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Issue Alert - 06-05-01

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Date:

May 02, 2006

Program Area:

Adult Medical Program (AMP) -- also known as Adult Benefits Waiver (ABW) or County Health Plan A

Issue Summary:

Enrollment in the AMP/ABW/Plan A will be open from June 1 to June 30, 2006.

Persons Affected:

Uninsured individuals (or those with County Plan B coverage) with income below 35% of the federal poverty level and cash assets of less than $3,000.

For More Information:

Center for Civil Justice
320 S. Washington, 2nd Floor
Saginaw, MI 48607
(989) 755-3120, (800)724-7441
Fax: (989) 755-3558
E-mail: info@ccj-mi.org


Background

The Adult Medical Program (AMP) provides health coverage to uninsured individuals who are unable to qualify for Medicaid and who have monthly income below 35% of the federal poverty level ($284 for an individual, $413 for a couple) and cash assets (bank accounts, securities, cash) totaling less than $3,000. When evaluating income eligibility for AMP, the Department of Human Services (DHS) considers gross income, but excludes the first $200 plus 20% of the remainder of any earned income.

AMP is also known as the Adult Benefits Waiver (ABW) program, because it is partially funded with federal SCHIP (State Children’s Health Insurance Program) funds under a waiver granted by the federal government.

Although DHS determines eligibility for AMP/ABW, the health coverage for eligible recipients is provided either by the Department of Community Health (DCH) or, in some counties, by the County Health Plan. When the AMP/ABW coverage is provided by the county, it usually is known as County Health Plan A.

Beginning July 1, 2004, enrollment in the AMP/ABW program was frozen, except for brief periods. During the freeze, no new applications are approved (including applications by AMP/ABW recipients who fail to complete their yearly redeterminations on time).

What's Happening?

Individuals who submit applications to DHS from June 1 through June 30, 2006 may be approved for AMP/ABW, if they qualify.  

IMPORTANT NOTE: During the open enrollment period in January 2005, DHS refused to approve AMP/ABW for individuals whose applications for medical coverage were PENDING in January if the application was SUBMITTED prior to January 1, 2005. Therefore, it is important to advise clients who have an application for medical coverage pending at DHS that they should submit a new application -- or meet with their DHS caseworker to update and re-sign their pending application during June, 2006.

DHS must RECEIVE the application on or after June 1 and on or before June 30 in order for the individual to be considered for AMP eligibility. Applications received prior to June 1 or after June 30 will be denied AMP based on the freeze.

Applicants should complete the full application form by June 30, 2006.  They  can also:
(1) submit an 1171F "Filing Document" to protect the application date, or
(2) submit the application with just the applicant's name, address, birth date and signature.  

The Filing Document is available at DHS or online at http://www.michigan.gov/dhs.

(Click on "Doing Business with FIA" and "Forms & Applications").

A flyer for sharing with clients is linked here.  You can also access a Spanish version of the flyer here.

What Should Advocates Do?

Get the word out about the open enrollment period. Use the flyer linked in the previous section.

Share this information with other agencies or organizations that work with very low income, uninsured, childless adults -- including persons with disabilities who may not meet the stringent standard for disability-based Medicaid, persons who are homeless, domestic violence survivors, etc.

Get the word out to local medical providers, including free clinics and federally qualified health centers.

Share this information with attorneys who represent Social Security and SSI disability applicants, to assist those who need medical coverage but may be unable to establish Medicaid eligibility while their RSDI/SSI case is pending.

What Should Clients Do?

If you are uninsured or have County Plan B coverage should submit an application to DHS during June 2006. Check the box for "medical assistance."

If you already have applied for medical assistance or Medicaid, you must RE-APPLY if your application was submitted before June 1, 2006. You can re-apply by meeting with your caseworker to update and re-sign you pending application if it has not been approved or denied yet. It must be re-signed in June 2006.

If you cannot complete the full application form by June 30, 2006, you can
(1) submit an 1171F "Filing Document" to protect your application date, or
(2) submit the application with just your name, address, birth date and signature.

DHS must help you fill out the application if you ask them for help. The Filing Document is available at DHS or online at http://www.michigan.gov/dhs (Click on "Doing Business with FIA" and "Forms & Applications").

Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.

You can locate various sources of legal and related services, including the free legal aid office that serves your county, at MichiganLegalAid.org.

You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.