What’s changing with Medicaid in Michigan?

Changes are coming to Medicaid in Michigan, including rules that will affect who qualifies, who needs to work, and what you need to do to keep your health coverage active.

Not all of the new Medicaid rules will start at once, so it’s important to stay on top of the changes in Michigan.

The best way to stay up-to-date is to make sure that the Michigan benefits office has your current mailing address and contact information. The state is required to send a notice in the mail whenever there are changes with your Medicaid case.

What changes are coming to Medicaid in Michigan?#what-changes-are-coming-to-medicaid-in-michigan

There are four main rule changes coming to Medicaid in Michigan over the next few years, including:

• Less retroactive Medicaid coverage for everyone: Under new rules, Medicaid will cover fewer months of eligible medical bills from before you applied. Exact coverage depends on your eligibility category, but this makes it all the more important to stay on top of your renewals.
• New community engagement requirements for some adults: Also called, “work rules” or “work requirements,” this new rule requires some adults, called “able-bodied adults” who do not have a dependent under 14 to complete qualifying activities each month to keep their benefits.
• More frequent Medicaid renewals for some adults: This new rule requires some people with Medicaid to renew every six months instead of once per year.
• Changes to eligibility rules for some immigrants: Under new rules, some lawfully-present immigrants will no longer qualify for federally funded Medicaid based on their immigration status.
• Less retroactive Medicaid coverage: Under new rules, Medicaid will cover fewer months of eligible medical bills from before you applied. Exact coverage depends on your eligibility category, but this makes it all the more important to stay on top of your renewals.

Rule changes do not apply to everyone who has Medicaid. The Michigan Department of Health and Human Services (MDHHS) will send you a notice before changes to your case take effect.

If you have questions about how upcoming changes might affect you, reach out to your case manager or local benefits office.

Who will be affected by the Medicaid changes in Michigan?#who-will-be-affected-by-the-medicaid-changes-in-michigan

Many of the biggest changes affect adults ages 19 to 64 who are part of the Healthy Michigan Plan (HMP). If your health insurance comes through Healthy Michigan, that's part of Medicaid and you'll still have to follow these new rules.

HMP is Michigan's Medicaid expansion program for adults with low incomes who don’t have other qualifying statuses. Adults who are enrolled in HMP will now have to complete renewals every six months, and some will also need to meet new Medicaid work requirements.

All Medicaid applicants will be affected by shorter retroactive coverage periods, although the new time limit depends on your Medicaid eligibility group.

Some noncitizens will also see changes to their coverage based on immigration status.

Who is exempt from Medicaid changes?#who-is-exempt-from-medicaid-changes

The exemptions depend on the specific rule. For example, Michigan says you may be exempt from the new work requirements if you are:

• Already subject to work requirements for SNAP benefits
• Already meeting work requirements for TANF benefits
• Pregnant or gave birth within the past 12 months
• A parent or caregiver of a child age 13 or under
• A caregiver of a person (or multiple people) with a disability (meaning someone who needs help with daily activities)
• An American Indian or Alaska Native (AI/AN)
• A person that was in foster care at age 18 and is currently younger than age 26
• A disabled veteran
• In a treatment program for a substance use disorder
• In jail or prison now or in the past three months
• A person with complex health needs, also referred to as medically frail
• Living with a substance use disorder
• Living with a physical, intellectual or developmental disability that makes it hard to do daily activities
• Living with a mental health disorder
• Living with a serious health condition that requires regular treatment
• Living in an area with a high unemployment rate
• Receiving care in a facility such as a hospital, nursing facility, psychiatric hospital, or other type of healthcare institution
• Traveling outside of your community of residence for medical care for yourself or a dependent because it is not available in your community.
• Living in a federally declared disaster area.

What are the new community engagement requirements for Medicaid in Michigan?#what-are-the-new-community-engagement-requirements-for-medicaid-in-michigan

Starting January 1, 2027, some adults ages 19 to 64 enrolled in the Healthy Michigan Plan (HMP) will need to meet new work requirements, called “community engagement requirements” or qualify for an exemption.

There are two main ways to meet these requirements:

• Earn at least $580 in one month during your review period, including income from a job or self-employment
• Complete at least 80 hours of qualifying activities in at least one month during your review period

Community engagement can include activities such as:

• Paid or unpaid employment
• Internship or work programs
• Volunteering or community service
• Attending a high school or GED program
• Attending a college or vocational program

You can combine activities to reach 80 hours monthly, it doesn’t have to be 80 hours from one thing alone.

