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Making Sense of Medicaid

Keeping yourself and loved ones healthy right now is more important than ever.

So, let’s walk through the basics of Medicaid to make sure you know all your options. That way, you can be sure you’re making decisions that fit best for you and your family.

Let’s start with the basics.

Medicaid is a federal and state program that helps with medical costs for those who have limited income or resources. It covers many of the same things that commercial plans cover, but with zero or low copays. There are 10 Medicaid health plans in Michigan, including Blue Cross Complete of Michigan. The plans offer benefits ranging from routine visits, screenings, even nursing home care. Some plans, such as those through Blue Cross Complete, also offer other services like immunizations, inpatient and outpatient hospital care, and even prescription drug coverage.

Who is eligible for Medicaid?

Eligibility for Medicaid coverage is based on a number of factors, specifically those related to income and resources. Different plans have different eligibility requirements, so let’s break them down.

Traditional Medicaid is for people of any age, with incomes under 80% of the federal poverty level (FPL). Based on 2021 federal poverty guidelines, an individual earning $12,880 or less, or a family of four earning $26,500 or less, would be eligible.

The Healthy Michigan Plan is an expansion program for those aged 19-64 with incomes between 80% and 133% of the FPL, who don’t have Medicare coverage. If you’ve lost your income, you could be covered by this program – even if you have assets.

If your family does not qualify for Medicaid, your children may still qualify for MIChild. This program provides medical coverage to uninsured and underinsured children ages 19 and under. To check eligibility, call 1-888-988-6300 (TTY: 1-888-263-5897).

What exactly do Medicaid plans cover?

They cover things like routine visits, screenings and immunizations so you can keep up with preventive care and stay healthy. Things like routine dental, vision and hearing checkups are also covered, plus the cost of transportation to medical appointments or services should you ever need them.

Specifically, Blue Cross Complete benefits include coverage for:

  • Care management and counseling
  • Childhood immunizations
  • Children’s special health care services
  • Dental care
  • Emergency services
  • Family planning
  • Hearing and speech services
  • Hospice care
  • Immunizations
  • Inpatient and outpatient hospital care
  • Maternal and infant health
  • Medical supplies
  • Mental health services
  • Non-emergency medical transportation
  • Nursing home care
  • Physical and occupational therapy
  • Preventive care for children and adults
  • Prescription drug coverage
  • Smoking cessation
  • Telemedicine
  • Vision care

When exploring options, knowing the size of your network is important. That way, you can see the doctors you know and get care you trust. For example, Blue Cross Complete coverage connects you with contracted providers that are also a part of the Blue Cross Blue Shield of Michigan network. Which means you’ll have access to care that more people in Michigan trust for their health care coverage.

Major health systems that participate in our network include:

  • Michigan Medicine – Ann Arbor
  • Sparrow Hospital – Lansing
  • Genesys – Flint
  • Detroit Medical Center – Detroit
  • Metro Health – Grand Rapids
  • Ascension – Southeast Michigan
  • Beaumont Health System – Oakland County
  • Trinity Health – Southeast Michigan

Ready to get started?

The first step is to find out if you, your partner and/or your children are eligible to receive Medicaid. Visit mibridges.michigan.gov to complete an application online. Then your results will be sent back to you from the Michigan Department of Health and Human Services.

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