adoptio assistac agrmt i ffct. 36. SSI Rcipits: Provids Mdicaid ligibility to all Michiga rsidts who rciv Supplmtal Scurity Icom (SSI). 37. TANF Rcipits: Provids Mdicaid ligibility to all familis rcivig cash assistac through th Tmporary Assistac for Ndy Familis (TANF) program (kow i Michiga as th Family Idpdc Program, or FIP). 38. Titl IV-E Rcipits: Provids Mdicaid ligibility to childr wh ithr fostr car maitac paymts or adoptio assistac paymts ar big mad o thir bhalf udr Titl IV-E of th Social Scurity Act. 39. Trasitioal Mdical Assistac (Trasitioal MA): Provids Mdicaid ligibility to familis who ar o logr ligibl for Low-Icom Family mdical assistac du to icom from th mploymt of a cartakr, for up to 12 moths. 40. Trasitioal Mdical Assistac Plus (TMA Plus): Extds mdical ligibility through a prmium-paymt pla for adults i familis with mior childr who caot purchas mployr-sposord halth car aftr thir Trasitioal MA ds. To b ligibl for TMA Plus, family icom must b at or blow 185 prct of povrty. CHRT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Mdicaid Eligibility i Michiga: 40 Ways July

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