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Issue Alert - 13-3-03

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Date:

Mar 08, 2013

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 April 1, 2013 through April 30, 2013

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


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 ($335 a month  for an individual, $452 a month for a couple) and cash assets (bank or retirement 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 an applicant’s earned income.

AMP is also known as the Adult Benefits Waiver (ABW) program, because it is partially funded with federal Medicaid 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 most 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 on or after April 1, 2013 and on or before April 30, 2013 may be approved for AMP/ABW, if they qualify.  

IMPORTANT NOTE: During past open enrollment periods, DHS refused to approve AMP/ABW for individuals whose applications for medical coverage were PENDING in the open enrollment period if their applications were SUBMITTED prior to the start date of enrollment. Therefore, individuals who have an application for medical coverage pending at DHS should submit a new application -- or meet with their DHS caseworker to update and re-sign their pending application during the enrollment period between April 1 and on or before April 30, 2013.   

DHS must RECEIVE the application on or after April 1 AND on or before April 30, 2013 in order for the individual to be considered for AMP eligibility. Applications received prior to April 1 or after the enrollment period closes will be denied AMP based on the freeze.

What Should Advocates Do?

Get the word out about the open enrollment period.

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.

Make sure clients with pending Medicaid applications re-apply during the AMP open enrollment period if their eligibility for Medicaid is uncertain.

 

What Should Clients Do?

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

If you already have applied for medical assistance or Medicaid, you must RE-APPLY to be considered for AMP if your application was submitted before March 30, 2013.    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 after March 30 and before May 1, 2013.   If it is difficult for you to meet with your caseworker or to get to the DHS office, you can file a new application.

 

HOW TO APPLY – online or with a paper application

1.    Apply online at www.michigan.gov/mibridges

a.    Online applications are accepted until 7 p.m. daily

b.    Computers AND HELP are available at DHS offices

c.    You can scan and upload your documents at the computer stations

 

2.    Get paper application at DHS office

a.    Sign and date application

b.    Drop off or mail the application

 

è DHS will need proof of:  income for the last 30 days; bank and/or retirement accounts; investments; and where you live

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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