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Issue Alert - 04-04-02

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Apr 01, 2004

Issue Summary:

Medicaid coverage continues until age 22 for clients who are inpatients of an Institution for Mental Diseases on the date s/he turns 21.

Persons Affected:

Medicaid recipients who are inpatients of an Institution for Mental Diseases

For More Information:

Center for Civil Justice320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441 (989) 755-3558 FaxE-mail:


Medicaid - PEM 265

What's Happening?

A person between the ages of 21 and 65 who is a resident of an Institution for Mental Diseases (IMD) is not eligible for MA. Ineligibility applies when an eligibility determination is made, either at the time of application or during any periodic review of eligibility. If the person is an inpatient of an IMD when he turns age 21, he is eligible to continue as an inpatient until age 22. However, if the individual is discharged at some time following his 21st birthday, coverage is terminated on the discharge date.

What Should Advocates Do?

Advocates who advise clients regarding this change in eligibility should note the change and advise clients accordingly.

What Should Clients Do?

Seek legal advice if you recive a notice that your Medicaid is being terminated. If you request a hearing within 11 days of the date on the notice, your Medicaid will continue pending the outcome of your hearing. FIA must receive an original, signed hearing request within the 11 day period.

Finding Help

Most legal aid and legal services office handle these type of cases, and they do not charge a fee. You can locate the "free" legal services or legal aid office that serves your county on the Michigan LawHelp web site ( or look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.