In Michigan, you don't have to prove 80 hours for every month between renewals. If you already have Medicaid, you generally need to show that you met the requirement during at least one month since your last renewal.

If it is your first time applying to Medicaid, you'll need to meet the requirement during either the month before you apply or the month you apply.

Michigan will begin checking work requirements at renewals with dates on or after March 1, 2027.

If you qualify for an exemption to work requirements, your state may ask you to fill out a letter to verify the exemption—you may need to show proof that you meet an exemption category.

How are Medicaid renewals changing in Michigan?#how-are-medicaid-renewals-changing-in-michigan

Starting January 1, 2027, adults enrolled in the Healthy Michigan Plan for Illinois Medicaid will need to renew their eligibility twice per year to keep their health coverage instead of once. (Renewals are sometimes called redeterminations but they mean the same thing).

The change will take effect at your next renewal. This means you may receive more frequent notices and requests for information from your state.

Be sure to keep your contact information up to date with the state of Michigan so you don’t miss a renewal and lose your health coverage.

How is Medicaid eligibility changing for immigrants in Michigan?#how-is-medicaid-eligibility-changing-for-immigrants-in-michigan

Starting October 1, 2026, new federal rules limit which noncitizens can qualify for Medicaid.

Some immigrant statuses including refugees, asylees, trafficking survivors, and other humanitarian immigrants will no longer qualify until they become lawful permanent residents and meet the applicable requirements.

The following noncitizens will continue to qualify for Medicaid if they meet the program's other eligibility requirements:

• Lawful permanent residents (LPRs) who have met or are exempt from the five-year bar
• Cuban/Haitian entrants
• Compacts of Free Association migrants
• Most pregnant individuals
• Children under the age of 21 who lawfully reside in Michigan

Your state will attempt to verify your eligibility with available information. If there is not enough information to complete your verification, Michigan will contact you and request additional documentation. Documents or information related to your immigration status, should be uploaded to your MI Bridges benefits portal.

If you don't have a qualifying immigration status, your Medicaid coverage may end as of October 1, 2026. If you lose coverage you will move to Emergency Services Only (ESO) coverage which includes treatment for emergency medical conditions and does not cover routine doctors visits or preventative care.

If your coverage is affected by this change, Michigan will send you a notice by mail, text, or email.

How is retroactive coverage for Medicaid changing in Michigan?#how-is-retroactive-coverage-for-medicaid-changing-in-michigan

Starting January 1, 2027, Medicaid in Michigan will cover fewer months of eligible medical expenses from before you applied for Medicaid.

Under the old rule, retroactive Medicaid could cover eligible medical expenses for up to three months before the month you applied, as long as you were eligible for Medicaid during those months.

Under the new rule, Healthy Michigan Plan members will be limited to one month of retroactive coverage. All other Medicaid plan members get up to two months. This change makes it especially important for you to apply for Medicaid as soon as you think you may qualify, particularly if you have unpaid medical bills.

When do the Medicaid changes start in Michigan?#when-do-the-medicaid-changes-start-in-michigan

What if I lose Medicaid in Michigan because of the new rules?#what-if-i-lose-medicaid-in-michigan-because-of-the-new-rules

If you lose Medicaid because of the new rules, you may have other options for health coverage. What you should do next depends on why your coverage ended and whether you qualify for another program.

Depending on your situation, you may be able to:

• Reapply for Medicaid if you become eligible again or provide missing information
• Appeal the Medicaid decision if you believe your coverage was ended incorrectly
• Get Emergency Services Only (ESO) coverage if you lose full Medicaid because of your immigration status. ESO covers treatment for qualifying emergency medical conditions but does not provide the same routine and preventive care as full Medicaid
• Get coverage through the federal Health Insurance Marketplace and see if you qualify for financial help that lowers your monthly premium or other healthcare costs. Losing Medicaid counts as a qualifying event for a special enrollment period which lets you sign-up for federally sponsored plans outside of the traditional open enrollment window
• Enroll in Medicare if you qualify based on your age, disability, or other status

Be sure to read any notices you receive from the Michigan Department of Health and Human Services (MDHHS). Your notice should explain why your Medicaid coverage is changing, when the change takes effect, and what you can do next.