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Issue Alert - Income limits updated for 2008

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Date:

Jul 01, 2008

Program Area:

Medicaid PEM 174, 546, 630, 655

Issue Summary:

Income limits have been updated for Healthy Kids, AD-Care,Medicare Savings Program, QDWI,Freedom to Work, Adult Medical Program, RAP-Medical and Transitional Medicaid Plus (TMA-Plus) and MI-Child

Persons Affected:

Persons enrolled in or applying for the above-referenced programs

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

Michigan Poverty Law Program 611 Church Street, Suite 4A Ann Arbor, MI 48104-3000 (734) 998-6100 (734) 998-9125 Fax (734)998-6125


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.

What's Happening?

The Michigan Department of Human Services (DHS) has now issued updated income limits and allowances for some Medicaid categories and for MIChild, based on the poverty guidelines for 2008. Medicaid categories that have income limits that that are based on federal poverty levels are: Healthy Kids for Pregnant Women (185% of poverty)Healthy Kids for Children under age 1 (185% of poverty)Healthy Kids for other children (150% of poverty)ADCare (100% of poverty)QMB Medicare cost sharing (100% of poverty)SLMB Medicare cost sharing (100-120% of poverty)ALMB Medicare cost sharing (120 - 135% of poverty)(Note: Medicare cost sharing categories do not provide full Medicad coverage.) MIChild eligibility requires income below 200% of poverty. The new limits are to be used for all other recipients the next time the case is handled but not later than the next redetermination. As a result, clients may no longer be eligible for benefits and will be sent a negative action notice.
In Program Policy Bulletin 2008-007 (PPB 2008-007), DHS has issued the final income limits for these 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 and encourage them to seek legal advice if it appears their income is near 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.

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