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Issue Alert - Revised Limits and Allowances

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Date:

Jan 07, 2008

Program Area:

Medicaid, Adult Medical Program, AdCare, Healthy Kids, MIChild and Plan First!

Issue Summary:

Limits and allowances for various programs have been changed for 2008

Persons Affected:

Applicants and recipients of the above-referenced programs.

For More Information:

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

Michigan Poverty Law Program
611 Church Street, Suite 4A
Ann Arbor, MI 48104-3000
Phone: (734) 998-6100
Fax: (734) 998-9125


Background

The Adult Medical Program (AMP) and a few of the Medicaid eligibility categories, including the Medicare Savings Programs (QMB, SLMB, and ALMB), have income limits that are based on the Federal Poverty Levels, which are updated every year.
The full coverage Medicaid categories with income limits based on the federal poverty levels are: Healthy Kids Medicaid for children (age 19 or younger) and pregnant women, ADCare Medicaid for persons who are elderly (65 or older) or disabled and Freedom to Work Medicaid for working persons who are disabled.

Medicare Savings Program recipients are automatically entitled to Low Income Subsidies for Medicare Part D. In addition, the QMB program provides Medicaid payment for Medicare premiums and protects recipients from having to pay Medicare co-payments and deductibles for services covered under Part A and Part B, but does not provide coverage for services that are not covered by Medicare, such as dental or vision services. The SLMB and ALMB Medicare Savings Programs provide Medicaid payment of Medicare Part B premiums, but do not provide help with co-payments and deductibles.

The Plan First! Family Planning Program is a health coverage program operated by the Department of Community Health (DCH). Plan First! will enable DCH to provide family planning services to women who otherwise
would not have full medical coverage for these services. It is targeted at non-pregnant women who are:
•19-44 years of age, and
•Not currently covered by Medicaid, including
Adult Medical Program (AMP), and
•Have family income at or below 185% of the
and
•Residents of Michigan, meet residency requirements,
•Meet Medicaid citizenship requirements.

What's Happening?

In Program Policy Bulletin 2008-001 (PPB 2008-001), DHS has issued the final income limits for the Adult Medical Program, the Medicare Savings Programs, and the other full coverage Medicaid categories that are based on the federal poverty levels. DHS's Program Policy Bulletins and Manuals are available online at http://www.mfia.state.mi.us/olmweb/ex/htm or by using the "Quick Link" at www.mplp.org. The revised income limits are contained in the Program Reference Tables.

What Should Advocates Do?

Be alert for individuals who may be terminated, denied, or assigned a high deductible for Medicaid during February or March 2007, and encourage them to seek legal advice if it appears their income is near the income limit.

What Should Clients Do?

Seek legal advice if you were denied or terminated from Medicaid in February or March and you think that your income was close to the income limit.

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.